Sample Record
Owner Lab
- CT QASI - Sacramento Field Laboratory
DIME Sample ID 2021-03-05-5
Project Information
Project Identifiers | Project ID: 215032 DEA: 030H5204 EFIS: 0315000202 |
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DIST-CO-RTE-PM | 03-ED-50-0.0/80.4 |
Award Date | 08/13/2020 |
Closeout Date | Not set |
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 | 03/05/2021 | Sample Unique Key | 5 |
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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 | 03/15/2021 |
Sample type | Quality Assurance | A brief description of the sample | Anchor bolt 2.25" x 55" F1554-55 HDG |
The quantity of what the sample constitutes | 171 anchor bolt assemblies | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Mark | Last name of sampler or witnessed by | Lara |
Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 610-662-4557 |
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 | B391-001-21 | Structure unique identifier | |
Structure name |
Material Information
Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
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Heat Number(s) | 58043509 06 | Nut Mfg. Lot Number(s) | DECC / 201206 |
Washer Mfg. Lot Number(s) | 109259 | Bolt Specification | ASTM F1554 |
Bolt Length(s) | 55" | Nut Specification | ASTM A194 |
Washer Specification | F436 | Finish | HDG |
Diameter/Size | 2.25" | Bolt Mfg. Lot Number | 58043509/06 |
Rocap Test Requirement(s) | Lubricant Requirements(s) |