Summary for Test 2021-08-16-19-4
Test performed: SMTL BILST-06Project Information
| Project Identifiers | Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-3-38.0/38.6 |
| Award Date | 04/05/2021 |
| Closeout Date | 08/14/2023 |
| Work Description | BRIDGE REPLACEMENT |
| Location Description | SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD |
| QA Service Level | 1 (Verified on 01/19/2021) |
Sample Information
| Sample Taken Date | 08/16/2021 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 | 08/19/2021 |
| Sample type | Quality Assurance | A brief description of the sample | bearing pad |
| The quantity of what the sample constitutes | 1 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Patrick | Last name of sampler or witnessed by | Loomis |
| 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) | 20539-1 |
|---|---|---|---|
| Material/Compound/Elastomer ID | na | Samples Representing | 21 |
| Description (size) | 2.3"x12"x14" | Comments | |
| Description (Number of Shims) | 4 | 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: 2021-08-16-19
DIME Test ID: 2021-08-16-19-4
Testing Lab: CT HQ - Sacramento Chemistry Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2021-08-27
Test Results
Input Type: Calculated
Tester's full name: Mariano Pontillas
Date of test: 08/27/2021
Result: Pass
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 8/27/2021 ✔