Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994326 DEA: 051C3604 EFIS: 0512000134
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-217-0.9/1.4
Work Description: REPLACE BRIDGE.
Location Description: SANTA BARBARA COUNTY NEAR GOLETA FROM 0.2 MILE EAST OF GOLETA SLOUGH BRIDGE TO 0.4 MILE EAST OF SAN JOSE CREEK BRIDGE
Contractor Name: MCM CONSTRUCTION
Contractor Address: 6413 32nd Street, North Highlands, Ca 95660
Resident Engineer: Manny Yogarajah Structure Rep.: Alis Chhay
DIME Sample ID: 2023-04-14-40
TL Number from the TL Form:
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: 04/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 04/17/2023
The quantity of what the sample constitutes: 24
A brief description of the sample: Bearing Pad
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bridge Rubber Bearing
Mfg. Lot Number(s): 2527-6
Material/Compound/Elastomer ID: NA
Samples Representing: 24
Description (size): .5" x 12" x 18"
Comments:
Description (Number of Shims): 0
Type of Bearing Pad: Plain
Description (Thickness of Shims): NA
Manufacturer(s): Bridge Rubber Bearing
Batch Number: 132252
DIME Test ID: 2023-04-14-40-1
Test Method: ASTM D2240-15r21: Standard Test Method for Rubber Property - Durometer Hardness
Verified Date: 05/11/2023
Date Tested: 05/01/2023
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:
Test Result Compliance:
Additional Comments When Verified:
Temperature
|
72 f
|
Humidity
|
50 %
|
Reading #1
|
53
|
Reading #2
|
50
|
Reading #3
|
51
|
Reading #4
|
50
|
Reading #5
|
51
|
Mean
|
51
|