Sample Record for 2023-05-23-5
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213750 DEA: 120K0224 EFIS: 1214000097
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-14.5/17.1
Work Description: South County Improvement Project (Phase 2 - Oso/Alicia) CONST BRIDGES, RW, SW, HMA PVMT, JPCP, DRAINAGE, AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN MISSION VIEJO AND LAGUNA HILLS FROM 0.7 MILE SOUTH OF OSO PARKWAY OVERCROSSING TO 0.3 MILE SOUTH OF ALICIA PARKWAY OVERCROSSING
Contractor Name: Flatiron West, Inc
Contractor Address: 1770 La Costa Meadows Drive, San Marcos, California 92078
Resident Engineer: Steven Kim Structure Rep.: Sara Soleimani
Sample Information
DIME Sample ID: 2023-05-23-5
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: 05/23/2023
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 5
A brief description of the sample: ASTM F1554 Grade 55 Anchor Bolt
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Blue Circle Corp
Material Information
Rocap Number(s):
Heat Number(s): 1202044130
Nut Mfg. Lot Number(s):
Washer Mfg. Lot Number(s):
Bolt Specification: ASTM F1554
Bolt Length(s): 36"
Nut Specification: N/A
Washer Specification: N/A
Finish: ASTM F2329 - Hot Dip
Diameter/Size: 1 1/4"- 7 x 36" x 4"
Bolt Mfg. Lot Number: 120204413021
Rocap Test Requirement(s):
Lubricant Requirements(s):
Test Results
