DIME - Test Summary

Summary for Test 2016-09-28-11-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 211383 DEA: 010E5704 EFIS: 0114000102
DIST-CO-RTE-PM	01-HUM-101,299-VAR
Award Date	06/08/2016
Closeout Date	06/28/2017
Work Description	BRIDGE REPAIR
Location Description	HUMBOLDT COUNTY AT VARIOUS LOCATIONS
QA Service Level	1 (Verified on 09/26/2016)

Sample Taken Date	09/28/2016	Sample Unique Key	11
Date that the sample was received by the laboratory/organization performing the testing	10/03/2016	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	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	NA	Inspector Lot Number from the Transportation Laboratory (TL) Form	NA
Structure unique identifier	Not set	Structure name	Not set
Bid Item	Not set

Material Type	SMTL TM1 - Elastomeric Bearing Pad	Mfg. Lot Number(s)	15196-1
Material/Compound/Elastomer ID	NA	Samples Representing	7
Description (size)	2.3" x 16" x 20"	Comments	Unknown
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: 2016-09-28-11

DIME Test ID: 2016-09-28-11-4

Testing Lab: CT HQ - Sacramento Structural Materials Testing Laboratory

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

Test Release Date: 2016-10-12

Input Type: Measured

Tester's full name: Fred Saylor

Date of test: 10/11/2016

Result: Pass

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

Test was verified on 10/12/2016 ✔