Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000783 DEA: 041Q7004 EFIS: 0418000319
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-101-22.8/32.8
Work Description: REPLACE BRIDGE RAILING AND GUARDRAIL, & RECONSTRUCT SIDEWALK.
Location Description: SONOMA COUNTY AT VARIOUS LOCATIONS FROM MENDOCINO AVENUE OVERCROSSING TO LIMERICK LANE OVERCROSSING
Contractor Name: GHILOTTI CONSTRUCTION COMPANY, INC.
Contractor Address: Unknown
Resident Engineer: Leonard Brajnikoff Structure Rep.: Nick Abuhamdieh
DIME Sample ID: 2025-09-04-13
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3672 - Santa Rosa
Sample Organization Contact: (510) 774-6009
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 09/04/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2025
The quantity of what the sample constitutes: MULTIPLE LANES
A brief description of the sample: SKID TESTING REQUEST
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 20-0179
Structure name: Mendocino Avenue OC
The fabricator/manufacturer/facility name: Dees Burke
Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: Behind K-Rail/Barrier
DIST-CO-RTE: 04-SON-101
Direction of Travel: East
Post Mile:
Lanes to be Tested: Lane #1,Lane #2
Station:
DIME Test ID: 2025-09-04-13-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 09/18/2025
Date Tested: 09/18/2025
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: Mendocino Avenue OC. WB TESTED AND RESULTED IN .40 AVG
Test Result Compliance: complies
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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0.40
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