FASTENER FAILURE REQUEST FORM

For All Externally Threaded Bolts and Studs, Washers and Nuts

In order to provide the best service possible, please complete this form with your initial Fastener Failure Request.

  1. Briefly describe the connection and part(s) the fastener was holding together.

  2. How many bolts were there in the connection?

  3. Was the connection new or had it been in service long?

  4. Are the parts worn, warped or rusty?

  5. If the bolt head is missing, can you describe the markings on the head? Grade?

  6. How thick was the part(s) the bolt went through?

  7. If a tapped hole, how deep are the threads?

  8. Was a nut used?

  9. Was the nut a plain hex, nylon lock nut or metal lock nut?

  10. Any markings on the nut?_________ Color of the nut?

  11. What were the original dimensions of the bolt; length,______diameter,______thread pitch_____?

  12. Was a torque wrench used for assembly? ________ Amount?_________

  13. Was a power wrench/air wrench/impact wrench used for assembly?

  14. How many bolts were in the connection?

  15. How was the joint/bolts tightened?

  16. Was the bolt head or nut tightened?

  17. Any high temperatures involved?

  18. Any washers used?______ How many and where: under the head?______ under the nut?_______

  19. What type of washer was used?

  20. Was the connection subjected to impact and shock loads?

  21. Bending or shear loads involved?

  22. Any other types of loads or chemical environment involved?

  23. Any lubricants used or present on the threads, parts or in the hole?

Please send all fastener parts available; nut, bolt and washer. If not all parts are available, send representative samples of new parts and indicate they are new. See our contact information for mailing address.

Be sure to indicate whether you want the parts saved, returned or scrapped!

RATE:  a basic report is $225

Any required secondary laboratory work or documentation will be charged the applicable fee of the third party plus an administrative fee. Extra report copies and separate mailings will also be at an extra nominal fee.

You will be notified of any extra costs beyond those quoted for approval.