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Sample Record for 2024-08-06-36

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

Project Information

Project ID: 1000079 DEA: 051Q1704 EFIS: 0522000178 QA Service Level: 1
DIST-CO-RTE-PM: 05-MON,SLO-1,41,46,58,101-Var
Work Description: BRIDGE DECK REPAIRS, POLYESTER CONCRETE OVERLAYS, AND PLACING HMA.
Location Description: MONTEREY AND SAN LUIS OBISPO COUNTIES AT VARIOUS LOCATIONS
Contractor Name: VELARDE CONCRETE CONSTRUCTION, INC.
Contractor Address: 523 SOUTH BRAND BOULEVARD, SAN FERNANDO, CA 91340
Resident Engineer: Hassan Iman Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2024-08-06-36
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - FFS - Skid Testing
Sample Organization Contact: (916) 227-7287
Type of Sample: Acceptance
Type of Material: Roadway/Bridge Surface
Sample Taken Date: 08/06/2024
Date that the sample was received by the laboratory/organization performing the testing: 08/06/2024
The quantity of what the sample constitutes: POLY
A brief description of the sample: POLY
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: Stationary Lane Closure
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: 2024-08-06-36-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/13/2024
Date Tested: 08/06/2024
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: LITTLE PICO CREEK BR#49-0048
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.49

Test 2 of 2

DIME Test ID: 2024-08-06-36-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 09/04/2024
Date Tested: 09/04/2024
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 RAMON RD OC
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.46