Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2023-10-10-5

Project Information

Project IdentifiersProject ID: 215620
DEA: 01436404
EFIS: 0100000193
DIST-CO-RTE-PM01-DN-101-35.8/36.5
Award Date07/11/2022
Closeout DateNot set
Work DescriptionDr. Fine Bridge Replacement
Location DescriptionDR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
QA Service Level1 (Verified on 03/26/2021)

Sample Information

Sample Taken Date10/10/2023 Sample Unique Key5
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 typeVerification A brief description of the sampleTBD
The quantity of what the sample constitutesTBD From where was the sample collectedSource
First name of sampler or witnessed byHalim Last name of sampler or witnessed byBas
Title of samplerQA Inspector Telephone number of sampler16463798761
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTBD Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)TBD
Heat Number(s)TBD Nut Mfg. Lot Number(s)
Washer Mfg. Lot Number(s) Bolt SpecificationASTM A325
Bolt Length(s) Nut SpecificationASTM A194
Washer SpecificationASTM F488 Finish
Diameter/Size Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
No results found.

Test File Attachments