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Sample Record for 2023-08-02-24

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Project Information

Project ID: 993717 DEA: 021J8304 EFIS: 0220000148 QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA,TEH-5,36,44-VAR
Work Description: REINF STRUCTURAL CONC BRIDGE, APPROACH SLAB & POLYESTER CONC OVERLAY.
Location Description: SHASTA AND TEHAMA COUNTIES AT VARIOUS LOCATIONS
Contractor Name: MYERS AND SONS CONSTRUCTION, LLC
Contractor Address: 45 Morrison Ave, Sacramento, CA 95838
Resident Engineer: Joel Gasik Structure Rep.: Eric Chaffee

Sample Information

DIME Sample ID: 2023-08-02-24
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: 08/02/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/02/2023
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: AT THE 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 on following page(s): 3

Test Results

Test 1 of 3

DIME Test ID: 2023-08-02-24-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/04/2023
Date Tested: 08/02/2023
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: COW CREEK BRIDGE #06-0152 APPROACH SLAB. VISUALLY INSPECTED WB AND NO ISSUES SPOTTED AND LOOKS AS GOOD AS EB
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.43

Test 2 of 3

DIME Test ID: 2023-08-02-24-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/04/2023
Date Tested: 08/02/2023
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: COW CREEK BRIDGE #06-0152 BRIDGE, VISUALLY INSPECTED WB AND NO ISSUES SPOTTED AND LOOKS AS GOOD AS EB
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.44

Test 3 of 3

DIME Test ID: 2023-08-02-24-3
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/04/2023
Date Tested: 08/02/2023
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: COW CREEK BRIDGE #06-0152 DEPARTURE, VISUALLY INSPECTED WB AND NO ISSUES SPOTTED AND LOOKS AS GOOD AS EB
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.42