Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2020-11-18-5
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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 | 11/18/2020 | 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 | 11/18/2020 |
| Sample type | Quality Assurance | A brief description of the sample | A325 Bolt Assembly |
| The quantity of what the sample constitutes | 39 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Ken | Last name of sampler or witnessed by | Riley |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 510-520-4147 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Structural and Steel Products | Transportation Laboratory (TL) Number | TL-102 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B389-012-20 | Structure unique identifier | |
| Structure name | OHSS S63 |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | 430807A |
|---|---|---|---|
| Heat Number(s) | 100201805, DL19105173, 180226 | Nut Mfg. Lot Number(s) | 431190A |
| Washer Mfg. Lot Number(s) | 317500 | Bolt Specification | ASTM A325 |
| Bolt Length(s) | 2-1/4" | Nut Specification | A563 |
| Washer Specification | F436 | Finish | Mech Galv-B695 |
| Diameter/Size | 3/4"x2-1/4" | Bolt Mfg. Lot Number | 430807A |
| Rocap Test Requirement(s) | Lubricant Requirements(s) |
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. | |||