Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1235 DEA: 033M7304
QA Service Level: 1
DIST-CO-RTE-PM: 03-COL,YOL-VAR-VAR
Work Description: BRIDGE DECK METHACRYLATE
Location Description: COLUSA AND YOLO COUNTIES AT VARIOUS LOCATIONS
Contractor Name: BLAISDELL CONSTRUCTION INC
Contractor Address: P.O. BOX 938, ANDERSON, CA 96007-0938
Resident Engineer: PRESTON TRI Structure Rep.: JACK ROTHAUS
DIME Sample ID: 2025-03-06-15
TL Number from the TL Form:
Sample Submitted By Organization: Structures Maintenance and Investigations
Sample Organization Contact: (916) 719-0108
Type of Sample: Informational
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 03/06/2025
Date that the sample was received by the laboratory/organization performing the testing: 03/11/2025
The quantity of what the sample constitutes: Multiple Lanes
A brief description of the sample: Skid Testing Request
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier: 22-0111
Structure name: Route 16/505 Separation
The fabricator/manufacturer/facility name: Unknown
Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: N/A
DIST-CO-RTE: 03-YOL-16
Direction of Travel: East
Post Mile: 31.84
Lanes to be Tested: Shoulder,Lane #1,Lane #2
Station:
DIME Test ID: 2025-03-06-15-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 03/13/2025
Date Tested: 03/12/2025
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: Test date tentative.
Test Result Compliance: does not comply
Additional Comments When Verified:
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Pavement or Bridge Deck?
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Bridge Deck
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Average Coefficient of Friction
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0.10
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