Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 212880 DEA: 050F9704 EFIS: 0513000017
QA Service Level: 1
DIST-CO-RTE-PM: 05-MON-101-62.7
Work Description: N. SOLEDAD OH DECK REPLACEMENT
Location Description: ON RTE 101 IN MONTEREY COUNTY NEAR SOLEDAD AT THE NORTH SOLEDAD OH BRIDGE BR 44-0091L/R
Contractor Name: Graniterock Construction
Contractor Address: 5225 Hellyer Ave, Suite 220, San Jose, CA 95138
Resident Engineer: Baljinder Brar Structure Rep.: Dean Russu
DIME Sample ID: 2023-05-09-40
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: 05/09/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/09/2023
The quantity of what the sample constitutes: skid testing
A brief description of the sample: BRIDGE
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: N SOLEDAD OH
The fabricator/manufacturer/facility name: SOLEDAD
DIME Test ID: 2023-05-09-40-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 05/10/2023
Date Tested: 05/09/2023
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
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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0.45
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