Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2019-05-02-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213846 DEA: 041J5614 EFIS: 0419000117 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-0.0/6.7 |
| Award Date | 12/21/2018 |
| Closeout Date | 09/01/2022 |
| Work Description | Barrier modifications, overhead signs, freeway lighting and electronic toll system components |
| Location Description | SANTA CLARA AND SAN MATEO COUNTIES IN PALO ALTO AND REDWOOD CITY FROM 0.3 MILE NORTH OF SAN ANTONIO ROAD TO WHIPPLE AVENUE OVERCROSSING |
| QA Service Level | 1 (Verified on 12/27/2018) |
Sample Information
| Sample Taken Date | 05/02/2019 | Sample Unique Key | 3 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 05/02/2019 |
| Sample type | Quality Assurance | A brief description of the sample | 1" x 2.25" A325 Bolt and washer only |
| The quantity of what the sample constitutes | 48 ea | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Greg | Last name of sampler or witnessed by | Thompson |
| Title of sampler | ASSOC STEEL INSP | Telephone number of sampler | 510-376-7155 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | UIS | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | Not set |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | none |
|---|---|---|---|
| Heat Number(s) | Bolt- 20391740 Washer- 532619 | Nut Mfg. Lot Number(s) | none |
| Washer Mfg. Lot Number(s) | D1862 | Bolt Specification | A325 |
| Bolt Length(s) | 2 1/4" | Nut Specification | none |
| Washer Specification | F436 | Finish | Mechanically Galvanized |
| Diameter/Size | 1" | Bolt Mfg. Lot Number | BM0196 |
| Rocap Test Requirement(s) | Lubricant Requirements(s) |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||