DIME - Test Summary

Summary for Test 2022-12-13-39-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 993424 DEA: 04281204 EFIS: 0400000769
DIST-CO-RTE-PM	04-NAP-29,221-5.5/6.7,0.0/0.2
Award Date	03/21/2022
Closeout Date	Not set
Work Description	HMA, RDWY EXCAVATION, STRUCTURAL CONC AND MODIFYING LIGHTING SYSTEMS.
Location Description	NAPA COUNTY NEAR NAPA ON ROUTE 29 FROM 0.7 MILE SOUTH TO 0.5 MILE NORTH OF ROUTE 221 AND ON ROUTE 221 FROM 0.2 MILE NORTH OF ROUTE 29 TO ROUTE 29
QA Service Level	1 (Verified on 12/08/2021)

Sample Taken Date	12/13/2022	Sample Unique Key	39
Date that the sample was received by the laboratory/organization performing the testing	12/14/2022	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	Fabricator	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 Corp
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)	22331-1
Material/Compound/Elastomer ID	NA	Samples Representing	1
Description (size)	4x14x16	Comments
Description (Number of Shims)	8	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	NA

DIME Sample ID: 2022-12-13-39

DIME Test ID: 2022-12-13-39-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2022-12-20

Input Type: Measured

Tester's full name: Rachael Chavez

Date of test: 12/20/2022

Result: Pass

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

Test was verified on 12/20/2022 ✔