Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2020-01-15-9

Project Information

Project IdentifiersProject ID: 213737
DEA: 07289104
EFIS: 0700021123
DIST-CO-RTE-PM07-LA-405-11.9/13.2
Award Date01/09/2019
Closeout Date07/14/2022
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 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 sample1 1/4" ASTM A194 Heavy Hex Nut Grade 2H, HDG
The quantity of what the sample constitutes70 nuts 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 719046
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)144235 Nut Mfg. Lot Number(s)19298-144235
Washer Mfg. Lot Number(s)n/a Bolt Specificationn/a
Bolt Length(s)n/a Nut SpecificationA194 Heavy Hex Nut Grade 2H
Washer Specificationn/a FinishHot Dipped Galvanized ASTM A-153
Diameter/Size1 1/4" Bolt Mfg. Lot Numbern/a
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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