Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994732 DEA: 043Q5004 EFIS: 0419000218
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-580,980-Var
Work Description: POLYESTER CONCRETE OVERLAY, HMA (TYPE A), & SOIL DENSIFICATION.
Location Description: ALAMEDA COUNTY AT VARIOUS LOCATIONS
Contractor Name: MYERS & SONS CONSTRUCTION, LLC /Francisco Castillo
Contractor Address: Myers and Sons Construction, LLC 45 Morrison Ave., Sacramento, CA 95838
Resident Engineer: Jasmaninder (Jas) Singh Structure Rep.: Unknown
DIME Sample ID: 2024-03-14-32
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: 03/14/2024
Date that the sample was received by the laboratory/organization performing the testing: 03/14/2024
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
Pavement Surface Type: Polyester Concrete
Type of Traffic Control Provided: Stationary Lane Closure
DIST-CO-RTE:
Direction of Travel:
Post Mile:
Lanes to be Tested: Lane #4
Station:
DIME Test ID: 2024-03-14-32-1
Test Method: CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Verified Date: 03/15/2024
Date Tested: 03/14/2024
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: LOCATION 1 580 WB
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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