Sample Record for 2026-06-29-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1002028 DEA: 081K8704 EFIS: 0819000126
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-VAR-VAR
Work Description: Modifying traffic monitoring stations
Location Description: District-County-Route-Post Mile: 08-SBd-2, 10, 15, 18, 38, 40, 58, 83, 138, 142, 173, 178, 189, 215 and 395-Var
Contractor Name: KANAAN CONSTRUCTION, INC.
Contractor Address: Unknown
Resident Engineer: Chi Yen (Acting RE) Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-06-29-6
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: 06/29/2026
Date that the sample was received by the laboratory/organization performing the testing: 06/29/2026
The quantity of what the sample constitutes: 3 samples from 770
A brief description of the sample: ASTM F1554 Grade 55 Anchor Bolts
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle Corp
Material Information
Rocap Number(s): NA
Heat Number(s): 3146016
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: ASTM F1554 Grade 55
Bolt Length(s): 15"
Nut Specification: N/A
Washer Specification: N/A
Finish: Hot Dip Galvanized
Diameter/Size: 3/4"-10x15"x3"
Bolt Mfg. Lot Number: Lot 1
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Washer Inner Diameter(s): na
Test Results
Test
DIME Test ID: 2026-06-29-6-1
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: 2026-06-29-6-2
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: 2026-06-29-6-3
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.
