Summary for Test 2022-05-24-33-4
Test performed: SMTL BILST-06Project Information
| Project Identifiers | Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169 |
|---|---|
| DIST-CO-RTE-PM | 05-SB-101-4.4/R7.7 |
| Award Date | 03/01/2021 |
| Closeout Date | Not set |
| Work Description | Please cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B. |
| Location Description | 101 freeway in Summerland, CA |
| QA Service Level | 1 (Verified on 05/06/2021) |
Sample Information
| Sample Taken Date | 05/24/2022 | Sample Unique Key | 33 |
|---|---|---|---|
| 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 | 05/31/2022 |
| 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 | Brad | Last name of sampler or witnessed by | Streeter |
| 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 Information
| Material Type | SMTL TM1 - Elastomeric Bearing Pad | Mfg. Lot Number(s) | 21708-1 |
|---|---|---|---|
| Material/Compound/Elastomer ID | NA | Samples Representing | 433 |
| Description (size) | 0.75x4x6 | Comments | |
| Description (Number of Shims) | NA | Type of Bearing Pad | Plain |
| Description (Thickness of Shims) | NA | Manufacturer(s) | Scougal Rubber |
| Batch Number | NA |
Test Details
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DIME Sample ID: 2022-05-24-33
DIME Test ID: 2022-05-24-33-4
Testing Lab: CT HQ - Sacramento Chemistry Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2022-06-01
Test Results
Input Type: Measured
Tester's full name: Rachael Chavez
Date of test: 06/01/2022
Result: Pass
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 6/1/2022 ✔