Sample Record for 2026-08-25-8
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001403 DEA: 11430824 EFIS: 1119000162
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-5-R66.2/R67.4
Work Description: PCC & HMA PAVING, SIGNS AND STRIPING, WSMS & AUTOMATED LANE CLOSURE.
Location Description: SAN DIEGO COUNTY ABOUT 12 MILES NORTH OF OCEANSIDE FROM 1.2 MILES SOUTH OF SAN ONOFRE COMMERCIAL VEHICLE ENFORCEMENT FACILITIES TO SAN ONOFRE COMMERCIAL VEHICLE ENFORCEMENT FACILITIES
Contractor Name: Montano Pipeline
Contractor Address: 231 Fourth Ave, Chula Vista, CA 91910
Resident Engineer: Rosemarie Pagunsan Structure Rep.: Allison Harizal
Sample Information
DIME Sample ID: 2026-08-25-8
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: 08/25/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/25/2026
The quantity of what the sample constitutes: 258
A brief description of the sample: 1-1/2" x 4-1/2" 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): 20998500
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): n/a
Bolt Specification: A325
Bolt Length(s): 4-1/2"
Nut Specification: n/a
Washer Specification: n/a
Finish: Mech. Galvanization
Diameter/Size: 1-1/2"
Bolt Mfg. Lot Number: M6370
Rocap Test Requirement(s): 0
Lubricant Requirements(s): 0
Washer Inner Diameter(s): 0
Test Results
