Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000365 DEA: 033H9014 EFIS: 0323000075
QA Service Level: 1
DIST-CO-RTE-PM: 03-SOL,YOL-50,80,113-Var
Work Description: HMA, RHMA, SIGN STRUCTURE, CAMERA SYSTEMS, & FO CABLE SYSTEMS.
Location Description: SOLANO AND YOLO COUNTIES AT VARIOUS LOCATIONS
Contractor Name: DESILVA GATES CONSTRUCTION, LLC
Contractor Address: 3855 North Freeway Boulevard, Suite 100, Sacramento, CA 95834
Resident Engineer: TJ Tullo Structure Rep.: Michael Charak
DIME Sample ID: 2026-08-18-15
TL Number from the TL Form:
Sample Submitted By Organization: CT D11 - South County/Trade Corridor Field Office
Sample Organization Contact: 6197607875
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 08/18/2026
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2026
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: 23-0156R
Structure name: South Davis OH
The fabricator/manufacturer/facility name: DeSilva Gates
Pavement Surface Type: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Behind K-Rail/Barrier
DIST-CO-RTE: 04-sol-80
Direction of Travel: East
Post Mile: 43.96
Lanes to be Tested: Lane #6
Station:
DIME Test ID: 2026-08-18-15-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/28/2026
Date Tested: 08/26/2026
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: DEPARTURE SLAB ALSO COMPLIES: .45/.43/.50=.46 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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0.37
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