Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1001025 DEA: 023J3304 EFIS: 0222000035
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA,TEH-5,44,273-Var
Work Description: FURNISH AND PLACE POLYESTER CONCRETE OVERLAY AND REPLACE JOINT SEALS.
Location Description: SHASTA AND TEHAMA COUNTIES AT VARIOUS LOCATIONS
Contractor Name: MCCUEN CONSTRUCTION, INC.
Contractor Address: 3132 thunder valley ct. ste 300, lincoln CA 95648
Resident Engineer: Nathan Alexander Structure Rep.: Chris Brace
DIME Sample ID: 2026-07-02-7
TL Number from the TL Form:
Sample Submitted By Organization: CT D02 - Redding Construction Laboratory
Sample Organization Contact: (530) 949-7937
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 07/02/2026
Date that the sample was received by the laboratory/organization performing the testing: 07/02/2026
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: 06-0038R
Structure name: North Cottonwood
The fabricator/manufacturer/facility name: McCuen Construction
Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: Moving Lane Closure
DIST-CO-RTE: 02-Sha-5
Direction of Travel: South
Post Mile:
Lanes to be Tested: Lane #1,Lane #2
Station: 1.91
DIME Test ID: 2026-07-02-7-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 07/08/2026
Date Tested: 07/07/2026
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: TEST REPRESENTS BR #06-0038R
Test Result Compliance: does not comply
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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0.28
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DIME Test ID: 2026-07-02-7-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 07/08/2026
Date Tested: 07/08/2026
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: BR#06-0189 COMPLIES AS DOES BR#0213 WHICH RECEIVED AN .37AVG.
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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0.45
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