Sample Record for 2026-07-14-5
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000081 DEA: 081J5404 EFIS: 0818000069
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-2.4
Work Description: CB, JPCP (RSC), STRUCTURAL CONCRETE AND MODIFYING LIGHTING SYSTEMS.
Location Description: SAN BERNARDINO COUNTY IN ONTARIO AT ROUTE 10/15 SEPARATION
Contractor Name: FLATIRON WEST, INC.
Contractor Address: 12121 Scripps Summit Drive, Suite 400, San Diego, CA 92131
Resident Engineer: Giang-Sinh Tran Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-07-14-5
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: 07/14/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2 of 72
A brief description of the sample: F1554 Grade 55 HDG Anchor Bolts
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle
Material Information
Rocap Number(s): N/A
Heat Number(s): 3147142
Nut Mfg. Lot Number(s): None
Washer Mfg. Lot Number(s): None
Bolt Specification: F1554 Gr.55
Bolt Length(s): 60"
Nut Specification: None
Washer Specification: None
Finish: Galvanize
Diameter/Size: 3"
Bolt Mfg. Lot Number: 86871147/147142A106
Rocap Test Requirement(s): None
Lubricant Requirements(s): None
Washer Inner Diameter(s): None
Test Results
Test
DIME Test ID: 2026-07-14-5-1
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: 2026-07-14-5-2
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.
