Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 88888 DEA: SMTL-STOCK EFIS: SMTL-STOCK
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for SMTL stock material. Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-03-19-9
TL Number from the TL Form:
Sample Submitted By Organization: CT - Unassigned/General Field Laboratory
Sample Organization Contact: 5625005861
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 03/19/2025
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 30
A brief description of the sample: ASTM A449
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales
Rocap Number(s): na
Heat Number(s): 58050838-07
Nut Mfg. Lot Number(s): na
Washer Mfg. Lot Number(s): na
Bolt Specification: ASTM A449
Bolt Length(s): 8"
Nut Specification: na
Washer Specification: na
Finish: Plain
Diameter/Size: 5/8"
Bolt Mfg. Lot Number: 61572
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Washer Inner Diameter(s):
