DIME - Test Summary

Summary for Test 2021-06-21-22-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 215179 DEA: 010F4704 EFIS: 0116000011
DIST-CO-RTE-PM	01-HUM-299-30.7/37.7
Award Date	11/19/2020
Closeout Date	11/27/2023
Work Description	PLACE HMA & RHMA-G & CONSTRUCT SOLDIER PILE WALL.
Location Description	HUMBOLDT COUNTY NEAR WILLOW CREEK AT VARIOUS LOCATIONS FROM 0.1 MILE EAST OF CEDAR CREEK ROAD TO 1.1 MILES WEST OF ROUTE 96 JUNCTION
QA Service Level	1 (Verified on 09/15/2020)

Sample Taken Date	06/21/2021	Sample Unique Key	22
Date that the sample was received by the laboratory/organization performing the testing	06/30/2021	Sample type	Quality Assurance
A brief description of the sample	bearing pad	The quantity of what the sample constitutes	1
From where was the sample collected	Manufacturer	First name of sampler or witnessed by	Patrick
Last name of sampler or witnessed by	Loomis	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Scougal Rubber
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	SMTL TM1 - Elastomeric Bearing Pad	Mfg. Lot Number(s)	20323-1
Material/Compound/Elastomer ID	na	Samples Representing	77
Description (size)	1.15"x14.5"x13.5"	Comments
Description (Number of Shims)	2	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	na

DIME Sample ID: 2021-06-21-22

DIME Test ID: 2021-06-21-22-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test

Test Release Date: 2021-07-02

Input Type: Measured

Tester's full name: Yared Melketsadik

Date of test: 07/02/2021

Result: Pass

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 7/2/2021 ✔