Test 2017-07-31-4-4 (SMTL BILST-06) Summary

Project Information
Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Sample Information
Sample Taken Date7/31/2017 Sample Unique Key4
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 testing8/11/2017
Sample typeQuality Assurance A brief description of the sample.75x8x12 Bearing Pad
The quantity of what the sample constitutes2 From where was the sample collectedManufacturer
First name of sampler or witnessed byScott Last name of sampler or witnessed byLeavitt
Title of samplerQA Inspector Laboratory sample identificationUnknown
The fabricator/manufacturer/facility nameScougal Rubber Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormS28-201-17 Structure unique identifierNot set
Structure nameNot set
Material Information
Material TypeSMTL TM1 - Elastomeric Bearing Pad Mfg. Lot Number(s)16066-1
Material/Compound/Elastomer IDCP2527V55DURO Samples Representing2
Description (size).75x8x12 CommentsUnknown
Description (Number of Shims)Plain Type of Bearing PadPlain
Description (Thickness of Shims)NA Manufacturer(s)Scougal Rubber
Batch NumberUnknown
Test Details
DIME Sample ID: 2017-07-31-4
DIME Test ID: 2017-07-31-4-4
Testing Lab: CT HQ - Sacramento Structural Materials Testing Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2017-08-23
Test Results

Input Type: Measured
Tester's full name: Glen Weldon
Date of test: 08/16/2017
Result:Pass
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 08/16/2017