Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Laboratory

DIME Sample ID 2019-07-29-17

Project Information

Project IdentifiersProject ID: 208945
DEA: 07288604
EFIS: 0700021080
COOP: 074663
DIST-CO-RTE-PM07-LA-710-6.0-9.4
Award Date09/02/2011
Closeout DateNot set
Work DescriptionGerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location DescriptionPort of Long Beach (District 7)
QA Service Level1 (Verified on 06/03/2013)

Sample Information

Sample Taken Date07/29/2019 Sample Unique Key17
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 testing07/31/2019
Sample typeQuality Assurance A brief description of the sampleA325 Fastener Assembly
The quantity of what the sample constitutes600 From where was the sample collectedJob Site
First name of sampler or witnessed byNicholas Last name of sampler or witnessed byHoffmann
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameLeJeune Bolt Company Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s) Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s) Bolt Specification1-8 x 3 1/2
Bolt Length(s)Unknown Nut Specification1-8 A563 DH
Washer SpecificationF436 Finish
Diameter/SizeUnknown Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

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