Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2023-04-18-14
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 213903 DEA: 043G4544 EFIS: 0412000054 |
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DIST-CO-RTE-PM | 04-ALA,SM-92-R14.4/R18.8,R0.0/R.2.4 |
Award Date | 12/31/2019 |
Closeout Date | Not set |
Work Description | Repair Spalled Concrete Columns and Spandrel Beams |
Location Description | San Mateo-Hayward Bridge |
QA Service Level | 1 (Verified on 01/22/2019) |
Sample Information
Sample Taken Date | 04/18/2023 | Sample Unique Key | 14 |
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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 | 04/21/2023 |
Sample type | Quality Assurance | A brief description of the sample | F436 Washer Square Bevel |
The quantity of what the sample constitutes | 134 | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | Sherri | Last name of sampler or witnessed by | Brannon |
Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 9168266371 |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | XKT Engineering | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | B22-148-23 | Structure unique identifier | |
Structure name |
Material Information
Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
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Heat Number(s) | Nut Mfg. Lot Number(s) | ||
Washer Mfg. Lot Number(s) | 3800016174 | Bolt Specification | x |
Bolt Length(s) | Nut Specification | x | |
Washer Specification | F436 | Finish | HDG |
Diameter/Size | 1/2 | Bolt Mfg. Lot Number | |
Rocap Test Requirement(s) | Lubricant Requirements(s) |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2023-04-18-14-1 ASTM B499-09r21 (Verified)
DIME Test ID: 2023-04-18-14-2 ASTM B499-09r21 (Verified)