Sample Record for 2020-01-15-8
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213737 DEA: 07289104 EFIS: 0700021123
QA Service Level: 1
Work Description: Rehabilitate the existing Commercial Vehicle Enforcement Facility.
Location Description: LOS ANGELES COUNTY IN CARSON FROM DEL AMO BOULEVARD OVER CROSSING TO VERMONT AVENUE (190TH) UNDER CROSSING.
Contractor Name: POWELL CONSTRUCTORS, INC.
Contractor Address: 8555 Banana Avenue, Fontana, CA 92335
Resident Engineer: Samuel Gallardo Structure Rep.: Bernabe Contreras Jr
DIME Sample ID: 2020-01-15-8
TL Number from the TL Form: TL101 719045
Sample Submitted By Organization: CT QASI - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7263
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 01/15/2020
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 24 anchor bolts
A brief description of the sample: 1 1/4" x 1'5" ASTM A1554 GR105 HDG Anchor Bolt
From where was the sample collected: Fabricator
Laboratory sample identification: Lot 1
Structure unique identifier:
Structure name: Canopy
The fabricator/manufacturer/facility name: Michael and Company
Heat Number(s): 166981
Nut Mfg. Lot Number(s): n/a
Washer Mfg. Lot Number(s): n/a
Bolt Specification: F1554 GRADE 105 HVY HEX
Bolt Length(s): 1'5" shank and thread
Nut Specification: n/a
Washer Specification: n/a
Finish: Hot Dipped Galvanized ASTM A-153
Diameter/Size: 1 1/4"
Bolt Mfg. Lot Number: 8085
Rocap Test Requirement(s):
Tests Assigned to this Sample
|DIME Test ID||Test Method||Assigned Date||Test Date||Assigned By||Assigned Lab||Test Comments||Assigned To|
|No tests have been assigned to this sample.|