Sample Record for 2026-06-18-1
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000207 DEA: 060Q4324 EFIS: 0619000026 COOP: 061730
QA Service Level: 1
DIST-CO-RTE-PM: 06-TUL-190-13.1/16.6
Work Description: HMA, MINOR CONCRETE AND JPCP.
Location Description: TULARE COUNTY IN AND NEAR PORTERVILLE AT VARIOUS LOCATIONS FROM 0.2 MILE WEST OF WESTWOOD STREET TO 0.1 MILE EAST OF SOUTH MAIN STREET
Contractor Name: CAL VALLEY CONSTRUCTION, INC.
Contractor Address: 5125 North Gates Avenue, Suite 102, Fresno CA 93722
Resident Engineer: Tyler Street Structure Rep.: Vicente Sanchez
Sample Information
DIME Sample ID: 2026-06-18-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 06/18/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 300
A brief description of the sample: 1" x 5.5" A325 Bolt Assembly
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ameron Pole Products
Material Information
Rocap Number(s): Not required for Slip Base Plates per 56-3.02B(2)
Heat Number(s): Bolt 10972630
Nut 5806690802
Washer 190159269
Nut Mfg. Lot Number(s): N0090-5806690802
Washer Mfg. Lot Number(s): 0126-884
Bolt Specification: ASTM A325
Bolt Length(s): 5.5"
Nut Specification: ASTM A563
Washer Specification: ASTM F436
Finish: Galvanized
Diameter/Size: 1"
Bolt Mfg. Lot Number: E615W1
Rocap Test Requirement(s): NA
Lubricant Requirements(s): Blue Dye
Washer Inner Diameter(s): 1 in
Test Results
Test
DIME Test ID: 2026-06-18-1-1
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
Data has not been verified.
Test
DIME Test ID: 2026-06-18-1-2
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
Data has not been verified.
Test
DIME Test ID: 2026-06-18-1-3
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: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
Data has not been verified.
