Sample Record

Owner Lab

  • CT QASI - Bay Area Field Laboratory

DIME Sample ID 2016-12-01-1

Project Information

Project IdentifiersProject ID: 211004
DEA: 05330784
EFIS: 0512000076
DIST-CO-RTE-PM05-SLO-46-46.0/50.2
Award Date02/10/2016
Closeout Date10/15/2019
Work DescriptionCONVERT 2-LANE TO 4 LANE EXPRESSWAY.
Location DescriptionNEAR SHANDON FROM 0.2 MILE EAST OF MCMILLIAN CANYON ROAD TO 0.4 MILE WEST OF LUCY BROWN ROAD
QA Service Level1 (Verified on 01/08/2016)

Sample Information

Sample Taken Date12/01/2016 Sample Unique Key1
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 sampleA449 Bolt/nut/Washer
The quantity of what the sample constitutes36 From where was the sample collectedManufacturer
First name of sampler or witnessed byStacey Last name of sampler or witnessed byDavis
Title of samplerQAI Telephone number of sampler562 480-6984
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePortland Bolt Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) FormB362-075-16 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeSMTL TM3 - Fastener Assembly Rocap Number(s)N/A
Heat Number(s)Bolt- 3051123 Nut 75062745, washer 267181 Nut Mfg. Lot Number(s)23468-75062745
Washer Mfg. Lot Number(s)0616-264 Bolt SpecificationASTM A449
Bolt Length(s)15.5" Nut SpecificationASTM A563
Washer SpecificationASTM F436 FinishASTM A153 - Hot Dip
Diameter/Size7/8" Bolt Mfg. Lot Number
Rocap Test Requirement(s) Lubricant Requirements(s)

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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