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Sample Record for 2023-08-18-4

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Project Information

Project ID: 994062 DEA: 010F5104 EFIS: 0116000015 QA Service Level: 1
DIST-CO-RTE-PM: 01-MEN,HUM-101-R106.2/T106.8
Work Description: SOUTH FORK EEL RIVER BRIDGE SEISMIC
Location Description: MENDOCINO AND HUMBOLDT COUNTIES NEAR COOKS VALLEY FROM 0.4 MILE SOUTH OF SOUTH FORK EEL RIVER BRIDGE TO 0.1 MILE NORTH OF ROUTE 271
Contractor Name: J.F. SHEA CONSTRUCTION, INC.
Contractor Address: 667 BREA CANYON ROAD, SUITE 3, WALNUT CA 91789
Resident Engineer: Joaquin Rodriguez Structure Rep.: George Moore

Sample Information

DIME Sample ID: 2023-08-18-4
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: 08/18/2023
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2023
The quantity of what the sample constitutes: BRIDGE
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 on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2023-08-18-4-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 08/22/2023
Date Tested: 08/21/2023
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: SOUTH FORK EEL RIVER-BRIDGE # 10-0218. DID WALK THROUGH AND ALL LOOKED UNIFORMED. WAS POTHOLE SIZE HOLE ON LIVE TRAFFIC LANE, INSPECTOR WAS AWARE OF IT
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.41

Test 2 of 2

DIME Test ID: 2023-08-18-4-2
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: 08/21/2023
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: SOUTH FORK EEL RIVER- BRIDGE # 10-0218. DID WALK THROUGH AND ALL LOOKED UNIFORMED
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.43