Sample Record for 2026-03-11-87

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

DIME Sample ID: 2026-03-11-87

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: Stock

Type of Material: SMTL TM3 - Fastener Assembly

Sample Taken Date: 03/11/2026

Date that the sample was received by the laboratory/organization performing the testing: 03/20/2026

The quantity of what the sample constitutes: 500

A brief description of the sample: 3/4" x 12" F1554 Gr. 55 ATR

From where was the sample collected: Fabricator

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Universal Industrial Sales

Rocap Number(s): N/A

Heat Number(s): 1201051078

Nut Mfg. Lot Number(s): N/A

Washer Mfg. Lot Number(s): N/A

Bolt Specification: F1554

Bolt Length(s): 12"

Nut Specification: N/A

Washer Specification: N/A

Finish: HDG

Diameter/Size: 3/4"

Bolt Mfg. Lot Number: 1201051078

Rocap Test Requirement(s): 0

Lubricant Requirements(s): 0

Washer Inner Diameter(s): 0