Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Laboratory

DIME Sample ID 2021-06-14-7

Project Information

Project IdentifiersProject ID: 214922
DEA: 100X3104
EFIS: 1013000265
DIST-CO-RTE-PM10-SJ-99-16.8/17.6
Award Date06/30/2020
Closeout Date04/07/2022
Work DescriptionREPLACE BRIDGE.
Location DescriptionSAN JOAQUIN COUNTY IN STOCKTON FROM 0.4 MILE SOUTH TO 0.4 MILE NORTH OF FARMINGTON ROAD OVERCROSSING
QA Service Level1 (Verified on 04/28/2020)

Sample Information

Sample Taken Date06/14/2021 Sample Unique Key7
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing06/14/2021
Sample typeQuality Assurance A brief description of the sampleF436 Flat washers
The quantity of what the sample constitutes4200 From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byLund
Title of samplerCT METS QA INSPECTOR Telephone number of sampler1-385-447-0624
Laboratory sample identificationna Linked DIME Sample IDna
The fabricator/manufacturer/facility nameUniversal Industrial Sales Inc Transportation Laboratory (TL) Numberna
Inspector Lot Number from the Transportation Laboratory (TL) FormB390-080-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)na
Heat Number(s)NA Nut Mfg. Lot Number(s)na
Washer Mfg. Lot Number(s)200263 Bolt Specificationna
Bolt Length(s) Nut Specificationna
Washer SpecificationF436 FinishHDG
Diameter/Size2-1/2" Bolt Mfg. Lot Numberna
Rocap Test Requirement(s)na Lubricant Requirements(s)na

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments