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: 2026-03-11-8
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Stock
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 03/11/2026
Date that the sample was received by the laboratory/organization performing the testing: 03/20/2026
The quantity of what the sample constitutes: 1000
A brief description of the sample: 3/4" x 2-1/4" F3125 (A325) Hex Bolt Rocap Assembly
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Universal Industrial Sales
Rocap Number(s): TT0198936
Heat Number(s): 10928380 Bolt
5806686302 Nut
140565 Washer
Nut Mfg. Lot Number(s): 43319-S-5806686302
Washer Mfg. Lot Number(s): 46551-140565
Bolt Specification: F3125 (A325)
Bolt Length(s): 2-1/4"
Nut Specification: A563
Washer Specification: F436
Finish: Mech. Galv.
Diameter/Size: 3/4"
Bolt Mfg. Lot Number: M6074
Rocap Test Requirement(s): 28 kips
Lubricant Requirements(s): 0
Washer Inner Diameter(s): 0
