Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2020-05-27-4

Project Information

Project IdentifiersProject ID: 214601
DEA: 041J5694
EFIS: 0419000313
Award Date12/03/2019
Closeout Date09/28/2022
Work DescriptionSan Mateo US 101 Express Lanes North
Location DescriptionNot set
QA Service Level1 (Verified on 04/08/2022)

Sample Information

Sample Taken Date05/27/2020 Sample Unique Key4
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 testing05/27/2020
Sample typeQuality Assurance A brief description of the sample2.5" D.E. Anchor Bolt
The quantity of what the sample constitutes339 From where was the sample collectedFabricator
First name of sampler or witnessed byDaniel Last name of sampler or witnessed byReyes
Title of samplerCT METS QA INSPECTOR Telephone number of sampler(707) 656-9086
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMadden Bolt Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB301-014-20 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)N/A
Heat Number(s)201332 3066493 293079 Nut Mfg. Lot Number(s)W3560
Washer Mfg. Lot Number(s)D079692 Bolt SpecificationASTM F1554 Gr55
Bolt Length(s)60" Nut SpecificationASTM 194 Gr.2H
Washer SpecificationASTM F436 FinishHDG/Black
Diameter/Size2.5 Bolt Mfg. Lot NumberNot Provided
Rocap Test Requirement(s)No Lubricant Requirements(s)Yes

Submitted Tests

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