Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2022-01-11-12

Project Information

Project IdentifiersProject ID: 88888
DEA: SMTL-STOCK
EFIS: SMTL-STOCK
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date01/11/2022 Sample Unique Key12
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 testing01/11/2022
Sample typeQuality Assurance A brief description of the sample2-1/2" Anchor Bolt Nuts
The quantity of what the sample constitutes150 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 sampler3854470624
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) FormB390-009-22 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)na
Heat Number(s)201548 Nut Mfg. Lot Number(s)DECN
Washer Mfg. Lot Number(s)na Bolt Specificationna
Bolt Length(s)na Nut SpecificationA563-DH
Washer Specificationna FinishHot Dip Galvanize
Diameter/Size2-1/2" Bolt Mfg. Lot Numberna
Rocap Test Requirement(s)na Lubricant Requirements(s)Wax and Dye

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