Sample Record for 2026-08-27-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001281 DEA: 11430234 EFIS: 1118000029
QA Service Level: 1
DIST-CO-RTE-PM: 11-SD-805-0.1/14.6
Work Description: REPLACE CONC PVMT, CONSTRUCT AUX LANE & BIKE TRAIL, ELECT, & LANDSCAPE
Location Description: SAN DIEGO COUNTY IN SAN DIEGO, CHULA VISTA AND NATIONAL CITY FROM 0.3 MILE SOUTH OF ROUTE 805/5 SEPARATION TO ROUTE 805/15 SEPARATION
Contractor Name: GRIFFITH COMPANY
Contractor Address: 13400 Sabre Springs, Suite 200 | San Diego, CA 92128, San Diego, CA 92128
Resident Engineer: Jason Alsheikh Structure Rep.: Carlos Guzman
Sample Information
DIME Sample ID: 2026-08-27-6
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: 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 1,200
A brief description of the sample: Anchor Bolt Asembly
From where was the sample collected: Distributor
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue circle Corp
Material Information
Rocap Number(s): none
Heat Number(s): 245774
Nut Mfg. Lot Number(s): 42998-256449
Washer Mfg. Lot Number(s): E9588
Bolt Specification: F1554 Gr.105
Bolt Length(s): 40"
Nut Specification: A563-DH
Washer Specification: F436
Finish: Galvanize
Diameter/Size: 1"
Bolt Mfg. Lot Number: 245774/K49722
Rocap Test Requirement(s): none
Lubricant Requirements(s): none
Washer Inner Diameter(s): 1
Test Results
