Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2021-02-10-4

Project Information

Project IdentifiersProject ID: 213406
DEA: 030F2504
EFIS: 0300000075
DIST-CO-RTE-PM03-YOL,SAC-80-R11.1/R11.7,M0.0/M0.5
Award Date08/21/2020
Closeout Date07/31/2023
Work DescriptionSAC RIVER BOH (BRYTE BEND)
Location DescriptionSACRAMENTO AND YOLO COUNTIES IN WEST SACRAMENTO AND SACRAMENTO FROM 0.1 MILE WEST OF REED AVENUE UNDERCROSSING TO 0.1 MILE EAST OF SACRAMENTO RIVER BRIDGE AND OVERHEAD
QA Service Level1 (Verified on 06/07/2018)

Sample Information

Sample Taken Date02/10/2021 Sample Unique Key4
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 testingNot set
Sample typeQuality Assurance A brief description of the sample5/8" F436 Washers
The quantity of what the sample constitutes16,689 washers From where was the sample collectedFabricator
First name of sampler or witnessed byMahlon Last name of sampler or witnessed byLindenmuth
Title of samplerQA Inspector Telephone number of sampler646-740-3704
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCK Johnson Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS46-150-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)443696A and 448446A
Heat Number(s)B57380 Nut Mfg. Lot Number(s)N/A
Washer Mfg. Lot Number(s)E0076 Bolt SpecificationN/A
Bolt Length(s)N/A Nut SpecificationN/A
Washer SpecificationASTM F436 FinishASTM F2329 AND A153 HDG
Diameter/Size5/8" Bolt Mfg. Lot NumberN/A
Rocap Test Requirement(s)YES Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments