Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2019-10-31-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214141 DEA: 081J1204 EFIS: 0817000208 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-15,91,215-Var |
| Award Date | 06/13/2019 |
| Closeout Date | 02/07/2020 |
| Work Description | REMOVE, PREPARE AND FURNISH POLYESTER CONCRETE OVERLAY. |
| Location Description | RIVERSIDE COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 08/23/2019) |
Sample Information
| Sample Taken Date | 10/31/2019 | Sample Unique Key | 2 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | Not set |
| Sample type | Quality Assurance | A brief description of the sample | A325 HDG Rocap Assembiy |
| The quantity of what the sample constitutes | 24 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Mahlon | Last name of sampler or witnessed by | Lindenmuth |
| Title of sampler | QA Inspector | Telephone number of sampler | 646-740-3704 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CK Johnson | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S46-922-19 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | 424370B |
|---|---|---|---|
| Heat Number(s) | 100896901 | Nut Mfg. Lot Number(s) | 406871A |
| Washer Mfg. Lot Number(s) | C6542D | Bolt Specification | A325 |
| Bolt Length(s) | 2-1/4" | Nut Specification | A563 Grade DH |
| Washer Specification | F436 | Finish | HDG |
| Diameter/Size | 3/4" | Bolt Mfg. Lot Number | 424370B |
| Rocap Test Requirement(s) | Lubricant Requirements(s) | Lubed |
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. | |||