Sample Record for 2026-04-15-51
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001902 DEA: 061H6704 EFIS: 0625000240
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-190-26.65
Work Description: Replace exiting bridge rail on EB direction of SR 190, demo and reconstruct overhang, remove existing AC overlay, deck overhang strengthening at bridge rail, poly conc overlay, install new ST-75 barrier rail.
Location Description: Tule River Bridge (BR #46-0187).
Contractor Name: Chapco Construction (Matthew Clifford)
Contractor Address: 6000 Mortono Street, Sacramento, CA 95828
Resident Engineer: Cesar Mandujano Structure Rep.: Ye Yang
Sample Information
DIME Sample ID: 2026-04-15-51
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: 04/15/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/24/2026
The quantity of what the sample constitutes: 6
A brief description of the sample: 1" x 19" F1554 Grade 105 Rod
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Atwater Metal Fabrication
Material Information
Rocap Number(s): n/a
Heat Number(s): 1000128077 Bolt
21002280 Nut
190054844 Washer
Nut Mfg. Lot Number(s): E591W1
Washer Mfg. Lot Number(s): 0925-778
Bolt Specification: F1554 Grade 105
Bolt Length(s): 19"
Nut Specification: A563 Grade DH
Washer Specification: F436 Type 1
Finish: HDG
Diameter/Size: 1"
Bolt Mfg. Lot Number: 100012807740
Rocap Test Requirement(s): 0
Lubricant Requirements(s): 0
Washer Inner Diameter(s): 0
Test Results
