Sample Record for 2023-06-11-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993869 DEA: 061E1904 EFIS: 0621000224
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE,TUL-41,137,168-Var
Work Description: BRIDGE DECK SURFACING AND POLYESTER CONCRETE OVERLAY.
Location Description: FRESNO AND TULARE COUNTIES AT VARIOUS LOCATIONS
Contractor Name: Peterson Chase General Engineering
Contractor Address: 16351 Construction Circle West, Irvine, CA 92606
Resident Engineer: Fernando De Alba Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-06-11-9
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: 06/11/2023
Date that the sample was received by the laboratory/organization performing the testing: 06/11/2023
The quantity of what the sample constitutes: BRIDGE DECK
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:
Type of Traffic Control Provided:
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested:
Station:
Test Results
Test 1 of 2
DIME Test ID: 2023-06-11-9-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Submitted By Organization: CT HQ - FFS - Skid Testing
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: steven.seifert@dot.ca.gov
Organization Phone: (916) 227-7287
This test has been superseded on 06/13/2023. The corrected test ID is: 2023-06-11-9-2
Reason: corrected
Test 2 of 2
DIME Test ID: 2023-06-11-9-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 09/06/2023
Date Tested: 06/11/2023
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: VISUAL INSPECTION DONE ON APPROACH SLAB, LOOKED CONSISTENT WITH BRIDGE DECK AND NO BAD SPOTS FOUND BUT WAS TOO WET STILL TO TEST. DEPARTURE SLAB WAS NOT PLACED
The test was superseded from test ID: 2023-06-11-9-1
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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0.40
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