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Sample Record for 2025-12-01-8

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

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

Sample Information

DIME Sample ID: 2025-12-01-8
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Bay Area Field Office
Sample Organization Contact: (916) 284-6784
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 12/01/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/01/2025
The quantity of what the sample constitutes: 1000
A brief description of the sample: A563-DH hex nut
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales, Inc.

Material Information

Rocap Number(s): na
Heat Number(s): 234979
Nut Mfg. Lot Number(s): WLS060
Washer Mfg. Lot Number(s): na
Bolt Specification: na
Bolt Length(s): na
Nut Specification: A563-DH
Washer Specification: na
Finish: MG
Diameter/Size: 1 1/4"
Bolt Mfg. Lot Number: na
Rocap Test Requirement(s): na
Lubricant Requirements(s): na
Washer Inner Diameter(s): na
Test results on following page(s): 6

Test Results

Test 1 of 6

DIME Test ID: 2025-12-01-8-1
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 01/12/2026
Date Tested: 01/08/2026
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number WLS060
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 1.25 in
Bolt Length no data in
Measurement Average 2.7 mils

Test 2 of 6

DIME Test ID: 2025-12-01-8-2
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 01/12/2026
Date Tested: 01/08/2026
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number WLS060
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 1.25 in
Bolt Length no data in
Measurement Average 2.2 mils

Test 3 of 6

DIME Test ID: 2025-12-01-8-3
Test Method: ASTM B499-09r21: Standard Test Method for Measurement of Coating Thicknesses by the Magnetic Method: Nonmagnetic Coatings on Magnetic Basis Metals (Coating)
Verified Date: 01/12/2026
Date Tested: 01/08/2026
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number WLS060
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 1.25 in
Bolt Length no data in
Measurement Average 2.3 mils

Test 4 of 6

DIME Test ID: 2025-12-01-8-4
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/12/2026
Date Tested: 01/08/2026
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1A
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number WLS060
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 1.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 34.2
Spacing Ok

Test 5 of 6

DIME Test ID: 2025-12-01-8-5
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/12/2026
Date Tested: 01/08/2026
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1B
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number WLS060
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 1.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 33.3
Spacing Ok

Test 6 of 6

DIME Test ID: 2025-12-01-8-6
Test Method: ASTM E18-20: Standard Test Methods for Rockwell Hardness of Metallic Materials (Hardness)
Verified Date: 01/12/2026
Date Tested: 01/08/2026
Submitted By Organization: Atlas - Oakland
Organization Address: 534 23rd Avenue,
Organization City: Oakland
Organization State: CA
Organization Zipcode: 94606
Organization Email: guillermo.baltazar@oneatlas.com
Organization Phone: (510) 434-3018
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Sample No. 1C
Rocap Number no data
Heat Number(s) no data
Mfg. Lot Number WLS060
Finish Coating ASTM B695 - Mech Galv
Product Markings no data
Size 1.25 in
Bolt Length no data in
Hardness Reading Scale C Scale
Hardness Reading Average 33.7
Spacing Ok