Sample Record for 2026-08-27-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001176 DEA: 042Q5204 EFIS: 0419000021
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-29-0.0/6.0
Work Description: HMA PVMT, MOD DRAINAGE, SIGNALS, SIDEWALKS, CURB RAMPS AND LANDSCAPE.
Location Description: SOLANO COUNTY IN VALLEJO FROM 0.2 MILE NORTH OF ROUTE 80/ 29 SEPARATION TO NAPA COUNTY LINE
Contractor Name: BAY CITIES PAVING & GRADING, INC.
Contractor Address: Unknown
Resident Engineer: Tran Quang Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-08-27-2
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: 08/27/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 3 of 410
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 Cirlce Corp
Material Information
Rocap Number(s): none
Heat Number(s): 3146016
Nut Mfg. Lot Number(s): none
Washer Mfg. Lot Number(s): none
Bolt Specification: F1554
Bolt Length(s): 6"
Nut Specification: none
Washer Specification: none
Finish: Galvanize
Diameter/Size: 3/4
Bolt Mfg. Lot Number: 86779332/146016A434
Rocap Test Requirement(s): none
Lubricant Requirements(s): none
Washer Inner Diameter(s): none
Test Results
