Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2021-03-09-14

Project Information

Project IdentifiersProject ID: 214601
DEA: 041J5694
EFIS: 0419000313
Award Date12/03/2019
Closeout Date09/28/2022
Work DescriptionSan Mateo US 101 Express Lanes North
Location DescriptionNot set
QA Service Level1 (Verified on 04/08/2022)

Sample Information

Sample Taken Date03/09/2021 Sample Unique Key14
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 sampleBolt Assy
The quantity of what the sample constitutes1 lot of 19 From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byGray
Title of samplerQAI Telephone number of sampler5593134832
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameStructural and Steel Products Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS32-002-21 Structure unique identifier
Structure nameOHSS

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)432430AR
Heat Number(s)10010716 Nut Mfg. Lot Number(s)435651A
Washer Mfg. Lot Number(s)317600 Bolt SpecificationASTM F3125, A325
Bolt Length(s)2-1/4" Nut SpecificationASTM A563
Washer SpecificationASTM A436 FinishASTM B569
Diameter/Size3/4" Bolt Mfg. Lot Number432430A
Rocap Test Requirement(s)Yes Lubricant Requirements(s)Yes

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