Sample Record for 2023-07-10-28
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215453 DEA: 051M3904 EFIS: 0519000140
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON,SBT,SCR-1,9,17,68,101,129,146,156,183,-var
Work Description: TREAT BRIDGE DECKS WITH METHACRYLATE & PLACE POLYESTER CONC OVERLAYS.
Location Description: MONTEREY, SAN BENITO AND SANTA CRUZ COUNTIES AT VARIOUS LOCATIONS
Contractor Name: PETERSON-CHASE GENERAL ENGINEERING CONSTRUCTION, INC.
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Farshad Keshavarzi Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-07-10-28
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - FFS - Skid Testing
Sample Organization Contact: (916) 227-7287
Type of Sample: Department Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 07/10/2023
Date that the sample was received by the laboratory/organization performing the testing: 07/10/2023
The quantity of what the sample constitutes: job site
A brief description of the sample: bridge deck
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: job site
Material Information
Pavement Surface Type:
Type of Traffic Control Provided:
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested:
Station:
Test Results
Test 1 of 2
DIME Test ID: 2023-07-10-28-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Submitted By Organization: CT HQ - FFS - Skid Testing
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: steven.seifert@dot.ca.gov
Organization Phone: (916) 227-7287
This test has been superseded on 07/18/2023.
Reason: corrected
Test 2 of 2
DIME Test ID: 2023-07-10-28-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 07/18/2023
Date Tested: 07/16/2023
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: These results are for this project, the prior results are for the Beach Rd UC,
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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0.50
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