Sample Record

Owner Lab

  • CT HQ - Sacramento Structural Materials Testing Laboratory

DIME Sample ID 2025-12-16-49

Project Information

Project IdentifiersProject ID: 993446
DEA: 120J34U4
EFIS: 1218000034
DIST-CO-RTE-PM12-ORA-55,55-29.6,R6.4/10.3
Award Date05/27/2022
Closeout DateNot set
Work DescriptionCONSTR BRIDGES, RW, SW, JPCP, HMA PVMT, DRAINAGE AND ELECT SYSTEMS.
Location DescriptionORANGE 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
QA Service Level1 (Verified on 06/24/2022)

Sample Information

Sample Taken Date12/16/2025 Sample Unique Key49
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 testing01/07/2026
Sample typeQuality Assurance A brief description of the sampleBearing Pad
The quantity of what the sample constitutes102 From where was the sample collectedManufacturer
First name of sampler or witnessed byMario Last name of sampler or witnessed byRodriguez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameScougal Rubber Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeSMTL TM1 - Elastomeric Bearing Pad Mfg. Lot Number(s)27223-1
Material/Compound/Elastomer IDNA Samples Representing102
Description (size)1" x 4" x 6" Comments
Description (Number of Shims)0 Type of Bearing PadPlain
Description (Thickness of Shims)NA Manufacturer(s)Scougal Rubber
Batch NumberNA

Submitted Tests

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