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: 2025-10-14-8
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: 10/14/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2025
The quantity of what the sample constitutes: 400
A brief description of the sample: 3/4" X 3" MG ASTM F3125 Bolt Assemblies
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: UIS Lindon UT
Rocap Number(s): TT0194640
Heat Number(s): 20932810
Nut Mfg. Lot Number(s): 41829-S-245736
Washer Mfg. Lot Number(s): 46551-140565
Bolt Specification: ASTM F3125
Bolt Length(s): 3"
Nut Specification: ASTM A563 Grade DH
Washer Specification: NA
Finish: ASTM B695
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: BM1364
Rocap Test Requirement(s): Test Bolt, Nut, and Washer
Lubricant Requirements(s): Blue Dye
Washer Inner Diameter(s):
DIME Test ID: 2025-10-14-8-1
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
DIME Test ID: 2025-10-14-8-2
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
DIME Test ID: 2025-10-14-8-3
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
Data has not been verified.
