Sample Taken Date	09/16/2026	Sample Unique Key	4
Date that the sample was received by the laboratory/organization performing the testing	09/23/2026	Sample type	Quality Assurance
A brief description of the sample	A563-DH HDG Nut	The quantity of what the sample constitutes	1500
From where was the sample collected	Fabricator	First name of sampler or witnessed by	Kevin M
Last name of sampler or witnessed by	Carpenter	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	UIS
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	SMTL TM3 - Fastener Assembly	Rocap Number(s)	N/A
Heat Number(s)	20722850	Nut Mfg. Lot Number(s)	E275S1X
Washer Mfg. Lot Number(s)	N/A	Bolt Specification	N/A
Bolt Length(s)	N/A	Nut Specification	ASTM A563
Washer Specification	N/A	Finish	MG
Diameter/Size	1-1/8"	Bolt Mfg. Lot Number	N/A
Rocap Test Requirement(s)	NONE	Lubricant Requirements(s)	SL LUBE ONLY
Washer Inner Diameter(s)	NONE	Bolt Mill Supplier	Not set
Nut Mill Supplier	Not set	Washer Mill Supplier	Not set

DIME Test ID: 2026-09-16-4-1 ASTM B499-09r21 (Verified)
DIME Test ID: 2026-09-16-4-2 ASTM B499-09r21 (Verified)
DIME Test ID: 2026-09-16-4-3 ASTM B499-09r21 (Verified)
DIME Test ID: 2026-09-16-4-4 ASTM F606-21 (Verified)