DIME - Test Summary

Summary for Test 2023-08-31-41-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 214830 DEA: 043G6304 EFIS: 0412000409
DIST-CO-RTE-PM	04-SCL-4-SCl-9 -4.75/4.9
Award Date	11/08/2022
Closeout Date	Not set
Work Description	Saratoga Creek Bridge Rehabilitation Project
Location Description	San Jose - Saratoga Creek
QA Service Level	1 (Verified on 11/09/2020)

Sample Taken Date	08/31/2023	Sample Unique Key	41
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	09/05/2023
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	William	Last name of sampler or witnessed by	Shanklin
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 Type	SMTL TM1 - Elastomeric Bearing Pad	Mfg. Lot Number(s)	23243-1
Material/Compound/Elastomer ID	NA	Samples Representing	1
Description (size)	2.3" x 8" x 15"	Comments
Description (Number of Shims)	4	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	NA

DIME Sample ID: 2023-08-31-41

DIME Test ID: 2023-08-31-41-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2023-09-21

Input Type: Measured

Tester's full name: Adam Herrera

Date of test: 09/21/2023

Result: Pass

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

Test was verified on 9/21/2023 ✔