Sample Record

Owner Lab

  • CT HQ - FFS - Skid Testing

DIME Sample ID 2023-08-18-4

Project Information

Project IdentifiersProject ID: 994062
DEA: 010F5104
EFIS: 0116000015
DIST-CO-RTE-PM01-MEN,HUM-101-R106.2/T106.8
Award Date09/15/2022
Closeout Date01/22/2024
Work DescriptionSOUTH FORK EEL RIVER BRIDGE SEISMIC
Location DescriptionMENDOCINO 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
QA Service Level1 (Verified on 06/27/2022)

Sample Information

Sample Taken Date08/18/2023 Sample Unique Key4
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing08/18/2023
Sample typeAcceptance A brief description of the samplepolyester
The quantity of what the sample constitutesBRIDGE From where was the sample collectedJob Site
First name of sampler or witnessed byHARISH Last name of sampler or witnessed byThakur
Title of sampler Telephone number of sampler9152961873
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJOB SITE Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeRoadway/Bridge Surface Pavement Surface TypeNot set
Type of Traffic Control ProvidedNot set DIST-CO-RTENot set
Direction of TravelNot set Post MileNot set
Lanes to be TestedNot set StationNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-08-18-4-1CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)Harish Thakur, CT HQ - FFS - Skid Testing08/21/2023Harish Thakur
Yes
08/22/2023SOUTH 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
2023-08-18-4-2CTM 342-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)Harish Thakur, CT HQ - FFS - Skid Testing08/21/2023Harish Thakur
Yes
08/21/2023SOUTH FORK EEL RIVER- BRIDGE # 10-0218. DID WALK THROUGH AND ALL LOOKED UNIFORMED

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-08-18-4-1 CTM 342-August 2012 (Verified)
DIME Test ID: 2023-08-18-4-2 CTM 342-August 2012 (Verified)