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Sample Record for 2025-09-26-14

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

Project Information

Project ID: 1000139 DEA: 010L9604 EFIS: 0122000068 QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN-101,253-VAR
Work Description: POLYESTER CONCRETE OVERLAY, HMA-A, COLD PLANE ASPHALT CONCRETE. (PROJECT NAME: SOUTH AREA BRIDGE 23-24)
Location Description: MENDOCINO COUNTY AT VARIOUS LOCATIONS
Contractor Name: TPA CONSTRUCTION, INC.
Contractor Address: 1770 Booth Road, Roseville, CA 95747
Resident Engineer: Kassaye Seyoum Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2025-09-26-14
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Redwood Valley Field Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 09/26/2025
Date that the sample was received by the laboratory/organization performing the testing: 10/06/2025
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:
Structure name:
The fabricator/manufacturer/facility name: TPA Construction Inc

Material Information

Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: N/A
DIST-CO-RTE: 01-Men 101 PM 20.71
Direction of Travel: East
Post Mile:
Lanes to be Tested: Lane #1
Station:
Test results on following page(s): 9

Test Results

Test 1 of 9

DIME Test ID: 2025-09-26-14-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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: Hwy 253/101 EB
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.43

Test 2 of 9

DIME Test ID: 2025-09-26-14-3
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.38

Test 3 of 9

DIME Test ID: 2025-09-26-14-4
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.37

Test 4 of 9

DIME Test ID: 2025-09-26-14-5
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.38

Test 5 of 9

DIME Test ID: 2025-09-26-14-6
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.36

Test 6 of 9

DIME Test ID: 2025-09-26-14-7
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.43

Test 7 of 9

DIME Test ID: 2025-09-26-14-8
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.47

Test 8 of 9

DIME Test ID: 2025-09-26-14-9
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/08/2025
Date Tested: 10/06/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.43

Test 9 of 9

DIME Test ID: 2025-09-26-14-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/17/2025
Date Tested: 10/16/2025
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 Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.36