Sample Record for 2025-09-25-54
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000176 DEA: 034H76U4 EFIS: 0323000040
QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT-32-5.0/10.2
Work Description: REHABILITATE PAVEMENT, INSTALL SIGNAL, LIGHTING, DRAINAGE, & ADA RAMPS
Location Description: BUTTE COUNTY IN CHICO FROM MUIR AVENUE TO INTERCHANGE OF STATE ROUTES 99 AND 32
Contractor Name: BALDWIN CONTRACTING COMPANY, INC. DBA KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY, CHICO CA 95928
Resident Engineer: Husam Makhoul Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-09-25-54
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 09/25/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/01/2025
The quantity of what the sample constitutes: 4
A brief description of the sample: F1554 Gr. 105 Anchor Assembly
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Halo
Material Information
Rocap Number(s):
Heat Number(s): 58034658, 8000033527, 32312470
Nut Mfg. Lot Number(s): W000235398
Washer Mfg. Lot Number(s): E6242
Bolt Specification: F1554 Gr. 105
Bolt Length(s): 40
Nut Specification: A563
Washer Specification: F436
Finish: HDG
Diameter/Size: 1
Bolt Mfg. Lot Number:
Rocap Test Requirement(s):
Lubricant Requirements(s):
Washer Inner Diameter(s):
Test Results
Test 1 of 1
DIME Test ID: 2025-09-25-54-1
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
