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 FILE NO.
TORQUE/CONTROLLED ASSEMBLY REPORT
I
FACILITY
DATE
JOB NO.
REC NO.
LEAD SHOP/WORK CENTER
SYSTEM
FASTENER MATERIAL
SIZE
REFERENCE FOR MATL.
TYPE
INSPECTION
REFERENCE(S)
O
NEW
O REUSED
I
TORQUE REQUIRED
REFERENCE FOR TORQUE
TORQUE SEOUENCE SKETCH
INSTALLATION PROC.
ANTI-SEIZE MATERIAL
SEALING COMPOUND
TORQUE DEVICE RANGE
CAL DUE DATE
RUNNING TORQUE
FINAL TORQUE (Required & Running Torque)
THREAD ENGAGEMENT
I
PARTS REPAIRED
GASKET/O-RING DATA
OTHER PARTS REPLACED
REF.
SPECIFICATIONS
REF.
NSN/COMMERlCAL STOCK NO.
EXP. DATE
SEALING
SURFACE
FINISH
IAW
LOCKWIRED IAW
REASSEMBLY COMPLETED IAW
MICROMETER SERIAL NO.
BLUE CHECK RESULTS
REMARKS
PERFORMED/DATE
The person designated to sign for an action verifies based on personal obser-
vation, and certifies by his signature, that the action has actually been per-
QA INSP. WITNESSED/DATE
formed in accordance with specified requirements.
E-6
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