Sample Record for 2025-04-09-4
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994751 DEA: 010C5004 EFIS: 0112000292
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-36-11.3/34.6
Work Description: Project Name: Bridge Rail Replacement - 3 Bridges
Location Description: Hely Creek, Little Larabee Creek and Butte Creek Bridge.
Contractor Name: Mercer-Fraser Company
Contractor Address: 200 Dinsmore Dr, Fortuna, CA 95540
Resident Engineer: Joaquin Rodriguez Structure Rep.: Shantanu Nalawade
Sample Information
DIME Sample ID: 2025-04-09-4
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 04/09/2025
Date that the sample was received by the laboratory/organization performing the testing: 04/09/2025
The quantity of what the sample constitutes: 1 lane
A brief description of the sample: Skid Testing Request
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 04-0315
Structure name: Helly Creek
The fabricator/manufacturer/facility name: Mercer Fraser - Fortuna
Material Information
Pavement Surface Type: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Stationary Lane Closure
DIST-CO-RTE: 01-HUM-36
Direction of Travel: East
Post Mile: 11.46
Lanes to be Tested: Lane #2
Station:
Test Results
Test 1 of 2
DIME Test ID: 2025-04-09-4-2
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: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: steven.seifert@dot.ca.gov
Organization Phone: (916) 227-7287
This test has been superseded on 04/17/2025. The corrected test ID is: 2025-04-09-4-3
Reason: retested
Test 2 of 2
DIME Test ID: 2025-04-09-4-3
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.
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2025-04-09-4-1 | CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid) | 04/09/2025 | 04/11/2025 | Shantanu Nalawade | CT HQ - FFS - Skid Testing | Please let Shantanu Nalawade, SR (707-296-6324) know about the test date to make sure that the contractor has a closure on that day. | |
128700
