Sampling & Testing Guide-Minimum Frequency

April 21, 2020

SUPPLEMENTAL GUIDE Ė BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes October 15, 2019

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Admixture-Air Entraining

403

C. Ouyang

4103

1 pt.

DME or RCE

Approved Brand Name (Lot)

Project

Contact District Matls.

Admixture-Corrosion Inhibitor

402

4103

1 pt.

DME or RCE

Approved Brand Name (Lot)

Project

Contact District Matls.

Admixture-Retarder

403

4103

1 pt.

DME or RCE

Approved Brand Name (Lot)

Project

Contact District Matls.

Admixture-Water Reducer

403

4103

1 pt.

DME or RCE

Approved Brand Name (Lot)

Project

Contact District Matls.

Aggregates-Non-proportioned

209

B. Gossman

4110-4133

IM 301

DME/PROD.

Approved Source/Certified Truck Tickets, (Form #821278)

Source

Certified Ticket for pay items by weight

Aggregates-Proportioned

209 & 204

4110-4133

IM 301

CONTR/RCE/DME

Approved Source/Certified Truck Tickets, (Form #821278)

Source Project

 

Aluminum, Structural

 

K. Frame

4190.01

 

 

Approved Shop Drawing & Inspection Report

 

 

Anchor Bolts & Swedge Anchor

453.08

K. Frame

2522.03, E,4

4185.02, B

4187.01, C

1 bolt, nut & washer per size, per source, per year

DME

Approved Source/Test Report/Steel Mill Certifications

Project

 

Anchors, Concrete

453.09

C. Ouyang

 

 

 

Approved Brand Name

 

 

Anti-Strip Agent

491.16

C. Brakke

 

 

 

Approved Brand Name

 

 

Arrow Panels, Solar-Assisted

486.12

M. Bortle

2528.03, G

 

 

Approved Brand Name

 

 

Asphalt Binder

437

C. Brakke

4137

1 4-oz. tin

CONTR/DME

Approved Source/Certification Statement /Test Rpt.

Source Project

 

Asphalt, Cutback

437

4138

1 qt. tin

RCE

Approved Source/Certification Statement /Test Rpt.

Source

 

Asphalt, Emulsified

437

C. Brakke

4140

1 qt. bottle

RCE

Approved Source/ Certification Statement /Test Rpt.

Source

Project verification for seal coat

Attenuators, Guardrail

 

K. Frame

 

 

 

As per plan

 

 

Attenuators -see crash cushion

 

 

 

 

 

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Backer Rod for Cold Pour Joint Seal

436.04

S. Sommers

4136.02, B

 

 

Approved Brand Name

 

 

Backer Rod for Hot Pour Joint Seal

436.04

S. Sommers

4136.02, B

 

 

Approved Brand Name

 

 

Barrier Rail, Permanent Precast Concrete

571

M. Khoda

2419, 2513

 

 

Approved Source/DOT Stamp/Inspection Report/Certification Statement

Source

 

Barrier Rail, Temporary Precast Concrete

571

M. Khoda

2419, 2513

 

 

Approved Source/Fabricatorís trade mark/ Date of Manufacture

 

 

Beads, Glass (Reflective Elements)

484

S. Sommers

4184

1 Pint

 

Approved Manufacturer

 

 

Bearing, Bronze

 

K. Frame

4190.03

1/project

DME

Test Report

Project

 

Bearing, Lead

 

K. Frame

4195.01

 

 

Certification Statement

 

 

Bearing, Neoprene

495.03

S. Sommers

4195.02

1/100 plain or laminated pads

DME

Approved Brand Name

Fabricator

 

Bentonite Clay

 

C. Ouyang

2501.03, Q

 

 

Visual Approval by RCE

 

 

Bolts, Nuts & Washers, Structural

453.06B

K. Frame

4153.06

Per IM 453.06B

DME

Mill Certification/Rotational Capacity Test/Test Report per IM 453.06B

Project

 

Calcium Chloride Solution

373

S. Sommers

4194.01

4 lbs. or 1 qt.

RCE

Test by RCE

 

 

Caulking Compound

 

S. Sommers

4192

 

 

Visual Approval by RCE

 

 

Concrete, Mechanically Stabilized Earth Panels (MSE)

445.03

M. Khoda

2432

 

 

Approved Source/Certification Statement/Shop Drawing

Source

 

Concrete, Modular & Segmental Block (Dry Cast/Wet Cast)

445.04

445.05

M. Khoda

 

2419, 2430, 2431

 

 

Approved Source/Certification Statement

 

 

Concrete, Noise Wall, Precast

445.06

2436

 

 

Approved Source/Certification Statement/Shop Drawing

Source

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Concrete, Precast Box Culvert

445.02

 

2415

 

 

Approved source, Approved Shop Drawing, Fabricatorís trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

Concrete, Prestressed, Precast Units

570

 

2407

 

 

Approved Source, Fabricatorís trade mark, Date of Manufacture, DOT Inspection stamp, Inspection Report/Certification Statement

Source

 

Concrete Sealer

491.12

C. Ouyang

4139

 

 

Approved Brand Name

 

 

Conduit Ė See Lighting Matl.

 

 

 

 

 

 

 

 

Curing Matls., Burlap

 

S. Sommers

4104

 

 

Visual Approval by RCE

 

 

Curing Matls., Clear

405.07

S. Sommers

4105.07

 

 

Approved Brand Name

 

 

Curing Matls., Dark-colored

437

C. Brakke

4105.06

 

 

Approved Source

Source

 

Curing Matls., Plastic Film

 

S. Sommers

4106.01

 

 

Visual Approval by RCE

 

 

Curing Matls., White Pigmented

405

S. Sommers

4105.05

1 qt.

 

Batch (Lot) Accept

Source

 

Crash Cushion

455

S. Sommers

2551

 

 

Approved Brand Name, Certification Statement if source not clearly marked

 

 

DelineatorsĖSee Signing Matls.

 

 

 

 

 

 

 

Detectable Warning Panels

411

M. Khoda

4171

 

 

Approved Source/Certification Statement

 

 

Dowel-See Steel Reinforcement

 

 

 

 

 

 

 

Drainage Trough, Elastomeric Bridge Joints

494

S. Sommers

 

 

 

Approved Brand Name

 

 

Drains, Floor

 

K. Frame

2406.03, D

 

 

Approved Shop Drawing & Inspection Report

 

 

Drums, Channelizing

488.02

S. Sommers

4188.02

 

 

Approved Brand Name

 

 

Epoxy-coated Steel-See Steel Reinforcement

 

 

 

 

 

 

Epoxy Injection Resin

491.19

C. Ouyang

 

 

 

Approved Brand Name

 

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Erosion Control, Fertilizer

469.03

M. Serio

4169.03

 

 

Bagged: Bag label analysis.

Bulk:  Blend ticket/sheet

 

 

If material is suspect, DME will sample

 

Erosion Control, Mulch, Hydraulic

469.10

S. Sommers

4169.07

 

 

Approved Brand Name

 

 

 

Erosion Control, Mulch, Straw

 

S. Sommers

4169.07

 

 

Weed Free Certification

 

 

 

Erosion Control, Perimeter & Slope Sediment Control Devices- Wattles & Filter Socks

469.10

4169.12

 

 

Certification Statement

 

 

 

Erosion Control, Seed

469.02

4169.02

 

 

Seed Ticket Printed with Test Data (rural stabilizing)

Approved Source, seed mixture report and certification (seed mixes except rural stabilizing)

 

 

 

Erosion Control, Silt Fence Fabric

496.01

4196.01

 

 

Approved Brand Name

 

 

 

Erosion Control, Silt Fence Wire & Posts

 

 

 

 

Visual Approval by RCE

 

 

 

Erosion Control, Sod

 

S. Sommers

4169.06

 

 

Visual Approval by RCE

 

 

 

Erosion Control, Sod Stakes

 

S. Sommers

4169.09

 

 

Visual Approval by RCE

 

 

 

Erosion Control, Sticking Agent

 

S. Sommers

4169.05

 

 

Seed Manufacturing Recommendation

 

 

 

Erosion Control, Wire Staples

 

S. Sommers

4169.10, A

 

 

Visual Approval by RCE

 

 

 

Erosion Control Mats

469.10

S. Sommers

4169.10

 

 

Approved Brand Name

 

 

 

Expansion Device, Steel

 

K. Frame

4152.02

 

 

Approved Shop Drawing & Inspection Report

 

 

 

Expansion Tube

 

K. Frame

4191.01, B

 

 

Visual Approval by RCE

 

 

 

Fence, Chain Link Fabric

454.10

 

4154.03

 

 

Approved Source/ Certification Statement

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Fence, Chain Link Fittings

 

 

4154.11

 

 

Certification Statement

 

 

Fence, Chain Link Posts, Braces, & Rails

454.10

 

4154.10

 

 

Approved Source/ Certification Statement

 

 

Fence, Field Fence Fabric

454.10

 

4154.02

 

 

Certification Statement

 

 

Fence, Gate

 

4154.12

 

 

Certification Statement

 

 

Fence, Orange Mesh Safety

488.03

S. Sommers

4188.03

 

 

Approved Brand Name

 

 

Fence, Silt-See Erosion Control

 

 

 

 

 

 

 

 

Fence, Staples

 

M. Khoda

4154.06

 

 

Visual Approval by RCE

 

 

Fence, Steel Line Posts and Braces

454.10

4154.08 &4154.09

 

 

Approved Source/ Certification Statement

 

 

Fence, Wood Fence Post

462

C. Ouyang

4154.07

 

 

Approved Source/Certification of Grade/Certified Treatment Test Report

 

 

Fertilizer-See Erosion Control

 

 

 

 

 

 

 

Fly Ash

491.17

C. Ouyang

4108

15 lbs.

DME

Approved Source/ Certification Statement

Project Source

Verification on paving only

Galvanized Items

410.01

K. Frame

4100.07

 

DME

Test Report per IM 410.01/Certification Statement

Project

 

GGBFS

491.14

C. Ouyang

4108.02

 

DME

Approved Source/ Certification Statement

Source Project

 

Grating (Aluminum)

 

K. Frame

4187.01, A

 

 

Approved Shop Drawing & Inspection Report

 

 

Grout, Hydraulic Cement

491.13

C. Ouyang

 

 

 

Approved Brand Name

 

 

Grout, Polymer

491.11

C. Ouyang

 

 

 

Approved Brand Name

 

 

Guardrail, High Tension Cable

455.01

J. De Vries

2505.03, B

 

 

Approved Source/ Certification Statement

 

 

Guardrail, Formed Steel Beam and Terminals

455.02

J. De Vries

4155.02

 

 

Approved Source

 

 

Guardrail, Steel Posts

455.02

J. De Vries

4155.05

 

 

Approved Source/ Mill Test Report

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Guardrail, Wood Posts

462

C. Ouyang

4155.04

 

 

Approved Source/Certification of Grade/Certified Treatment Test Report

 

 

Iron Castings, Utility Access Covers, etc.

453.04

K. Frame

4149, 4153.04

 

 

Certification Statement & Proper Identification Imprint

 

 

Iron Castings, Utility Access Adjustment Rings

449.05

4149, 4153.04

 

 

Approved Source/Certification Statement

 

 

Iron Bridge Rockers

 

4153.04

 

 

Approved Shop Drawing & Inspection Report

 

 

Joint Filler, Flexible Foam-Type CF & EF Joints

436.05

S. Sommers

4136.03, B 4136.03, D

 

 

Approved Brand Name

 

 

Joint Filler, Type E Joint

436.03

4136.03, A

 

 

Approved Brand Name

 

 

Joint Filler, Bituminous

436.03

4136.03, A

 

 

Approved Brand Name

 

 

Joint Sealer for Concrete Sewer Pipes

491.09

4149.04,D,2

 

 

Approved Brand Name

 

 

Joint Sealer, Elastomeric (Neoprene)

436.02

4136.03

 

 

Approved Brand Name

 

 

Joint Sealer, Poured

436.01

4136.02, A

 

 

Approved Brand Name

 

 

Keyway

 

K. Frame

4191.01, A

 

 

Visual Approval by RCE

 

 

Lighting Material, Aluminum Poles

557

K. Frame

4185.02, F

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

Lighting Material, Circuit Test

 

J. De Vries

2523.03, U

 

Contractor

Test Report (Contractor) Form #820928

 

 

Lighting Material, Connectors

 

S. Sommers

4185.11

 

 

Approved Catalog Cut

 

 

Lighting Material, Contactors

 

S. Sommers

4185.05

 

 

Approved Catalog Cut

 

 


Lighting Material, Control Cabinet

 

S. Sommers

4185.07

 

 

Approved Shop Drawing & Catalog Cut

 

 

Lighting Material, Conduit & Fittings, Plastic

 

S. Sommers

4185.09

4í-Plastic

DME

Test Report

Project

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Lighting Material, Conduit & Fittings, Steel

485.10

S. Sommers

4185.09

 

 

Approved Source

 

 

Lighting Material, Ground Rods & Clamps

 

S. Sommers

4185.04

 

 

Visual

 

 

Lighting Material, Precast Handholes

445.01

M. Khoda

4185.08

 

 

Approved Source, Fabricatorís trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

Lighting Material, Fiberglass Handholes

 

 

4185.08

 

 

Approved Catalog Cut

 

 

Lighting Material, Junction Boxes

 

S. Sommers

4185.09

 

 

Approved Catalog Cut

 

 

Lighting Material, Lighting Tower

557

K. Frame

2522.03, E

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

Lighting Material, Lowering Device

 

2522.03, G

 

 

Approved Shop Drawing & Inspection Report

 

 

Lighting Material, Luminaries

 

S. Sommers

4185.03

 

 

Approved Catalog Cut

 

 

Lighting Material, Photoelectric Control

 

4185.06

 

 

Approved Catalog Cut

 

 

Lighting Material, Sealant for Traffic Loop Detectors

491.18

S. Sommers

 

 

 

Approved Brand Name

 

 

Lighting Material, Steel Poles

557

K. Frame

4185.02, E

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

Lighting Material, Underground Warning Tape

 

S. Sommers

2523.03, E

 

 

Visual Approval by RCE

 

 

Lighting Material, Wire & Cable

 

 

4185.12

 

 

Approved Catalog Cut & Certification Statement

 

DME may obtain verification samples

Lighting Material, Fasteners for Poles

453.09

C. Ouyang

4185.02, B

1 each type

DME

Test Report & Approved Shop Drawing

 

 

Lighting Material, Mastarms

557

K. Frame

4185.02, C

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Lighting Material, Slip Base

557

 

4185.02, B

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

Lighting Material, Wood Poles

462

C. Ouyang

4185.02, G

 

 

Approved Source/Certification Statement

 

 

Lighting Material, Transformer Base

557

 

4185.02, D

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

Markers (reflective) for Guardrail & Concrete Barrier Rail

486.08

S. Sommers

4186.12

 

 

Approved Brand Name

 

 

Markers, Raised Pavement

483.07

2527.02, D,5

 

 

Approved Brand Name

 

 

Mastarms-See Lighting Materials

 

 

 

 

 

 

 

Paint, Epoxy Aluminum

482.04

 

 

 

 

Approved Brand Name/Certification Statement

 

 

Paint, Traffic-VOC-Compliant Solvent-borne

483.03

4183.02

 

 

Approved Brand Name

 

 

Paint, Traffic Waterborne

483.03

4183.03

 

 

Approved Brand Name

Subcontr.

 

Paint, Waterborne Acrylic Finish (Bridge Paint)

482.05

S. Sommers

4182.03

 

 

Approved Brand Name/Certification Statement

 

 

Paint, Zinc-rich Epoxy

482.02

4182.02

 

 

Approved Brand Name/Certification Statement

 

 

Paint, Zinc-silicate Solvent-borne

482.05

4182.02

 

 

Approved Source/Certification Statement

 

 

Patch Material, Rapid-set Concrete

491.20

C. Ouyang

 

 

 

Approved Source

 

 

Piling, Concrete

570

M. Khoda

4166

 

 

Approved Source, Fabricatorís trade mark, Date of Manufacture, DOT Inspection stamp, Inspection Report/Certification Statement

Source

 

Piling, Timber

462

C. Ouyang

4165

20 cores /shipment

DME

Approved Source/Certification of Grade/Certified Treatment Test Report

Source

Charge number on butt ends

Piling, Steel

467

K. Frame

4167

 

 

Approved Source/Mill Certification

Project

 

Pipe, PVC Sewer

443, 446

S. Sommers

4149.02

 

 

Approved Source/Certification Statement

Source

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Pipe, Concrete Apron Guard

443.03

M. Khoda

DR-213

 

 

Approved Source, Certification Statement

 

 

Pipe, Concrete

445

M. Khoda

4145

 

 

Approved Source, Fabricatorís trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

Pipe, Concrete Sanitary and Storm Sewer and Structures (Precast)

445.01

M. Khoda

2435, 4149.04

 

 

Approved Source, Fabricatorís trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

Pipe, Concrete Special Sections

445.01

M. Khoda

2419, 4145

4149.02, B

 

 

Approved Source, Fabricatorís trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

Pipe, Corrugated Aluminized

441

M. Khoda

4141

 

 

Approved Source/Certification Statement

 

 

Pipe, Corrugated Polyethylene 3-10 in.

443

S. Sommers

4146.02

4143.01

 

 

Approved Source

Source

 

Pipe, Corrugated Polyethylene 12-36 in.

446

S. Sommers

 

4146.02

 

 

Approved Source/Certification Statement

Source

 

Pipe, Corrugated Steel

441

M. Khoda

4141

 

 

Approved Source/Certification Statement

Fabricator

 

Pipe, Ductile Iron Sewer

 

4149.02

 

 

Certification Statement

 

 

Pipe, Polyethylene Sewer

443, 446

S. Sommers

4146.03

 

 

Approved Source/Certification Statement

Source

 

Pipe, Concrete Subdrain Tile

448

S. Sommers

4148

 

 

Approved Source/Certification Statement

Source

 

Pipe, Corrugated Metal Subdrain Outlet

441

M. Khoda

4143.01, B

 

 

Approved Source/Certification Statement

Fabricator

 

Pipe, Corrugated Polyethylene Subdrain

443

S. Sommers

4143.01, B

 

 

Approved Source

Source

 

Pipe, Welded Steel for Bridge Rail (See Railing, Bridge)

 

K. Frame

 

 

 

 

 

 

Pipe, Horizontal Subdrain

443

S. Sommers

4143.01, A

 

 

Approved Source

Source

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Plant Material, Fertilizer

469.03

S. Sommers

4170.09, B

 

 

Bagged: Bag label analysis.

Bulk:  Blend ticket/sheet

 

If material is suspect, DME will sample

Plant Material, Mulch

470

S. Sommers

 

4170.09, D

 

RCE

Field Review Report

 

 

Plant Materials, Plants

470

 

4170.01-4170.08

 

Roadside Development

Field Review Report

 

Rpt. Issued-Roadside Development

Portland Cement Concrete Premix Pack

447

C. Ouyang

 

 

 

 

Approved Source/Certification Statement

Source

 

Portland Cement, All Types

401

4101

10 lbs.

DME

Approved Source/Certification Statement

Project Source

 

Railing, Bridge

 

K. Frame

4153.05

 

 

Approved Source/Approved Shop Drawing/ Inspection Report

 

 

Reflective Sheeting-See Signing Material

 

 

 

 

 

 

 

 

Release Agent

491.15

C. Ouyang

491.15

 

 

Approved Brand Name

 

 

Sealant, Traffic Loop-See Lighting Material

 

 

 

 

 

 

 

 

Seed-See Erosion Control

 

 

 

 

 

 

 

 

Signing Material, Delineator Posts

486.10

J. De Vries

4186.10, C

 

 

Certification Statement

 

 

Signing Material, Delineators, Prismatic Reflectors

486.07

S. Sommers

4186.11

 

 

Approved Brand Name

Project

 

Signing Material, Finished Sign

486

S. Sommers

4186

 

 

Shipping Report/Approved Source/Certification Statement

Source

 

Signing Material, Fasteners

 

S. Sommers

4186.09

 

 

Inspection Report

 

 

Signing Material, Reflective

486.03

S. Sommers

4186.03

 

 

Approved Brand Name

Source

 

Signing Material, Sign Panels

 

S. Sommers

4186.02

 

 

Approved Shop Drawing & Shipping Report

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Signing Material, Sign Support Structures

557

K. Frame

4187

 

 

Approved Source/Approved Shop Drawing/ Inspection Report

 

 

Signing Material, Stainless Steel Fasteners

453.07

K. Frame

 

 

 

Approved Source/Mill Certification

Project

 

Sod-See Erosion Control

 

 

 

 

 

 

 

 

Steel Castings

 

K. Frame

4153.03

 

 

Approved Source/Catalog Cut

 

 

Steel Masonry Plates

 

K. Frame

4152.02

 

 

Mill Certification

 

 

Steel Pipe, Welded

 

K. Frame

4153.05

 

 

Approved Shop Drawing & Inspection Report

 

 

Steel, Pins/Rollers, Cold Finished

 

K. Frame

4153.02

 

 

Approved Source/Catalog Cut

 

 

Steel, Pins/Rollers, Forged

 

K. Frame

4153.01

 

 

Approved Source/Catalog Cut

 

 

Steel Reinforcement, Basket Assemblies

451.03B

M. Khoda

4151.02

 

 

Approved Source/Certification Statement

 

 

Steel Reinforcement, Epoxy-coated

451.03B

M. Khoda

4151.03, C

6 ft.

DME

Approved Source/Mill Certifications & Epoxy Certification Statement /Test Report

Project

Test sample should be 3 ft. away from end of the bar.

Steel Reinforcement, Epoxy-coated Tie Bars

451.03B

 

4151.02, A

1 bar

DME

Approved Source/Certification Statement

Project

1 per source per year

Steel Reinforcement, Epoxy-coated Dowels

451.03B

 

4151.02, B

1 bar

DME

Approved Source/Certification Statement

Project

1 per source per year

Steel Reinforcement, Galvanized

451

 

4151.03, B

3 ft.

DME

Mill Certifications & Test Report for Galvanizing

Project

 

Steel Reinforcement, Stainless

452

M. Khoda

4151

6 ft.

DME

Approved Source/Mill Certification

Project

Sample when project quantity >=1ton.

Steel Reinforcement, Uncoated

451

 

4151

*6 ft. of most common

DME

Approved Source/Mill Certification

Project

Sample when project quantity >=45ton.

Steel Reinforcement, Wire Mesh

451

4151.04

 

 

 

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Steel Mechanical Splicers for Reinforcement

451

M. Khoda

 

 

DME

Approved Source/Mill Certification/Epoxy Certification

Project

Need: Certification Statement, Project #, Quantity, Heat #

Steel Structural, Main Members (Except Bearing Devices)

557, 561 to 565

K. Frame

2408

4152

 

 

Approved Source/Approved Shop Drawing/Fabrication Report/Mill Certifications

 

 

Steel Structural, Bridge Components

557, 561 to 565

K. Frame

2408

4152

 

 

Approved Source/Approved Shop Drawing/Inspection Report/Mill Certifications

 

 

Steel Structural, Engineered Truss Trail Bridge

557, 561 to 565

K. Frame

2408

4152

 

 

Approved Source/Approved Shop Drawing

 

 

Step Irons for Utility Access

 

M. Khoda

4149.04, L

 

 

Inspection Report

 

 

Structural Items, Other

 

K. Frame

 

 

 

Approved Shop Drawing & Inspection Report

 

 

Structural Plate (Arches)

444

M. Khoda

4144

Visual

RCE

Approved Source/Certification Statement

 

 

Studs, Shear

453.10

K. Frame

 

 

 

Approved Source/ Mill Certification

 

 

Tape, Pavement Marking

483.06

S. Sommers

2527.02, D

 

 

Approved Source

 

 

Torque Calibration Machine (Skidmore)

 

K. Frame

2408.03, S

Verified every 12 mo.

CTRL

Approved Brand Name

 

 

Torque Wrench

 

K. Frame

2408.03, S

Verified every 12 mo.

CTRL

Test Report

 

 

Utility Access Adjustment Rings

449.05

K. Frame

4149.04

 

 

Approved Source/Certification Statement

 

 

Traffic Signalization, Electrical Tests

 

J. De Vries

2525.03, E

2525.03, H

 

Contractor

Test Report (Contractor) Form #820928

 

 

 

 

 

 

 

 

 

 

 

Wire & Cable-See Lighting Material

 

 

 

 

 

 

 

Watermain, Appurtenances

 

K. Frame

4150.05

 

 

Catalog Cut/Manufacturer Certification of Buy America IM 107

 

 

 

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Watermain, Ductile Iron Pipe

 

 

4150.02

 

 

Catalog Cut/Manufacturer Certification of Buy America IM 107

 

 

Watermain, Ductile Iron Pipe Fittings

 

 

4150.02

 

 

Catalog Cut/ Manufacturer Certification of Buy America IM 107

 

 

Watermain, Fire Hydrant Assembly

 

4150.04

 

 

Catalog Cut/ Manufacturer Certification of Buy America IM 107

 

 

Watermain, PVC Pipe

446

S. Sommers

4150.02

 

 

Catalog Cut

 

 

Watermain, PVC Pipe Fittings

446

4150.02

 

 

Catalog Cut

 

 

Watermain, Valves

 

4150.03

 

 

Catalog Cut/Manufacturer Certification of Buy America IM 107

 

 

Wood, Hardware for Timber Structure

462

S. Sommers

4153.07

1 ea. type

 

Test Report

 

 

Wood, Treated Posts

462

C. Ouyang

4164

 

 

Approved Source/Certification of Grade/Certified Treatment Test Report

 

 

Wood, Treated Timber & Lumber

462

 

4163

 

 

Approved Source/Certification of Grade/Certified Treatment Test Report

 

 

Wood, Untreated Timber & Lumber

462

4162

Visual

RCE

Quality grad mark or certification of grade on items requiring grade

 

 

 

NOTE: For Local agency projects with no Federal funding, verification samples or monitor samples sampled by the DME are not required. These samples may be sampled by the contracting authority. With prior approval, these samples may be tested by the Iowa Department of Transportation Central Laboratory.