DIME - Test Summary

Summary for Test 2023-05-04-11-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 994116 DEA: 010J4104 EFIS: 0119000025
DIST-CO-RTE-PM	01-HUM-299-30.7/33.4
Award Date	11/23/2022
Closeout Date	Not set
Work Description	Project Name: HUM-299 Curve Improvement
Location Description	HUMBOLDT COUNTY NEAR WILLOW CREEK FROM 0.1 MILE EAST OF CEDAR CREEK ROAD TO 0.1 MILE EAST OF EAST FORK WILLOW CREEK BRIDGE
QA Service Level	1 (Verified on 07/29/2022)

Sample Taken Date	05/04/2023	Sample Unique Key	11
Date that the sample was received by the laboratory/organization performing the testing	05/08/2023	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	Manufacturer	First name of sampler or witnessed by	Ahsan
Last name of sampler or witnessed by	Ativalu	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)	22937-1
Material/Compound/Elastomer ID	NA	Samples Representing	5
Description (size)	1" x 8" x 12"	Comments
Description (Number of Shims)	2	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	NA

DIME Sample ID: 2023-05-04-11

DIME Test ID: 2023-05-04-11-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2023-05-18

Input Type: Measured

Tester's full name: Kirolos Kelada

Date of test: 05/18/2023

Result: Pass

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

Test was verified on 5/18/2023 ✔