Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2023-04-18-16
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213903 DEA: 043G4544 EFIS: 0412000054 |
|---|---|
| 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 | 16 |
|---|---|---|---|
| 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 | 04/20/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 1035MR Cap |
| The quantity of what the sample constitutes | 31 | 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 | B22-155-23 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | |
|---|---|---|---|
| Heat Number(s) | 1000217207 | Nut Mfg. Lot Number(s) | |
| Washer Mfg. Lot Number(s) | Bolt Specification | 1035 | |
| Bolt Length(s) | 1 1/2 | Nut Specification | NA |
| Washer Specification | NA | Finish | |
| Diameter/Size | 3/8 | Bolt Mfg. Lot Number | 476026B |
| Rocap Test Requirement(s) | Lubricant Requirements(s) |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||