Sample Record for 2026-04-09-46
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994366 DEA: 044J9104 EFIS: 0416000010
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-87-0.0/6.1
Work Description: Cold plane AC, paving with RHMA, upgrade median CB and curb ramp.
Location Description: CONSTRUCTION ON STATE HIGHWAY IN SANTA CLARA COUNTY IN SAN JOSE FROM ROUTE 85/87 SEPARATION TO 0.1 MILE NORTH OF JULIAN STREET UNDERCROSSING.
Contractor Name: O.C. Jones & Sons Inc. (Juan M. Hernandez)
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Ali Nikzad Structure Rep.: STEVE GONG
Sample Information
DIME Sample ID: 2026-04-09-46
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: 04/09/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/21/2026
The quantity of what the sample constitutes: 3 of 500
A brief description of the sample: 3/8 X 1 1/4 HDG Hex bolt
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales
Material Information
Rocap Number(s): none
Heat Number(s): 1000226162
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: Gr. 5 HX Cap Screw
Bolt Length(s): 1-1/4
Nut Specification: none
Washer Specification: none
Finish: Galvanize
Diameter/Size: 3/8
Bolt Mfg. Lot Number: 26065673
Rocap Test Requirement(s): none
Lubricant Requirements(s): none
Washer Inner Diameter(s): none
Test Results
