DIME - Test Summary

Summary for Test 2023-05-22-62-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 994209 DEA: 010E7904 EFIS: 0115000021
DIST-CO-RTE-PM	01-HUM-254-4.2/4.2
Award Date	12/13/2022
Closeout Date	Not set
Work Description	Project Name: Fish Creek Bridge (Bridge No. 04-0317)
Location Description	HUMBOLDT COUNTY NEAR PHILLIPSVILLE AT 3.3 MILES NORTH OF OHMAN CREEK BRIDGE
QA Service Level	1 (Verified on 09/09/2022)

Sample Taken Date	05/22/2023	Sample Unique Key	62
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	05/31/2023
Sample type	Quality Assurance	A brief description of the sample	Bearing Pad
The quantity of what the sample constitutes	17	From where was the sample collected	Manufacturer
First name of sampler or witnessed by	Krishnamoorthy	Last name of sampler or witnessed by	Palaniappan
Title of sampler		Telephone number of sampler
Laboratory sample identification		Linked DIME Sample ID
The fabricator/manufacturer/facility name	Bridge Rubber Bearing	Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Type	SMTL TM1 - Elastomeric Bearing Pad	Mfg. Lot Number(s)	2527-8
Material/Compound/Elastomer ID	NA	Samples Representing	17
Description (size)	1" x 4" x 6"	Comments
Description (Number of Shims)	0	Type of Bearing Pad	Plain
Description (Thickness of Shims)	NA	Manufacturer(s)	Bridge Rubber Bearing
Batch Number	133213

DIME Sample ID: 2023-05-22-62

DIME Test ID: 2023-05-22-62-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test

Test Release Date: 2023-06-06

Input Type: Measured

Tester's full name: Richard Wilmshurst

Date of test: 06/06/2023

Result: Pass

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 6/6/2023 ✔