Sample Record for 2026-06-25-8

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 1001625 DEA: 11173704 EFIS: 1100020255 QA Service Level: 1

DIST-CO-RTE-PM: 11-SD-805-2.6/3.2

Work Description: WIDEN INTERCHANGE, STRUCTURES, HMA-A, RHMA-G, LANDSCAPE, & ELECTRICAL.

Location Description: SAN DIEGO COUNTY IN SAN DIEGO FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF PALM AVENUE OVERCROSSING

Contractor Name: SEMA CONSTRUCTION

Contractor Address: 1901 Cmino Vida Roble, Suite 100, Carlsbad, CA 92008

Resident Engineer: Karl Hartline Structure Rep.: Unknown

DIME Sample ID: 2026-06-25-8

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: 06/25/2026

Date that the sample was received by the laboratory/organization performing the testing: 06/25/2026

The quantity of what the sample constitutes: 101

A brief description of the sample: 1"x30" Double End Studs

From where was the sample collected: Source

Laboratory sample identification:

Structure unique identifier:

Structure name:

The fabricator/manufacturer/facility name: Halo

Rocap Number(s): No

Heat Number(s): 79020498, 80000028822, 190250877

Nut Mfg. Lot Number(s): W000222814

Washer Mfg. Lot Number(s): E8555

Bolt Specification: F1554

Bolt Length(s): 30"

Nut Specification: A563

Washer Specification: F436

Finish: Galvanized

Diameter/Size: 1"

Bolt Mfg. Lot Number: N/A

Rocap Test Requirement(s): No

Lubricant Requirements(s): No

Washer Inner Diameter(s): one one eight