Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2016-12-01-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 211004 DEA: 05330784 EFIS: 0512000076 |
|---|---|
| DIST-CO-RTE-PM | 05-SLO-46-46.0/50.2 |
| Award Date | 02/10/2016 |
| Closeout Date | 10/15/2019 |
| Work Description | CONVERT 2-LANE TO 4 LANE EXPRESSWAY. |
| Location Description | NEAR SHANDON FROM 0.2 MILE EAST OF MCMILLIAN CANYON ROAD TO 0.4 MILE WEST OF LUCY BROWN ROAD |
| QA Service Level | 1 (Verified on 01/08/2016) |
Sample Information
| Sample Taken Date | 12/01/2016 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | A449 Bolt/nut/Washer |
| The quantity of what the sample constitutes | 36 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Stacey | Last name of sampler or witnessed by | Davis |
| Title of sampler | QAI | Telephone number of sampler | 562 480-6984 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Portland Bolt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B362-075-16 | Structure unique identifier | Not set |
| Structure name | Not set |
Material Information
| Material Type | SMTL 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 Specification | ASTM A449 |
| Bolt Length(s) | 15.5" | Nut Specification | ASTM A563 |
| Washer Specification | ASTM F436 | Finish | ASTM A153 - Hot Dip |
| Diameter/Size | 7/8" | Bolt Mfg. Lot Number | |
| 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. | |||