Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2020-08-03-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212501 DEA: 022E4804 EFIS: 0200000586 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-96,263-103.1/103.6,56.8/57.2 |
| Award Date | 12/14/2018 |
| Closeout Date | 12/01/2021 |
| Work Description | BRIDGE REPLACEMENT |
| Location Description | SISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96 |
| QA Service Level | 1 (Verified on 06/06/2017) |
Sample Information
| Sample Taken Date | 08/03/2020 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 testing | Not set |
| Sample type | Quality Assurance | A brief description of the sample | 1/2" x 3-1/2" A325 bolts, 1/2" A563-DH nuts and 1/2" F436 washers |
| The quantity of what the sample constitutes | 87/87/174 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Craig | Last name of sampler or witnessed by | Hager |
| Title of sampler | QA Inspector | Telephone number of sampler | 925-899-1184 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | UIS Lindon UT | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B29-033-20 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | TT0131087 |
|---|---|---|---|
| Heat Number(s) | bolts - 20495460, nuts - 20650010, washers - 190394 | Nut Mfg. Lot Number(s) | L511Q1 |
| Washer Mfg. Lot Number(s) | 957-190394 | Bolt Specification | A325 |
| Bolt Length(s) | 3-1/2" | Nut Specification | A563-DH |
| Washer Specification | F436 | Finish | HDG - all |
| Diameter/Size | 1/2" | Bolt Mfg. Lot Number | G9825 |
| Rocap Test Requirement(s) | Yes | Lubricant Requirements(s) | none |
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. | |||