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Sample Record for 2023-12-05-18

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

Project Information

Project ID: 994248 DEA: 051K1204 EFIS: 0518000125 QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR-9-1.0,4.0
Work Description: CONSTRUCT SIDEHILL VIADUCTS.
Location Description: SANTA CRUZ COUNTY AT 0.5 MILE NORTH OF VERNON STREET AND AT 0.8 MILE SOUTH OF GLENGARRY ROAD
Contractor Name: GORDON N BALL INC
Contractor Address: 333 CAMILLE AVENUE, ALAMO, CA 94507
Resident Engineer: Farshad Keshavarzi Structure Rep.: James Wilcenski

Sample Information

DIME Sample ID: 2023-12-05-18
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: 12/05/2023
Date that the sample was received by the laboratory/organization performing the testing: 12/05/2023
The quantity of what the sample constitutes: BRIDGE DECK
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: PCC (Portland Cement Concrete)
Type of Traffic Control Provided: Behind K-Rail/Barrier
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested:
Station:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-12-05-18-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 01/25/2024
Date Tested: 01/23/2024
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: SAN LORENZO RIVER/36-0129
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.44

Test 2 of 2

DIME Test ID: 2023-12-05-18-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 01/25/2024
Date Tested: 01/23/2024
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: FELTON SIDEHILL VIADUCT
Test Result Compliance:
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.47