Summary for Test 2021-04-26-1-4
Test performed: SMTL BILST-06Project Information
| Project Identifiers | Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-8.4 |
| Award Date | 11/30/2020 |
| Closeout Date | 12/12/2023 |
| Work Description | CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 11/06/2020) |
Sample Information
| Sample Taken Date | 04/26/2021 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 05/03/2021 |
| Sample type | Quality Assurance | A brief description of the sample | 1 sample |
| The quantity of what the sample constitutes | 1 sample/lot | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Rommoney | Last name of sampler or witnessed by | Wu |
| Title of sampler | MR | Telephone number of sampler | 9164257894 |
| 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) | 19868-4 |
|---|---|---|---|
| Material/Compound/Elastomer ID | unkwn | Samples Representing | 3 |
| Description (size) | 9x9x2.88 | Comments | |
| Description (Number of Shims) | 5 | Type of Bearing Pad | Steel |
| Description (Thickness of Shims) | 14 gage | Manufacturer(s) | scougal |
| Batch Number | 102820 |
Test Details
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DIME Sample ID: 2021-04-26-1
DIME Test ID: 2021-04-26-1-4
Testing Lab: CT HQ - Sacramento Chemistry Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2021-05-12
Test Results
Input Type: Measured
Tester's full name: Kirolos Kelada
Date of test: 05/12/2021
Result: Pass
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 5/12/2021 ✔