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Sample Record for 2019-11-22-9

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

Project Information

Project ID: 3825 DEA: 07138204 EFIS: 0700000142 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-47,103-3.5/4.6,0.0/1.1
Work Description: REPLACE STEEL BRIDGE WITH CIP PS CONCRETE BOX GIRDER BRIDGE AND RAMPS.
Location Description: LOS ANGELES COUNTY IN LONG BEACH AND LOS ANGELES ON ROUTE 47 FROM OCEAN BOULEVARD TO ROUTE 103 JUNCTION AND ON ROUTE 103 FROM ROUTE 47 JUNCTION TO ANAHEIM STREET OVERHEAD
Contractor Name: M C M CONSTRUCTION INC
Contractor Address: P O BOX 620, NORTH HIGHLANDS, CA 95660
Resident Engineer: Daniel Leon Structure Rep.: Andy Chen

Sample Information

DIME Sample ID: 2019-11-22-9
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (916) 227-7253
Type of Sample: Quality Assurance
Type of Material: SMTL TM1 - Elastomeric Bearing Pad
Sample Taken Date: 11/22/2019
Date that the sample was received by the laboratory/organization performing the testing: 11/26/2019
The quantity of what the sample constitutes: 51
A brief description of the sample: Elastomeric Bearing pad
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: DS Brown

Material Information

Mfg. Lot Number(s): C1911-5558-11
Material/Compound/Elastomer ID: na
Samples Representing: 51
Description (size): 0.75"
Comments: Unknown
Description (Number of Shims): na
Type of Bearing Pad: Plain
Description (Thickness of Shims): NA
Manufacturer(s): DS Brown
Batch Number: na

Test Results

Test 1 of 4

DIME Test ID: 2019-11-22-9-1
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Verified Date: 11/27/2019
Date Tested: 11/27/2019
Submitted By Organization: CT HQ - Sacramento Chemistry Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: lisa.dobeck@dot.ca.gov
Organization Phone: (916) 227-7919
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified:
Result Pass

Test 2 of 4

DIME Test ID: 2019-11-22-9-2
Test Method: ASTM D2240-05re10: Standard Test Method for Rubber Property - Durometer Hardness
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
Data has not been verified.

Test 3 of 4

DIME Test ID: 2019-11-22-9-3
Test Method: ASTM D412-06a-re13: Standard Test Methods for Vulcanized Rubber and Thermoplastic Elastomers—Tension
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
Data has not been verified.

Test 4 of 4

DIME Test ID: 2019-11-22-9-4
Test Method: ASTM D624-00-re12: Standard Test Method for Tear Strength of Conventional Vulcanized Rubber and Thermoplastic Elastomers
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.