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Sample Record for 2017-10-17-5

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 211513 DEA: 120M4904 EFIS: 1212000090 QA Service Level: 1
DIST-CO-RTE-PM: 12-ORA-5-1.2/2.2
Work Description: WIDEN FWY AND BRIDGE AND CONSTRUCT RW, SOUND WALL, AND CONC BARRIERS.
Location Description: ORANGE COUNTY IN SAN CLEMENTE FROM 0.1 MILE NORTH OF AVENIDA MENDOCINO OVERCROSSING TO 0.2 MILE SOUTH OF AVENIDA PRESIDIO UNDERCROSSING
Contractor Name: POWELL CONSTRUCTORS, INC.
Contractor Address: 8555 Banana Ave, Fontana, CA 92335
Resident Engineer: Steve Kinaly Structure Rep.: Imad Karam

Sample Information

DIME Sample ID: 2017-10-17-5
TL Number from the TL Form: C741438
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: 10/17/2017
Date that the sample was received by the laboratory/organization performing the testing: 10/19/2017
The quantity of what the sample constitutes: 1
A brief description of the sample: Bearing Pad
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cal Neva

Material Information

Mfg. Lot Number(s): 100917
Material/Compound/Elastomer ID: NA
Samples Representing: 5
Description (size): 1" x 6" x 8"
Comments: Unknown
Description (Number of Shims): 1
Type of Bearing Pad: Steel
Description (Thickness of Shims): 14 gage
Manufacturer(s): Cal Neva
Batch Number: NA

Test Results

Test 1 of 1

DIME Test ID: 2017-10-17-5-1
Test Method: ASTM D4014-03re12: Standard Specification for Plain and Steel-Laminated Elastomeric Bearings for Bridges
Verified Date: 10/25/2017
Date Tested: 10/24/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test: Shim alignment does not comply with material specifications. Neoprene rubber is delaminating.
Test Result Compliance: does not comply
Additional Comments When Verified:
Visual Inspection Compliance Does Not Comply