Sample Record for 2026-07-14-18
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994675 DEA: 07390204 EFIS: 0722000334
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-47-0.4 / 2.1
Work Description: Bridge deck replacement with lightweight precast deck panels ultra high performance concrete. Also includes: replacement of seismic sensors, upgrades to median barrier, railings, fences and guard rails. New finger joints.
Location Description: RTE 47 between Terminal Island and San Pedro PM 0.4/2.1
Contractor Name: Skanska
Contractor Address: 1995 Agua Mansa Rd, Riverside, CA 92509
Resident Engineer: Sam Gallardo Structure Rep.: Sami Deeb
Sample Information
DIME Sample ID: 2026-07-14-18
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Stock
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: 07/14/2026
The quantity of what the sample constitutes: 1675
A brief description of the sample: 3/4" x 5-1/2" A325 Hex Bolt
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales
Material Information
Rocap Number(s): N/A
Heat Number(s): 10976250
Nut Mfg. Lot Number(s): N/A
Washer Mfg. Lot Number(s): N/A
Bolt Specification: A325
Bolt Length(s): 5-1/2"
Nut Specification: N/A
Washer Specification: N/A
Finish: HDG
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: BG3328
Rocap Test Requirement(s): 0
Lubricant Requirements(s): 0
Washer Inner Diameter(s): 0
Test Results
