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Sample Record for 2026-05-28-3

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

Project Information

Project ID: 1002169 DEA: 051S3304 EFIS: 0524000215 QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-12.3/13.49
Work Description:
Location Description:
Contractor Name: VELARDE CONCRETE CONSTRUCTION
Contractor Address: 523 S. BRAND BLVD suite 201, SAN FERNANDO CA 91340
Resident Engineer: Alis Farag Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2026-05-28-3
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3675 - Santa Barbara 1
Sample Organization Contact: (805) 441-6932
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 05/28/2026
Date that the sample was received by the laboratory/organization performing the testing: 05/28/2026
The quantity of what the sample constitutes: Trial Slab and 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: 51-0332
Structure name: Sycamore Creek
The fabricator/manufacturer/facility name: Velarde Concrete Construction

Material Information

Pavement Surface Type: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Stationary Lane Closure
DIST-CO-RTE: 05-SB-101
Direction of Travel: South
Post Mile: 12.30
Lanes to be Tested: Shoulder
Station:
Test results on following page(s): 1

Test Results

Test

DIME Test ID: 2026-05-28-3-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 06/07/2026
Date Tested: 06/05/2026
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: VISUALLY INSPECTED ENTIRE BRIDGE, ALL LOOKS UNIFORMED. TESTED APPROACH SLAB WHICH ALSO COMPLIES-.35-.30-.40=.35 AVG
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.39