Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2017-05-09-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212117 DEA: 044K4304 EFIS: 0417000309 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-128-1.3, 1.30 |
| Award Date | 02/09/2017 |
| Closeout Date | 12/20/2017 |
| Work Description | IN SONOMA COUNTY, ON ROUTE 128, EAST OF CLOVERDALE. REPAIR SLIPOUT BY CONSTRUCTING SOLDIER PILE TIE-BACK WALL |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 03/16/2017) |
Sample Information
| Sample Taken Date | 05/09/2017 | Sample Unique Key | 2 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | Not set |
| Sample type | Department Acceptance | A brief description of the sample | 1.15x8x12 elastomeric bearing |
| The quantity of what the sample constitutes | 16 | From where was the sample collected | Source |
| First name of sampler or witnessed by | Kevin | Last name of sampler or witnessed by | Muser |
| Title of sampler | QA | Telephone number of sampler | 9165170532 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Scougal Rubber | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S19-135-17 | Structure unique identifier | Not set |
| Structure name | Not set | Bid Item | Not set |
Material Information
| Material Type | SMTL TM1 - Elastomeric Bearing Pad | Mfg. Lot Number(s) | 15768-1 |
|---|---|---|---|
| Material/Compound/Elastomer ID | CP2527VCP2628ARS | Samples Representing | 16 pads |
| Description (size) | 1.15x8x12 | Comments | |
| Description (Number of Shims) | 2 | Type of Bearing Pad | Steel |
| Description (Thickness of Shims) | 14 gage | Manufacturer(s) | Scougal Rubber |
| Batch Number | 0 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||