Sample Record

Owner Lab

  • CT QASI - Bay Area Field Laboratory

DIME Sample ID 2021-03-09-16

Project Information

Project IdentifiersProject ID: 214601
DEA: 041J5694
EFIS: 0419000313
DIST-CO-RTE-PM04-SM-101-0.0/21.8
Award DateNot set
Closeout DateNot set
Work DescriptionBarrier modifications, overhead signs, freeway lighting and electronic toll system components
Location DescriptionSANTA CLARA AND SAN MATEO COUNTIES FROM 0.3 MILE NORTH OF SAN ANTONIO ROAD TO 0.3 MILE SOUTH OF GRAND AVENUE INTERCHANGE
QA Service Level1 (Verified on 02/21/2020)

Sample Information

Sample Taken Date03/09/2021 Sample Unique Key16
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)441480AR
Heat Number(s)100203581 Nut Mfg. Lot Number(s)42574A
Washer Mfg. Lot Number(s)D6577 Bolt SpecificationASTM F3125, A325
Bolt Length(s)3-1/2"" Nut SpecificationASTM A563
Washer SpecificationASTM A436 FinishASTM B569
Diameter/Size7/8" Bolt Mfg. Lot Number441490A
Rocap Test Requirement(s)Yes Lubricant Requirements(s)Yes

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.