DIME - Test Summary

Summary for Test 2020-09-24-12-5

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 214784 DEA: 023H8104 EFIS: 0218000036
DIST-CO-RTE-PM	02-LAS,PLU-36,70,89,395-VAR
Award Date	05/06/2020
Closeout Date	08/04/2022
Work Description	PAINT BRIDGE STEEL, SEAL AND OVERLAY DECKS AND REPLACE BEARINGS.
Location Description	LASSEN AND PLUMAS COUNTIES AT VARIOUS LOCATIONS
QA Service Level	1 (Verified on 03/20/2020)

Sample Taken Date	09/24/2020	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	09/28/2020
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	Ismail	Last name of sampler or witnessed by	Ibrahim
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)	19002-1
Material/Compound/Elastomer ID	NA	Samples Representing	1
Description (size)	2.3" x 8" x 8"	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: 2020-09-24-12

DIME Test ID: 2020-09-24-12-5

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

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

Test Release Date: 2020-09-30

Input Type: Measured

Tester's full name: Rheanna Andelin

Date of test: 09/30/2020

Result: Pass

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

Test was verified on 9/30/2020 ✔