Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2019-10-29-64
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 210837 DEA: 080J0804 EFIS: 0800000283 COOP: 081625 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-15-34.7/51.6 |
| Award Date | 04/17/2017 |
| Closeout Date | Not set |
| Work Description | (Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT |
| Location Description | Riverside County and SBD-15-0.0/1.3 |
| QA Service Level | 1 (Verified on 05/08/2017) |
Sample Information
| Sample Taken Date | 10/29/2019 | Sample Unique Key | 64 |
|---|---|---|---|
| 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 | 11/05/2019 |
| Sample type | Quality Assurance | A brief description of the sample | A325 MG Fastener Assembly |
| The quantity of what the sample constitutes | 12 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Mike | Last name of sampler or witnessed by | Foerder |
| Title of sampler | Telephone number of sampler | ||
| 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 | B285-078-19 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | TT0121423 |
|---|---|---|---|
| Heat Number(s) | 20403620 | Nut Mfg. Lot Number(s) | 29747 |
| Washer Mfg. Lot Number(s) | D7245 | Bolt Specification | A325 MG |
| Bolt Length(s) | 1"x6" | Nut Specification | A563 DH |
| Washer Specification | F436 | Finish | MG |
| Diameter/Size | Unknown | Bolt Mfg. Lot Number | BM0169 |
| 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. | |||