DIME - Test Summary

Summary for Test 2020-08-30-3-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 213762 DEA: 032F3404 EFIS: 0300020616
DIST-CO-RTE-PM	03-PLA-49-3.1/7.5
Award Date	02/28/2019
Closeout Date	05/11/2022
Work Description	WIDEN SHOULDERS, ADD RETAINING WALLS, REPLACE MBGR, CURBS & ELECTRICAL
Location Description	PLACER COUNTY IN AND NEAR AUBURN FROM 0.1 MILE SOUTH OF ROUTE 49/80 SEPARATION TO 0.1 MILE NORTH OF DRY CREEK ROAD
QA Service Level	1 (Verified on 01/08/2019)

Sample Taken Date	08/30/2020	Sample Unique Key	3
Date that the sample was received by the laboratory/organization performing the testing	09/04/2020	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	Ismail
Last name of sampler or witnessed by	IBRAHIM	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)	19033-1R
Material/Compound/Elastomer ID	na	Samples Representing	31
Description (size)	1.15"x9"x9"	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: 2020-08-30-3

DIME Test ID: 2020-08-30-3-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2020-09-09

Input Type: Measured

Tester's full name: Rheanna Andelin

Date of test: 09/09/2020

Result: Pass

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

Test was verified on 9/9/2020 ✔