Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Laboratory

DIME Sample ID 2021-06-15-5

Project Information

Project IdentifiersProject ID: 214795
DEA: 030H3424
EFIS: 0317000153
DIST-CO-RTE-PM03-SAC-99-22.6
Award Date11/13/2020
Closeout Date03/03/2022
Work DescriptionREPLACE BRIDGE DECK WITH PRESTRESSED CONCRETE BOX GIRDER.
Location DescriptionSACRAMENTO COUNTY IN SACRAMENTO AT 21ST AVENUE UNDERCROSSING
QA Service Level1 (Verified on 03/12/2020)

Sample Information

Sample Taken Date06/15/2021 Sample Unique Key5
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 testingNot set
Sample typeAcceptance A brief description of the samplePlain Elastomeric Bearing Pad
The quantity of what the sample constitutes1 lot From where was the sample collectedSupplier
First name of sampler or witnessed byRyan Last name of sampler or witnessed byParr
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCal-Neva Transportation Laboratory (TL) NumberC725807
Inspector Lot Number from the Transportation Laboratory (TL) FormB373-065-21 Structure unique identifier
Structure name

Material Information

Material TypeSMTL TM1 - Elastomeric Bearing Pad Mfg. Lot Number(s)12821
Material/Compound/Elastomer IDNC 8168 Samples Representing1 Lot
Description (size)0.5x8x12 Comments
Description (Number of Shims)0 Type of Bearing PadPlain
Description (Thickness of Shims)NA Manufacturer(s)Warco Biltrite
Batch Number1

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments