Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2023-08-04-16

Project Information

Project IdentifiersProject ID: 215421
DEA: 042K9504
EFIS: 0417000057
DIST-CO-RTE-PM04-ALA-580-14.4/14.4
Award Date02/02/2023
Closeout DateNot set
Work DescriptionCONSTRUCT MATERIAL TESTING LABORATORY BUILDING.
Location DescriptionALAMEDA COUNTY IN LIVERMORE AT 2201 KITTY HAWK ROAD
QA Service Level1 (Verified on 01/06/2021)

Sample Information

Sample Taken Date08/04/2023 Sample Unique Key16
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeDepartment Acceptance A brief description of the sample3/4" x 2.25" TC Bolt
The quantity of what the sample constitutes280 From where was the sample collectedSource
First name of sampler or witnessed byKevin Last name of sampler or witnessed byMuser
Title of samplerqa Telephone number of sampler916 517-0532
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameLB Construction Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormS19-417-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)1000219817 Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s) Bolt SpecificationF3125 GR F1852
Bolt Length(s)2.25" Nut SpecificationNA
Washer SpecificationNA FinishBlack
Diameter/Size3/4" Bolt Mfg. Lot Numberw000073239
Rocap Test Requirement(s) Lubricant Requirements(s)

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