Sample Record
Owner Lab
- CT QASI - Sacramento Field Laboratory
DIME Sample ID 2020-02-13-7
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214231 DEA: 051M1704 EFIS: 0519000077 |
|---|---|
| DIST-CO-RTE-PM | 05-SLO-1-71.5/72 |
| Award Date | 04/17/2019 |
| Closeout Date | Not set |
| Work Description | Polar Star Emergency wall and viaduct; NOTE ON FUNDING: This is an emergency project, per PM, METS (unit 3652) is covered for work on this project under WBS 270.44. Any issues with funding please notify METS Rep. |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 06/28/2019) |
Sample Information
| Sample Taken Date | 02/13/2020 | Sample Unique Key | 7 |
|---|---|---|---|
| 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 | 02/18/2020 |
| Sample type | Quality Assurance | A brief description of the sample | 7/8" A325 bolt assembly |
| The quantity of what the sample constitutes | 91 bolt assemblies | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Jane | Last name of sampler or witnessed by | Lillard |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 916-308-9430 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Portland Bolt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S52-015-20 | Structure unique identifier | |
| Structure name | Polar Star Sidehill Viaduct |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | none |
|---|---|---|---|
| Heat Number(s) | bolt 100794352, nut 190518, washer B52967 | Nut Mfg. Lot Number(s) | 31113-S-190518 |
| Washer Mfg. Lot Number(s) | 0619-188 | Bolt Specification | xASTM A325 Heavy Hex bolt Galv ASTM F3125 |
| Bolt Length(s) | 21" | Nut Specification | xASTM A563 HHN Grade DH HDG blue |
| Washer Specification | xASTM F436 | Finish | HDG |
| Diameter/Size | 7/8" | Bolt Mfg. Lot Number | 19529 |
| Rocap Test Requirement(s) | not required due to length | Lubricant Requirements(s) |