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Sample Record for 2023-08-22-13

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

Project Information

Project ID: 994572 DEA: 043Q5104 EFIS: 0419000219 QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-13,24,580-Var
Work Description: PLACE POLYESTER CONCRETE OVERLAY AND HMA (TYPE A).
Location Description: ALAMEDA COUNTY AT VARIOUS LOCATIONS
Contractor Name: Truesdell Corporation Of California, Inc. (Ahmad Soman)
Contractor Address: 1310 W 23rd Street, Tempe, AZ 85282
Resident Engineer: Jasmaninder "Jas" Singh Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-08-22-13
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: 08/22/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/22/2023
The quantity of what the sample constitutes: POLYESTER
A brief description of the sample: POLY 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 on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2023-08-22-13-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/28/2023
Date Tested: 08/24/2023
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: MORAGA AVE UC BRIDGE # 33-0227R. METHACRYLATE
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.45

Test 2 of 3

DIME Test ID: 2023-08-22-13-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/28/2023
Date Tested: 08/24/2023
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: MORAGA AVE UC BRIDGE # 33-0227R.POLYESTER
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.45

Test 3 of 3

DIME Test ID: 2023-08-22-13-3
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/30/2023
Date Tested: 08/28/2023
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: BRIDGE DECK TESTING-RESULTS SIMILAR TO TRIAL SLAB TESTING
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.45