Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Laboratory

DIME Sample ID 2019-06-13-6

Project Information

Project IdentifiersProject ID: 211775
DEA: 024E6504
EFIS: 0212000012
DIST-CO-RTE-PM02-SIS-96-R52.5/88.4
Award Date07/10/2017
Closeout Date01/05/2021
Work DescriptionWIDEN BRIDGES,POLYESTER CONC OVERLAY,COLD PLANE AC PVMT,HMA,GUARDRAIL
Location DescriptionSISKIYOU COUNTY NEAR SEIAD VALLEY AT VARIOUS LOCATIONS FROM 0.1 MILE WEST OF THOMPSON CREEK BRIDGE TO 0.2 MILE EAST OF BEAVER CREEK BRIDGE
QA Service Level1 (Verified on 08/23/2017)

Sample Information

Sample Taken Date06/13/2019 Sample Unique Key6
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 testing06/18/2019
Sample typeQuality Assurance A brief description of the sampleA325 Bolt
The quantity of what the sample constitutes494 From where was the sample collectedFabricator
First name of sampler or witnessed byMahlon Last name of sampler or witnessed byLindenmuth
Title of samplerQA Inspector Telephone number of sampler646-740-3704
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNucor Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS46-170-19 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)415844A 396618A 805830 392621A
Heat Number(s) Nut Mfg. Lot Number(s)415206A
Washer Mfg. Lot Number(s)309017 Bolt SpecificationA325
Bolt Length(s)2-1/4", 2-3/4", 3", 3-1/4" Nut SpecificationA563 Gr. DH
Washer SpecificationF436 FinishHot Dipped Galvanized
Diameter/Size7/8" Bolt Mfg. Lot Number415844A 396618A 805830 392621A
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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