Sample Record for 2026-04-02-43
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215741 DEA: 01366004 EFIS: 0100000127
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-80.0/84.0
Work Description: Indianola Cutoff UC
Location Description: HUMBOLDT COUNTY NEAR EUREKA FROM EUREKA SLOUGH BRIDGE TO BAYSIDE CUTOFF
Contractor Name: Granite Construction Company
Contractor Address: 1324 S. State Street, Ukiah, CA 95482
Resident Engineer: Efren Banuelos Structure Rep.: Adlai Evans
Sample Information
DIME Sample ID: 2026-04-02-43
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (213) 505-4213
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 04/02/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 288
A brief description of the sample: F1554 anchor rods
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales
Material Information
Rocap Number(s): N/A
Heat Number(s): 1201072766
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: F1554
Bolt Length(s): 5'
Nut Specification: N/A
Washer Specification: N/A
Finish: Galv
Diameter/Size: 2-1/2"
Bolt Mfg. Lot Number: 120107276620
Rocap Test Requirement(s): No
Lubricant Requirements(s): No
Washer Inner Diameter(s): No
Test Results
