Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994574 DEA: 050C7334 EFIS: 0518000116
QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-1-10.5/13.4
Work Description: CONSTRUCT OVERCROSSING AND AUXILIARY LANE/ Replace Capitola Ave OC + RWs and SWs
Location Description: SANTA CRUZ COUNTY IN AND NEAR CITY OF CAPITOLA FROM STATE PARK DRIVE OVERCROSSING TO 0.2 MILE NORTH OF BAY AVENUE UNDERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 580 West Beach Street, Watsonville, CA 95076
Resident Engineer: Fernando Dos Santos Structure Rep.: Daniel Dait
DIME Sample ID: 2025-11-05-20
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3675 - Monterey, Santa Cruz, San Benito
Sample Organization Contact: (805) 471-2109
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 11/05/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2025
The quantity of what the sample constitutes: MULTIPLE LANES
A brief description of the sample: Skid Test Request
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 36-0127
Structure name: Capitola OC
The fabricator/manufacturer/facility name: Granite Salinas
Pavement Surface Type: Other
Type of Traffic Control Provided: N/A
DIST-CO-RTE: 05-SCr-001
Direction of Travel:
Post Mile:
Lanes to be Tested: Lane #1,Lane #2
Station: 12.93
DIME Test ID: 2025-11-05-20-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 12/12/2025
Date Tested: 12/09/2025
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:
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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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0.36
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