DIME - Test Summary

Summary for Test 2016-06-21-11-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 210040 DEA: 04297624 EFIS: 0400020581 COOP: 042558
DIST-CO-RTE-PM	04-ALA-84-22.9/25.7
Award Date	09/30/2015
Closeout Date	03/12/2020
Work Description	WIDENING AND EXPRESSWAY UPGRADES
Location Description	ON ROUTE 84, FROM RUBY HILL DRIVE TO NORTH OF CONCANNON BOULEVARD
QA Service Level	1 (Verified on 11/10/2015)

Sample Taken Date	06/21/2016	Sample Unique Key	11
Date that the sample was received by the laboratory/organization performing the testing	06/23/2016	Sample type	Quality Assurance
A brief description of the sample	Bearing Pad	The quantity of what the sample constitutes	5
From where was the sample collected	Fabricator	First name of sampler or witnessed by	Corey
Last name of sampler or witnessed by	Nishioku	Title of sampler	Unknown
Telephone number of sampler	Unknown	Laboratory sample identification	Unknown
Linked DIME Sample ID	Unknown	The fabricator/manufacturer/facility name	Scougal Rubber
Transportation Laboratory (TL) Number	Unknown	Inspector Lot Number from the Transportation Laboratory (TL) Form	Unknown
Structure unique identifier	Not set	Structure name	Not set
Bid Item	Not set

Material Type	SMTL TM1 - Elastomeric Bearing Pad	Mfg. Lot Number(s)	14476 A B
Material/Compound/Elastomer ID	NA	Samples Representing	5
Description (size)	2in x 16in x 18in	Comments	Unknown
Description (Number of Shims)	4	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal
Batch Number	NA

DIME Sample ID: 2016-06-21-11

DIME Test ID: 2016-06-21-11-4

Testing Lab: CT HQ - Sacramento Structural Materials Testing Laboratory

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

Test Release Date: 2016-07-07

Input Type: Measured

Tester's full name: Glen Weldon

Date of test: 07/05/2016

Result: Pass

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

Test was verified on 7/7/2016 ✔