Summary for Test 2023-05-04-12-4
Test performed: SMTL BILST-06Project Information
| Project Identifiers | Project ID: 994443 DEA: 053307C4 EFIS: 0514000028 |
|---|---|
| DIST-CO-RTE-PM | 05-SLO-41,46-44.5/45.3,54.0/57.8 |
| Award Date | 02/27/2023 |
| Closeout Date | Not set |
| Work Description | Wye Segment - Route 41/46 Separation |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 12/16/2022) |
Sample Information
| Sample Taken Date | 05/04/2023 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 05/08/2023 |
| Sample type | Quality Assurance | A brief description of the sample | Bearing Pad |
| The quantity of what the sample constitutes | 23 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Ahsan | Last name of sampler or witnessed by | Ativalu |
| 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) | 22863-1 |
|---|---|---|---|
| Material/Compound/Elastomer ID | NA | Samples Representing | 23 |
| Description (size) | 3.5" x 18" x 24" | Comments | |
| Description (Number of Shims) | 7 | 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: 2023-05-04-12
DIME Test ID: 2023-05-04-12-4
Testing Lab: CT HQ - Sacramento Chemistry Laboratory
Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test
Test Release Date: 2023-05-18
Test Results
Input Type: Measured
Tester's full name: Kirolos Kelada
Date of test: 05/18/2023
Result: Pass
General comments (publicly viewable) (Max 1000 characters):
Test was verified on 5/18/2023 ✔