Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2017-05-09-4
Project Information
| Project Identifiers | Project ID: 211588 DEA: 030F3104 EFIS: 0300000078 |
|---|---|
| DIST-CO-RTE-PM | 03-ED-49-23.6/24.5 |
| Award Date | 12/12/2016 |
| Closeout Date | 01/08/2019 |
| Work Description | REPLACE BRIDGE. |
| Location Description | EL DORADO COUNTY NEAR COLOMA FROM 0.1 MILE EAST OF MARSHALL ROAD TO 0.3 MILE EAST OF LOTUS ROAD |
| QA Service Level | 1 (Verified on 10/19/2016) |
Sample Information
| Sample Taken Date | 05/09/2017 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 3.45x12x12 |
| The quantity of what the sample constitutes | 7 | 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 | Telephone number of sampler | 9165170532 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Scpugal Rubber | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S19-136-17 | 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) | 15771-1 |
|---|---|---|---|
| Material/Compound/Elastomer ID | CP2527VCP2628ARS | Samples Representing | 7 |
| Description (size) | 3.45x12x12 | Comments | |
| Description (Number of Shims) | 6 | 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. | |||
