Test 2021-03-02-22-4 (SMTL BILST-06) Summary

Project Information
Project IdentifiersProject ID: 214355
DEA: 120K0214
EFIS: 1214000096
DIST-CO-RTE-PM12-ORA-5-12.4/14.5
Work DescriptionSouth County Improvement Project (Phase 1 - Avery/Crown Valley) PLACE HMA, INSTALL CONC PAVEMENT, RETAIN WALL, MODIFY ELECT SYS. | Add one lane btwn 73 & Oso PKWY
Location DescriptionORANGE COUNTY IN SAN JUAN CAPISTRANO, LAGUNA HILLS, LAGUNA NIGUEL AND MISSION VIEJO FROM 0.5 MILE SOUTH OF AVERY PARKWAY UNDERCROSSING TO 0.8 MILE NORTH OF CROWN VALLEY PARKWAY OVERCROSSING
Sample Information
Sample Taken Date3/2/2021 Sample Unique Key22
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing3/5/2021
Sample typeQuality Assurance A brief description of the sampleBearing Pad
The quantity of what the sample constitutes8 From where was the sample collectedManufacturer
First name of sampler or witnessed byBrad Last name of sampler or witnessed byStreeter
Title of sampler Laboratory sample identification
The fabricator/manufacturer/facility nameScougal Rubber Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name
Material Information
Material TypeSMTL TM1 - Elastomeric Bearing Pad Mfg. Lot Number(s)19370-3
Material/Compound/Elastomer IDna Samples Representing390
Description (size)1"x4"x6" Comments
Description (Number of Shims)2 Type of Bearing PadSteel
Description (Thickness of Shims)14 gage Manufacturer(s)Scougal Rubber
Batch Numberna
Test Details
DIME Sample ID: 2021-03-02-22
DIME Test ID: 2021-03-02-22-4
Testing Lab: CT HQ - Sacramento Chemistry Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2021-03-24
Test Results

Input Type: Measured
Tester's full name: Kirolos Kelada
Date of test: 03/24/2021
Result:Pass
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 03/24/2021