Sample Record

Owner Lab

  • CT QASI - Bay Area Field Laboratory

DIME Sample ID 2019-11-14-9

Project Information

Project IdentifiersProject ID: 213724
DEA: 040K8404
EFIS: 0416000148
DIST-CO-RTE-PM04-CC-680-13.9/22.7
Award Date01/23/2019
Closeout Date09/28/2021
Work DescriptionINSTALL FREEWAY SAFETY LIGHTING
Location DescriptionCONTRA COSTA COUNTY AT VARIOUS LOCATIONS FROM OLYMPIC BOULEVARD TO ARTHUR ROAD
QA Service Level1 (Verified on 12/13/2018)

Sample Information

Sample Taken Date11/14/2019 Sample Unique Key9
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 testingNot set
Sample typeQuality Assurance A brief description of the sampleA325 Bolt Assemblies
The quantity of what the sample constitutes5ea, 12ea From where was the sample collectedFabricator
First name of sampler or witnessed byRyan Last name of sampler or witnessed byParr
Title of samplerASI Telephone number of sampler(510) 385-5910
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameStructural and Steel Products Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB373-056-19 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 SpecificationA325
Bolt Length(s) Nut SpecificationA563
Washer SpecificationF436 FinishMechanically Galvanized
Diameter/Size3/4" x 1-3/4" and 1" x 5" Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)Blue

Submitted Tests

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