Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2024-04-04-10
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Project Information
| Project Identifiers | Project ID: 215771 DEA: 09367504 EFIS: 0916000032 |
|---|---|
| DIST-CO-RTE-PM | 09--5756-NA |
| Award Date | 03/23/2023 |
| Closeout Date | Not set |
| Work Description | Building work, hot mix asphalt (type A) |
| Location Description | IN KERN COUNTY IN TEHACHAPI AT THE TEHACHAPI HIGHWAY MAINTENANCE STATION AT 305 INDUSTRIAL PARKWAY |
| QA Service Level | 1 (Verified on 05/13/2021) |
Sample Information
| Sample Taken Date | 04/04/2024 | Sample Unique Key | 10 |
|---|---|---|---|
| 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 testing | Not set |
| Sample type | Quality Assurance | A brief description of the sample | 1/2"-13 x 1 3/4" A325 Bolt assembly |
| The quantity of what the sample constitutes | 3,780 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Jacob | Last name of sampler or witnessed by | Garcia |
| Title of sampler | Quality Assurance Inspector | Telephone number of sampler | 3109128014 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Cordova Bolt Inc. | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L169-012-24 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM3 - Fastener Assembly | Rocap Number(s) | N/A |
|---|---|---|---|
| Heat Number(s) | Bolt- 100219761 Nut- 1000220291 Washer- 227284 | Nut Mfg. Lot Number(s) | W000060045 |
| Washer Mfg. Lot Number(s) | 0123-593 | Bolt Specification | ASTM A325 |
| Bolt Length(s) | 1-1/2" | Nut Specification | A563 |
| Washer Specification | F436 | Finish | Plain |
| Diameter/Size | 1/2" | Bolt Mfg. Lot Number | W000043560 |
| 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. | |||