Sample Record
Owner Lab
- CT HQ - Sacramento Materials Management Branch Field Office
DIME Sample ID 2020-05-27-5
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Project Information
| Project Identifiers | Project ID: 214601 DEA: 041J5694 EFIS: 0419000313 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-0.0/21.8 |
| Award Date | 12/03/2019 |
| Closeout Date | 09/28/2022 |
| Work Description | San Mateo US 101 Express Lanes North |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 05/27/2020 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 05/27/2020 |
| Sample type | Quality Assurance | A brief description of the sample | 2.25" D.E. Anchor Bolt |
| The quantity of what the sample constitutes | 9 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Daniel | Last name of sampler or witnessed by | Reyes |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | (707) 656-9086 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Madden Bolt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B301-015-20 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | N/A |
|---|---|---|---|
| Heat Number(s) | 58041029 188206 294167 | Nut Mfg. Lot Number(s) | W27520 |
| Washer Mfg. Lot Number(s) | D080450 | Bolt Specification | ASTM F1554 Gr55 |
| Bolt Length(s) | 40" | Nut Specification | ASTM 194 Gr.2H |
| Washer Specification | ASTM F436 | Finish | HDG/Black |
| Diameter/Size | 2.5 | Bolt Mfg. Lot Number | Not Provided |
| Rocap Test Requirement(s) | No | Lubricant Requirements(s) | Yes |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||