Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 215445 DEA: 100X7504 EFIS: 1013000009
QA Service Level: 1
DIST-CO-RTE-PM: 10-ALP-4,88,89-var
Work Description: REPLACE BRIDGE RAIL, BARRIER SLAB AND GUARDRAIL.
Location Description: ALPINE COUNTY AT VARIOUS LOCATIONS
Contractor Name: BRIDGEWAY CIVIL CONSTRUCTORS, INC.
Contractor Address: 3333 Vaca Valley Parkway, Suite 2000, Vacaville, CA 95688
Resident Engineer: Pawan Garg Structure Rep.: John Cooley
DIME Sample ID: 2024-09-25-29
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - FFS - Skid Testing
Sample Organization Contact: (916) 227-7287
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 09/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/25/2024
The quantity of what the sample constitutes: POLYESTER
A brief description of the sample: Poly
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: job site
Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: Stationary Lane Closure
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested: Lane #1
Station:
DIME Test ID: 2024-09-25-29-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Submitted By Organization: CT HQ - FFS - Skid Testing
Organization Address: ,
Organization City:
Organization State:
Organization Zipcode:
Organization Email: steven.seifert@dot.ca.gov
Organization Phone: (916) 227-8588
Data has not been verified.
