Summary for Test 2021-03-02-22-4
Test performed: SMTL BILST-06Project Information
| Project Identifiers | Project ID: 214355 DEA: 120K0214 EFIS: 1214000096 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-5-12.4/14.5 |
| Award Date | 12/20/2019 |
| Closeout Date | Not set |
| Work Description | South 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 Description | ORANGE 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 |
| QA Service Level | 1 (Verified on 10/31/2019) |
Sample Information
| Sample Taken Date | 03/02/2021 | Sample Unique Key | 22 |
|---|---|---|---|
| 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 testing | 03/05/2021 |
| Sample type | Quality Assurance | A brief description of the sample | Bearing Pad |
| The quantity of what the sample constitutes | 8 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Brad | Last name of sampler or witnessed by | Streeter |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Scougal Rubber | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | SMTL TM1 - Elastomeric Bearing Pad | Mfg. Lot Number(s) | 19370-3 |
|---|---|---|---|
| Material/Compound/Elastomer ID | na | Samples Representing | 390 |
| Description (size) | 1"x4"x6" | Comments | |
| Description (Number of Shims) | 2 | Type of Bearing Pad | Steel |
| Description (Thickness of Shims) | 14 gage | Manufacturer(s) | Scougal Rubber |
| Batch Number | na |
Test Details
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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 3/24/2021 ✔