Sample Record for 2025-12-16-49
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993446 DEA: 120J34U4 EFIS: 1218000034
QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-55,55-29.6,R6.4/10.3
Work Description: CONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS.
Location Description: ORANGE COUNTY IN IRVINE, SANTA ANA, AND TUSTIN ON ROUTE 5 AT NEWPORT AVENUE UNDERCROSSING AND ON ROUTE 55 FROM 0.4 MILE NORTH OF ROUTE 55/405 SEPARATION TO 0.1 MILE SOUTH OF ROUTE 5/55 SEPARATION
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Road, Suite 200, Westlake Village, CA 91361
Resident Engineer: Adrian Wu Structure Rep.: Yong Gyun Park
Sample Information
DIME Sample ID: 2025-12-16-49
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (530) 329-6527
Type of Sample: Quality Assurance
Type of Material: SMTL TM1 - Elastomeric Bearing Pad
Sample Taken Date: 12/16/2025
Date that the sample was received by the laboratory/organization performing the testing: 01/07/2026
The quantity of what the sample constitutes: 102
A brief description of the sample: Bearing Pad
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Scougal Rubber
Material Information
Mfg. Lot Number(s): 27223-1
Material/Compound/Elastomer ID: NA
Samples Representing: 102
Description (size): 1" x 4" x 6"
Comments:
Description (Number of Shims): 0
Type of Bearing Pad: Plain
Description (Thickness of Shims): NA
Manufacturer(s): Scougal Rubber
Batch Number: NA
Test Results
