Sample Record

Owner Lab

  • CT QASI - Sacramento Field Laboratory

DIME Sample ID 2020-01-15-8

Project Information

Project IdentifiersProject ID: 213737
DEA: 07289104
EFIS: 0700021123
DIST-CO-RTE-PM07-LA-405-11.9/13.2
Award DateNot set
Closeout DateNot set
Work DescriptionRehabilitate the existing Commercial Vehicle Enforcement Facility.
Location DescriptionLOS ANGELES COUNTY IN CARSON FROM DEL AMO BOULEVARD OVER CROSSING TO VERMONT AVENUE (190TH) UNDER CROSSING.
QA Service Level1 (Verified on 08/26/2019)

Sample Information

Sample Taken Date01/15/2020 Sample Unique Key8
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 sample1 1/4" x 1'5" ASTM A1554 GR105 HDG Anchor Bolt
The quantity of what the sample constitutes24 anchor bolts From where was the sample collectedFabricator
First name of sampler or witnessed byJane Last name of sampler or witnessed byLillard
Title of samplerCALTRANS METS QA INSPECTOR Telephone number of sampler916-308-9430
Laboratory sample identificationLot 1 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMichael and Company Transportation Laboratory (TL) NumberTL101 719045
Inspector Lot Number from the Transportation Laboratory (TL) FormS52-005-20 Structure unique identifier
Structure nameCanopy

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)166981 Nut Mfg. Lot Number(s)n/a
Washer Mfg. Lot Number(s)n/a Bolt SpecificationF1554 GRADE 105 HVY HEX
Bolt Length(s)1'5" shank and thread Nut Specificationn/a
Washer Specificationn/a FinishHot Dipped Galvanized ASTM A-153
Diameter/Size1 1/4" Bolt Mfg. Lot Number8085
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

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