Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2021-06-15-5
Project Information
| Project Identifiers | Project ID: 214795 DEA: 030H3424 EFIS: 0317000153 |
|---|---|
| DIST-CO-RTE-PM | 03-SAC-99-22.6 |
| Award Date | 11/13/2020 |
| Closeout Date | 03/03/2022 |
| Work Description | REPLACE BRIDGE DECK WITH PRESTRESSED CONCRETE BOX GIRDER. |
| Location Description | SACRAMENTO COUNTY IN SACRAMENTO AT 21ST AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 03/12/2020) |
Sample Information
| Sample Taken Date | 06/15/2021 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 testing | Not set |
| Sample type | Acceptance | A brief description of the sample | Plain Elastomeric Bearing Pad |
| The quantity of what the sample constitutes | 1 lot | From where was the sample collected | Supplier |
| First name of sampler or witnessed by | Ryan | Last name of sampler or witnessed by | Parr |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Cal-Neva | Transportation Laboratory (TL) Number | C725807 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | B373-065-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | SMTL TM1 - Elastomeric Bearing Pad | Mfg. Lot Number(s) | 12821 |
|---|---|---|---|
| Material/Compound/Elastomer ID | NC 8168 | Samples Representing | 1 Lot |
| Description (size) | 0.5x8x12 | Comments | |
| Description (Number of Shims) | 0 | Type of Bearing Pad | Plain |
| Description (Thickness of Shims) | NA | Manufacturer(s) | Warco Biltrite |
| Batch Number | 1 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name | Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||