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Sample Record for 2024-04-25-22

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

Project Information

Project ID: 995032 DEA: 023J0304 EFIS: 0221000165 QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH-5-R12.2
Work Description: EPOXY AND POLYESTER CONCRETE OVERLAYS, HMA, & STRIPING. INCLUDES E-CHEM EPC.
Location Description: TEHAMA COUNTY NEAR CORNING AT THOMES CREEK BRIDGE NO. 08-0165
Contractor Name: GOLDEN STATE BRIDGE, INC.
Contractor Address: 3701 Mallard Drive, Benicia, CA 94510
Resident Engineer: Shookie Alawar Structure Rep.: Eric Chaffee

Sample Information

DIME Sample ID: 2024-04-25-22
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: 04/25/2024
Date that the sample was received by the laboratory/organization performing the testing: 04/25/2024
The quantity of what the sample constitutes: JOB SITE
A brief description of the sample: POLYESTER
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: Polyester Concrete
Type of Traffic Control Provided: Moving Lane Closure
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested:
Station:
Test results on following page(s): 8

Test Results

Test 1 of 8

DIME Test ID: 2024-04-25-22-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE/SB
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 2 of 8

DIME Test ID: 2024-04-25-22-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 SB APPROACH
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 3 of 8

DIME Test ID: 2024-04-25-22-3
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 SB DEPARTURE
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 4 of 8

DIME Test ID: 2024-04-25-22-4
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 NB APPROACH
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 5 of 8

DIME Test ID: 2024-04-25-22-5
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 NB BRIDGE
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 6 of 8

DIME Test ID: 2024-04-25-22-6
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 NB DEPARTURE
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 7 of 8

DIME Test ID: 2024-04-25-22-7
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 SB PART 2
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50

Test 8 of 8

DIME Test ID: 2024-04-25-22-8
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 04/26/2024
Date Tested: 04/26/2024
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: THOMES CREEK BRIDGE NO. 08-0165 NB PART 2
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.50