Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2023-09-12-10
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215479 DEA: 080R4204 EFIS: 0812000076 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-SR 210 AND I-15 IC-Null |
| Award Date | 05/03/2021 |
| Closeout Date | Not set |
| Work Description | FONTANA MAINTENANCE STATION |
| Location Description | 14032 Victoria Street, Fontana, CA 92336 |
| QA Service Level | 1 (Verified on 02/11/2021) |
Sample Information
| Sample Taken Date | 09/12/2023 | Sample Unique Key | 10 |
|---|---|---|---|
| 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 | 09/15/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 3/4 x 11" Anchor Bolts A36 |
| The quantity of what the sample constitutes | 28 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Huidon | Last name of sampler or witnessed by | Joo |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 562-447-5379 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Maya Steel Fabrications, Inc | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L163-067-23 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | N/A |
|---|---|---|---|
| Heat Number(s) | 3118926, 5804880203, 32030360 | Nut Mfg. Lot Number(s) | 35918-5804880203 |
| Washer Mfg. Lot Number(s) | 164336 | Bolt Specification | ASTM F1554 Grade 36 |
| Bolt Length(s) | 11" | Nut Specification | ASTM A563 HHN, Grade DH |
| Washer Specification | ASTM F436 | Finish | Black |
| Diameter/Size | 3/4" | Bolt Mfg. Lot Number | CMC STEEL TEXAS 3118926 |
| 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. | |||