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Sample Record for 2023-12-05-17

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

Project Information

Project ID: 994639 DEA: 032G5504 EFIS: 0321000238 QA Service Level: 1
DIST-CO-RTE-PM: 03-BUT,COL,GLE-5,32,99,149,162-VAR
Work Description: PLACE AND FURNISH POLYESTER CONCRETE AND REPLACE JOINT SEALS.
Location Description: BUTTE, COLUSA, AND GLENN COUNTIES AT VARIOUS LOCATIONS
Contractor Name: AMERICAN CIVIL CONSTRUCTORS WEST COAST LLC
Contractor Address: 2990 Bay Vista Court, Ste D, Benicia, CA 94510
Resident Engineer: Matt Crete Structure Rep.: Adam Scardaci

Sample Information

DIME Sample ID: 2023-12-05-17
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: 12/05/2023
Date that the sample was received by the laboratory/organization performing the testing: 12/05/2023
The quantity of what the sample constitutes: BRIDGE DECK
A brief description of the sample: BRIDGE DECK
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: Methacrylate Resin
Type of Traffic Control Provided: Behind K-Rail/Barrier
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: 2023-12-05-17-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 12/08/2023
Date Tested: 12/08/2023
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: CLEAR CREEK/12-0073L
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: 2023-12-05-17-2
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 12/08/2023
Date Tested: 12/08/2023
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: COUNTY RD 35 OC/11-0062
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.40

Test 3 of 3

DIME Test ID: 2023-12-05-17-3
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 12/08/2023
Date Tested: 12/08/2023
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: COUNTY RD 35 OC/11-0062 WB
Test Result Compliance: complies
Additional Comments When Verified:
Pavement or Bridge Deck? Bridge Deck
Average Coefficient of Friction 0.41