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Testing Report for 2017-07-21-3-4

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

Project Information

DEA: 010H0304
EFIS: 0117000087
Project ID: 212253
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-96-20.0/24.0
Work Description: REPAIR SLIPOUT
Location Description: IN HUMBOLDT COUNTY NEAR WEITCHPEC FROM 3.0 MILES OF KLAMATH RIVER BRIDGE #04-0144 TO 0.6 MILE EAST OF WEITCHPEC ROAD
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Heidi Quintrell
Structure Rep.: Mike McCraken

Sample Information

DIME Sample ID: 2017-07-21-3
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Bay Area Field Laboratory
Sample Organization Contact: (707) 649-5453
Type of Sample: Quality Assurance
Type of Material: SMTL TM1 - Elastomeric Bearing Pad
Sample Taken Date: 7/21/2017
Date that the sample was received by the laboratory/organization performing the testing: 7/24/2017
The quantity of what the sample constitutes: 1 lot of 43
A brief description of the sample: 1 x 8 x 12 reinforced bearing pad
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cal-Neva

Material Information

Mfg. Lot Number(s): N/A Heat 811V04180
Material/Compound/Elastomer ID: RL305502
Samples Representing: 1 lot of 43
Description (size): 1 x 8 12
Comments:
Description (Number of Shims): 2
Type of Bearing Pad: Steel
Description (Thickness of Shims): 14 gage
Manufacturer(s): Arcelormittal
Batch Number: 071017

Test Information

DIME Test ID: 2017-07-21-3-4
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Date Tested: 7/28/2017
Verified Date: 7/31/2017
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