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Testing Report for 2017-04-27-5-4

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

Project Information

DEA: 072159U4
EFIS: 0715000160
Project ID: 211260
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: George Saker
Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2017-04-27-5
TL Number from the TL Form: C925885
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: 4/27/2017
Date that the sample was received by the laboratory/organization performing the testing: 5/3/2017
The quantity of what the sample constitutes: 4
A brief description of the sample: Bearing Pad
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Scougal Rubber

Material Information

Mfg. Lot Number(s): 15538-2, 3, 4, 5, 6, 7, 8, 16
Material/Compound/Elastomer ID: NA
Samples Representing: 4
Description (size): Various Size
Comments: Unknown
Description (Number of Shims): 4 - 8
Type of Bearing Pad: Steel
Description (Thickness of Shims): 14 gage
Manufacturer(s): Scougal Rubber
Batch Number: NA

Test Information

DIME Test ID: 2017-04-27-5-4
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Date Tested: 5/9/2017
Verified Date: 5/11/2017
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: paul.lukkarila@dot.ca.gov
Organization Phone: (916) 227-7253
General Comments for this Test:
Test Result Compliance: complies
Additional Comments When Verified :

Submitted Test Results

Result: Pass