Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2021-10-05-3
Project Information
Project Identifiers | Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246 |
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DIST-CO-RTE-PM | 03-SAC-5-9.7/24.9 |
Award Date | 05/01/2019 |
Closeout Date | 02/22/2024 |
Work Description | Not set |
Location Description | Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct |
QA Service Level | 1 (Verified on 07/19/2019) |
Sample Information
Sample Taken Date | 10/05/2021 | Sample Unique Key | 3 |
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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 testing | 10/05/2021 |
Sample type | Quality Assurance | A brief description of the sample | 2 1/2" x 5-0" Anchor Bolts |
The quantity of what the sample constitutes | 576 | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Lund |
Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 3854470624 |
Laboratory sample identification | na | Linked DIME Sample ID | na |
The fabricator/manufacturer/facility name | Universal Industrial Sales, Inc | Transportation Laboratory (TL) Number | na |
Inspector Lot Number from the Transportation Laboratory (TL) Form | B390-176-21 | Structure unique identifier | |
Structure name |
Material Information
Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | na |
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Heat Number(s) | 1202032511 | Nut Mfg. Lot Number(s) | na |
Washer Mfg. Lot Number(s) | na | Bolt Specification | F1554-55 S1 |
Bolt Length(s) | 60" | Nut Specification | na |
Washer Specification | na | Finish | HDG |
Diameter/Size | 2 1/2" | Bolt Mfg. Lot Number | na |
Rocap Test Requirement(s) | na | Lubricant Requirements(s) | na |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |