Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-10-31-4

Project Information

Project IdentifiersProject ID: 995115
DEA: 050T7704
EFIS: 0500020046
Permit Numbers: 0523NOP0228
DIST-CO-RTE-PM05-SCR-152-1.98
Award DateNot set
Closeout DateNot set
Work DescriptionImprove intersection.
Location DescriptionON RTE 152 IN STA CRUZ CO AT HOLOHAN COLLEGE RD NEAR THE CITY OF WATSONVILLE
QA Service Level1 (Verified on 11/03/2023)

Sample Information

Sample Taken Date10/31/2023 Sample Unique Key4
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 typeQuality Assurance A brief description of the sample1-1/2 X 42"
The quantity of what the sample constitutes1 From where was the sample collectedDistributor
First name of sampler or witnessed byLorenzo Last name of sampler or witnessed byGarcia
Title of samplerQuality Assurance Inspector Telephone number of sampler17029172503
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameBlue Circle Corp Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormL115-116-23 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)
Heat Number(s)3119886 Nut Mfg. Lot Number(s)DEHY12
Washer Mfg. Lot Number(s) Bolt SpecificationF1554-55
Bolt Length(s)42" Nut SpecificationA194
Washer SpecificationF436 FinishA153
Diameter/Size1-1/2 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
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Sample File Attachments

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Test File Attachments