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Sample Record for 2024-10-24-11

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 1000225 DEA: 023J3204 EFIS: 0222000034 QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-3,36,299-Var
Work Description: BRIDGE POLYESTER CONCRETE OVERLAY & METHACRYLATE DECK SEAL.
Location Description: TRINITY COUNTY AT VARIOUS LOCATIONS
Contractor Name: Q&D CONSTRUCTION, LLC
Contractor Address: Unknown
Resident Engineer: Edward Worden Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-10-24-11
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: 10/24/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/24/2024
The quantity of what the sample constitutes: POLYESTER
A brief description of the sample: polyester
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JOB SITES

Material Information

Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: Moving Lane Closure
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested:
Station:
Test results on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2024-10-24-11-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/24/2024
Date Tested: 10/24/2024
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
General Comments for this Test: BR #05-0064
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.44

Test 2 of 3

DIME Test ID: 2024-10-24-11-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/24/2024
Date Tested: 10/24/2024
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
General Comments for this Test: BR#05-0050
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.45

Test 3 of 3

DIME Test ID: 2024-10-24-11-3
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/24/2024
Date Tested: 10/24/2024
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
General Comments for this Test: BR#05-0047
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.43