Sample Record

Owner Lab

  • CT METS QASI - Los Angeles Design Build Field Laboratory

DIME Sample ID 2020-07-15-2

Project Information

Project IdentifiersProject ID: 214601
DEA: 041J5694
EFIS: 0419000313
DIST-CO-RTE-PM04-SM-101-0.0/21.8
Award DateNot set
Closeout DateNot set
Work DescriptionBarrier modifications, overhead signs, freeway lighting and electronic toll system components
Location DescriptionSANTA CLARA AND SAN MATEO COUNTIES FROM 0.3 MILE NORTH OF SAN ANTONIO ROAD TO 0.3 MILE SOUTH OF GRAND AVENUE INTERCHANGE
QA Service Level1 (Verified on 02/21/2020)

Sample Information

Sample Taken Date07/15/2020 Sample Unique Key2
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 testing07/15/2020
Sample typeQuality Assurance A brief description of the sample1/2"x 2-3/4" HH A325 Bolt
The quantity of what the sample constitutes7 total 82 in total From where was the sample collectedManufacturer
First name of sampler or witnessed byMichael Last name of sampler or witnessed byKopenski
Title of samplerQA Telephone number of sampler(310) 745-9655
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameStructural and Steel Products Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)060920AR
Heat Number(s)365604A Nut Mfg. Lot Number(s)405806A
Washer Mfg. Lot Number(s)317843 Bolt SpecificationASTM A325
Bolt Length(s)2-3/4" Nut SpecificationASTM A563
Washer SpecificationASTM F436 FinishMech.Zinc Galv. ASTM B695
Diameter/Size1/2"x 2-3/4" Bolt Mfg. Lot Number400458A
Rocap Test Requirement(s)060920AR Lubricant Requirements(s)

Submitted Tests

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