Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1002030 DEA: 020J7604 EFIS: 0219000157
QA Service Level: 1
DIST-CO-RTE-PM: 02-TRI-3-67.7/T85.06
Work Description: Tangle Blue CAPM
Location Description:
Contractor Name: Tullis, Inc
Contractor Address: 16951 Clear Creek Rd., Redding, CA 96049
Resident Engineer: Austin Henry Structure Rep.: Nicolas Jimenez
DIME Sample ID: 2026-09-23-21
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: 09/23/2026
Date that the sample was received by the laboratory/organization performing the testing: 09/23/2026
The quantity of what the sample constitutes: ONE LANE
A brief description of the sample: Bridge Deck and Approach slabs
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier: 05-0033
Structure name: Coffee Creek Overflow
The fabricator/manufacturer/facility name: JF Shea Construction
Pavement Surface Type: RSC (Rapid Strength Concrete)
Type of Traffic Control Provided: Behind K-Rail/Barrier
DIST-CO-RTE: 02-Tri-3
Direction of Travel: North
Post Mile: 67.98
Lanes to be Tested: Lane #1
Station:
DIME Test ID: 2026-09-23-21-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/07/2026
Date Tested: 10/07/2026
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: COFFEE CREEK BR OVERFLOW. INSPECTED ENTIRE BRIDGE ALL LOOKS UNIFORMED
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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0.44
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DIME Test ID: 2026-09-23-21-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 10/07/2026
Date Tested: 10/07/2026
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: INSPECTED ENTIRE APPROACH SLAB, ALL LOOKS UNIFORMED.
TESTED DEPARTURE SLAB WHICH ALSO COMPLIES WITH AN .43 AVG.
Test Result Compliance: complies
Additional Comments When Verified:
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Pavement or Bridge Deck?
|
Bridge Deck
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|
Average Coefficient of Friction
|
0.44
|
