DIME - Test Summary

Summary for Test 2018-05-01-5-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 212247 DEA: 010G8004 MINOR: 01A1727
DIST-CO-RTE-PM	01-MEN-1-78.0/83.5, 77.0/83.5
Award Date	01/11/2017
Closeout Date	04/12/2021
Work Description	Major Damage Restoration
Location Description	In Mendocino County near West port from 0.3 mile south of Wages Creek Bridge #10-137 to Solider Point Viaduct #10-271
QA Service Level	1 (Verified on 03/21/2017)

Sample Taken Date	05/01/2018	Sample Unique Key	5
Date that the sample was received by the laboratory/organization performing the testing	05/02/2018	Sample type	Quality Assurance
A brief description of the sample	Bearing Pad	The quantity of what the sample constitutes	4
From where was the sample collected	Manufacturer	First name of sampler or witnessed by	Pete
Last name of sampler or witnessed by	Etcheverry	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)	16732-1
Material/Compound/Elastomer ID	NA	Samples Representing	4
Description (size)	2.88" x 12" x 20"	Comments	Unknown
Description (Number of Shims)	6	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	NA

DIME Sample ID: 2018-05-01-5

DIME Test ID: 2018-05-01-5-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2018-05-15

Input Type: Measured

Tester's full name: Lisa Dobeck

Date of test: 05/08/2018

Result: Pass

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

Test was verified on 5/8/2018 ✔