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Testing Report for 2020-12-14-12-4

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: 080C2514
EFIS: 0816000076
Project ID: 212112
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-10-0.0/13.2
Work Description: Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location Description: LA/SBD County Line to PM 13.2 near I-15
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Matt Antonelli
Structure Rep.: Faisal Zahlout

Sample Information

DIME Sample ID: 2020-12-14-12
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Sample Organization Contact: (916) 227-7253
Type of Sample: Quality Assurance
Type of Material: SMTL TM1 - Elastomeric Bearing Pad
Sample Taken Date: 12/14/2020
Date that the sample was received by the laboratory/organization performing the testing: 12/15/2020
The quantity of what the sample constitutes: 17
A brief description of the sample: Bearing Pad
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Scougal Rubber

Material Information

Mfg. Lot Number(s): 19414-10
Material/Compound/Elastomer ID: NA
Samples Representing: 1
Description (size): 4.03" x 12" x 24"
Comments:
Description (Number of Shims): 7
Type of Bearing Pad: Steel
Description (Thickness of Shims): 14 gage
Manufacturer(s): Scougal Rubber
Batch Number: NA

Test Information

DIME Test ID: 2020-12-14-12-4
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Date Tested: 1/8/2021
Verified Date: 1/8/2021
Submitted By Organization: CT HQ - Sacramento Chemistry Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: lisa.dobeck@dot.ca.gov
Organization Phone: (916) 227-7919
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified :

Submitted Test Results

Result: Pass