DIME - Test Summary

Summary for Test 2022-03-01-42-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 993124 DEA: 101F1704 EFIS: 1016000032
DIST-CO-RTE-PM	10-SJ-26,99-1.1,19.3
Award Date	09/07/2021
Closeout Date	08/30/2023
Work Description	REMOVE AND REPLACE BRIDGE.
Location Description	SAN JOAQUIN COUNTY NEAR STOCKTON AT ROUTE 26/99 SEPARATION
QA Service Level	1 (Verified on 07/23/2021)

Sample Taken Date	03/01/2022	Sample Unique Key	42
Will the laboratory/organization for which you are a member perform testing on this material sample?	Yes	Date that the sample was received by the laboratory/organization performing the testing	03/07/2022
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)	21345-1
Material/Compound/Elastomer ID	na	Samples Representing	1
Description (size)	2.3"x8"x12"	Comments
Description (Number of Shims)	4	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	na

DIME Sample ID: 2022-03-01-42

DIME Test ID: 2022-03-01-42-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2022-03-22

Input Type: Calculated

Tester's full name: Mariano Pontillas

Date of test: 03/22/2022

Result: Pass

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

Test was verified on 3/22/2022 ✔