Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2021-02-02-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215032 DEA: 030H5204 EFIS: 0315000202 |
|---|---|
| DIST-CO-RTE-PM | 03-ED-50-0.0/80.4 |
| Award Date | 08/13/2020 |
| Closeout Date | 07/26/2023 |
| Work Description | INSTALL CMS, CAMERA SYSTEMS AND TMS ELEMENTS. |
| Location Description | EL DORADO COUNTY AT VARIOUS LOCATIONS FROM THE SACRAMENTO COUNTY LINE TO CALIFORNIA/NEVADA STATE LINE |
| QA Service Level | 1 (Verified on 07/20/2020) |
Sample Information
| Sample Taken Date | 02/02/2021 | 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 | F1554 gr 55 2-1/4" x 70" Anchor bolt assembly |
| The quantity of what the sample constitutes | 168 assemblies | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Jane | Last name of sampler or witnessed by | Lillard |
| Title of sampler | CALTRANS METS QA INSPECTOR | Telephone number of sampler | 916-291-8042 |
| 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 | S52-002-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
|---|---|---|---|
| Heat Number(s) | Nut Mfg. Lot Number(s) | ||
| Washer Mfg. Lot Number(s) | Bolt Specification | ASTM F1554 GR55 | |
| Bolt Length(s) | 70" | Nut Specification | N/A |
| Washer Specification | N/A | Finish | |
| Diameter/Size | Bolt Mfg. Lot Number | ||
| 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. | |||