TB 9-5220-213-24
(11) ACTUAL GAGE DIMENSIONS The average readings taken from worksheet
fig. A-3 will be annotated in this block, (it is recommended to use pencil here for any future
changes). If a reading is out of the required component dimensions, indicate the actual out
of tolerance dimension and stamp "UNSERVICEABLE" on the DA Form 3023 card.
NOTE
If gage is Unserviceable, do not return gage to the customer.
Only the DA Form 3023 stamped "unserviceable" (the
performer's condition coding stamp can be used) is returned to
owner. This stamped DA Form 3023 will allow the owner a
basis for requisitioning a replacement gage through normal
supply channels. All Unserviceable gages will be sent to Rock
Island for proper disposal, with a copy of DA Form 3023 to:
ROCK ISLAND TSC
ATTN: AMSAM-TMD-BRI
Bldg. 131
Rock Island, Il 61299-7430
(12) REMARKS If this is the original DA Form 3023 this section contains the
fielding lab information. If new DA Form 3023 is created, the performing activity's
information is listed here. If a bar code is assigned the sticker could also be put in this block.
(13) DATE Calendar date of gage's original certification (when this DA Form 3023
was created). The re-certification dates will appear on the back of this card.
(14) GAGE CHECKER Name of individual performing certification.
BACK OF DA FORM 3023
(1) RECHECK GAGE AFTER EACH Enter calibration interval 360 DAYS (draw a
line through or white out the word "PIECES".)
(2) IDENTIFICATION NO - Enter complete identification or serial number including
leading zeros, slashes, dashes, etc.
(3) RECHECK SIZE - Enter "Certified" after performing certification.
(4) RECHECK DATE - Enter calendar date gage was certified (e.g. 21 Apr 08).
(5) RECHECK BY - Enter gage inspector's initials.
(6) REMARKS - Enter calibration due date (e.g. 15 Apr 09).
Print "NEXT DUE
DATE" under the REMARKS heading as shown in fig. A-1.
PACKAGING
Gages should be carefully packaged. Preferred packaging would be sealed plastic bags
(recommend NSN 8105 00 334 4120) or plastic heat-treated bags. Acceptable options
include clean, dry paper, or treated paper. If paper is used, tape the paper in place taking
care to avoid taping the gages. After wrapping the gages, cushion the package in a
fiberboard box using either plastic or cellulose packing. Packing material may be reused if
clean and dry. Ensure enough cushioning material is included to make a tight pack.
Secure the box as appropriate. DA Form 3023 must be returned to owner with each gage set.
A-2
