Test 2019-11-19-4-1 (SMTL BILST-06) Summary

Project Information
Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Work Description(Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location DescriptionOrange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
Sample Information
Sample Taken Date11/19/2019 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 testing11/20/2019
Sample typeQuality Assurance A brief description of the sampleBearing Pad
The quantity of what the sample constitutes1 From where was the sample collectedManufacturer
First name of sampler or witnessed byRob Last name of sampler or witnessed byAnderson
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)17783-9
Material/Compound/Elastomer IDna Samples Representing33
Description (size)5" x 18" x 22" CommentsUnknown
Description (Number of Shims)10 Type of Bearing PadSteel
Description (Thickness of Shims)14 gage Manufacturer(s)Scougal Rubber
Batch Numberna
Test Details
DIME Sample ID: 2019-11-19-4
DIME Test ID: 2019-11-19-4-1
Testing Lab: CT HQ - Sacramento Chemistry Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2019-12-04
Test Results

Input Type: Measured
Tester's full name: Rachael Chavez
Date of test: 12/04/2019
Result:Pass
General comments (publicly viewable) (Max 1000 characters):

Test was verified on 12/04/2019