Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

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 Source Batch (Lot)

Project

Contact District Matls.

Admixture-Corrosion Inhibitor

402

4103

1 pt.

DME or RCE

Approved Brand Name Source Batch (Lot)

Project

Contact District Matls.

Admixture-Retarder

403

4103

1 pt.

DME or RCE

Approved Brand Name Source Batch (Lot)

Project

Contact District Matls.

Admixture-Water Reducer

403

4103

1 pt.

DME or RCE

Approved Brand Name Source Batch (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

 

 

Anchors, Concrete

453.09

C. Ouyang

 

 

 

Approved Brand Name Source

 

 

Anti-Strip Agent

491.16

C. Brakke

 

 

 

Approved Brand Name Source

 

 

Arrow Panels, Solar-Assisted

486.12

M. Bortle

2528.03, G

 

 

Approved Brand Name Source

 

 

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 -see crash cushion

 

 

 

 

 

 

 

Attenuators, Guardrail

 

K. Frame

 

 

 

As per plan

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Backer Rod for Cold Pour Joint Seal

436.04

S. Sommer

4136.02, B

 

 

Approved Brand Name Source

 

 

Backer Rod for Hot Pour Joint Seal

436.04

S. Sommer

4136.02, B

 

 

Approved Brand Name Source

 

 

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/Fabricator’s trade mark/ Date of Manufacture

 

 

Beads, Glass

484

S. Sommer

4184

1 qt.

 

Approved Brand Name Source

 

 

Bearing, Bronze

 

K. Frame

4190.03

1/project

DME

Test Report

 

 

Bearing, Lead

 

K. Frame

4195.01

 

 

Certification Statement

 

 

Bearing, Neoprene

495.03

S. Sommer

4195.02

1/pad

DME

Inspection Report/ Approved Brand Name Source

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

 

 

Calcium Chloride Solution

373

S. Sommer

4194.01

4 lbs. or 1 qt.

RCE

Test  by RCE

 

 

Caulking Compound

 

S. Sommer

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

 

Concrete, Precast Box Culvert

445.02

2415

 

 

Approved source, Approved Shop Drawing, Fabricator’s trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Concrete, Prestressed, Precast Units

570

 

2407

 

 

Approved Source, Fabricator’s trade mark, Date of Manufacture, DOT Inspection stamp, Inspection  Report/Certification Statement

Source

 

Concrete Sealer

491.12

C. Ouyang

4139

 

 

Approved Brand Name Source

 

 

Conduit – See Lighting Matl.

 

 

 

 

 

 

 

 

Curing Matls., Burlap

 

S. Sommer

4104

 

 

Visual Approval by RCE

 

 

Curing Matls., Clear

405.07

S. Sommer

4105.07

 

 

Approved Brand Name Source

 

 

Curing Matls., Dark-colored

437

C. Brakke

4105.06

 

 

Approved Source

Source

 

Curing Matls., Plastic Film

 

S. Sommer

4106.01

 

 

Visual Approval by RCE

 

 

Curing Matls., White Pigmented

405

S. Sommer

4105.05

1 qt.

 

Batch (Lot) Accept

Source

 

Crash Cushion

455

S. Sommer

 2551

 

 

Approved Brand Name Source, Certification Statement if source not clearly marked

 

 

Delineators–See Signing Matls.

 

 

 

 

 

 

 

Detectable Warning Panels

411

M. Khoda

4171

 

 

Approved Source/Certification Statement

 

 

Dowel-See Steel Reinforcement

 

 

 

 

 

 

 

Drainage Trough, Elastomeric Bridge Joints

494

S. Sommer

 

 

 

Approved Brand Name Source

 

 

Drains, Floor

 

K. Frame

2406.03, D

 

 

Approved Shop Drawing & Inspection Report

 

 

Drums, Channelizing

488.02

S. Sommer

4188.02

 

 

Approved Brand Name Source

 

 

Epoxy-coated Steel-See Steel Reinforcement

 

 

 

 

 

 

Epoxy Injection Resin

491.19

C. Ouyang

 

 

 

Approved Brand Name Source

 

 

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, Inoculant

 

M. Serio

4169.04

 

 

Seed Manufacturing Recommendation

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Erosion Control, Mulch, Hydraulic

469.10

S. Sommer

4169.07

 

 

Approved Brand Name Source

 

 

Erosion Control, Mulch, Straw

 

S. Sommer

4169.07

 

 

Weed Free Certification

 

 

Erosion Control, Perimeter & Slope Sediment Control Devices- Sediment Logs

469.10

S. Sommer

4169.12

 

 

Approved Brand Name Source

 

 

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 Source

 

 

Erosion Control, Silt Fence Wire & Posts

 

 

 

 

Visual Approval by RCE

 

 

Erosion Control, Sod

 

S. Sommer

4169.06

 

 

Visual Approval by RCE

 

 

Erosion Control, Sod Stakes

 

S. Sommer

4169.09

 

 

Visual Approval by RCE

 

 

Erosion Control, Sticking Agent

 

S. Sommer

4169.05

 

 

Seed Manufacturing Recommendation

 

 

Erosion Control, Wire Staples

 

S. Sommer

4169.10, A

 

 

Visual Approval by RCE

 

 

Erosion Control Mats

469.10

S. Sommer

4169.10

 

 

Approved Brand Name Source

 

 

Expansion Device, Steel

 

K. Frame

4152.02

 

 

Approved Shop Drawing & Inspection  Report

 

 

Expansion Tube

 

K. Frame

4191.01, B

 

 

Visual Approval by RCE

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Fabric Engineering

496.01

S. Sommer

4196.01

 

 

Approved Brand Name Source

 

 

Fasteners, Aluminum Structural

486

K. Frame

4190.02

 

 

Inspection Report

 

 

Fence, Barbed Wire

 

M. Khoda

4154.04

 

 

Certification Statement

 

 

Fence, Brace, Tie, & Tension Wire

454.10

M. Khoda

4154.05

 

 

Certification Statement

 

 

Fence, Chain Link Fabric

454.10

4154.03

 

 

Approved Source/ Certification Statement

 

 

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. Sommer

4188.03

 

 

Approved Brand Name Source

 

 

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

 

 

GGBFS

491.14

C. Ouyang

4108.02

 

 

Approved Source/ Certification Statement

Source Project

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Grating (Aluminum)

 

K. Frame

4187.01, A

 

 

Approved Shop Drawing & Inspection Report

 

 

Grout, Hydraulic Cement

491.13

C. Ouyang

 

 

 

Approved Brand Name Source

 

 

Grout, Polymer

491.11

C. Ouyang

 

 

 

Approved Brand Name Source

 

 

Guardrail, Cable

455.02

K. Jones

4155.03

6 ft.

DME

Test Report by Central Lab

 

 

Guardrail, High Tension Cable

455.01

K. Jones

2505.03, B

 

 

Approved Source/ Certification Statement

 

 

Guardrail, Formed Steel Beam and Terminals

455.02

K. Jones

4155.02

 

 

Approved Source

 

 

Guardrail, Steel Posts

455.02

K. Jones

4155.05

 

 

Approved Source/ Mill Test Report

 

 

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. Sommer

4136.03, B 4136.03, D

 

 

Approved Brand Name Source

 

 

Joint Filler, Type E Joint

436.03

4136.03, A

 

 

Approved Brand Name Source

 

 

Joint Filler, Bituminous

436.03

4136.03, A

 

 

Approved Brand Name Source

 

 

Joint Sealer for Concrete Sewer Pipes

491.09

4149.04,D,2

 

 

Approved Brand Name Source

 

 

Joint Sealer, Elastomeric (Neoprene)

436.02

4136.03

 

 

Approved Brand Name Source

 

 

Joint Sealer, Poured

436.01

4136.02, A

 

 

Approved Brand Name Source

 

 

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

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Lighting Material, Circuit Test

 

K. Jones

2523.03, U

 

Contractor

Test Report (Contractor) Form #820928

 

 

Lighting Material, Connectors

 

S. Sommer

4185.11

 

 

Approved Catalog Cut

 

 

Lighting Material, Contactors

 

S. Sommer

4185.05

 

 

Approved Catalog Cut

 

 


Lighting Material, Control Cabinet

 

S. Sommer

4185.07

 

 

Approved Shop Drawing & Catalog Cut

 

 

Lighting Material, Conduit & Fittings, Plastic

 

S. Sommer

4185.10, D

4’-Plastic

DME

Test Report

 

 

Lighting Material, Conduit & Fittings, Steel

485.10

S. Sommer

4185.10, B

 

 

Approved Source

 

 

Lighting Material, Ground Rods & Clamps

 

S. Sommer

4185.04

 

 

Visual

 

 

Lighting Material, Precast Handholes

445.01

M. Khoda

4185.08

 

 

Approved Source, Fabricator’s trade mark, Date of Manufacture, Certified stamp, Certification Statement

Source

 

Lighting Material, Fiberglass Handholes

 

 

4185.08

 

 

Approved Catalog Cut

 

 

Lighting Material, Junction Boxes

 

S. Sommer

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. Sommer

4185.03

 

 

Approved Catalog Cut

 

 

Lighting Material, Photoelectric Control

 

4185.06

 

 

Approved Catalog Cut

 

 

Lighting Material, Sealant for Traffic Loop Detectors

491.18

S. Sommer

 

 

 

Approved Brand Name Source

 

 

Lighting Material, Steel Poles

557

K. Frame

4185.02, E

 

 

Approved Shop Drawing/Approved Source/Certification Statement

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Lighting Material, Underground Warning Tape

 

S. Sommer

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, Wood Poles

462

C. Ouyang

4185.02, G

 

 

Approved Source/Certification Statement

 

 

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

 

 

Lighting Material, Slip Base

557

4185.02, B

 

 

Approved Shop Drawing/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. Sommer

4186.12

 

 

Approved Brand Name Source

 

 

Markers, Raised Pavement

483.07

2527.02, D,5

 

 

Approved Brand Name Source

 

 

Mastarms-See Lighting Materials

 

 

 

 

 

 

Paint, Epoxy Aluminum

482.04

 

 

 

Approved Brand Name Source /Certification Statement

 

 

Paint, Traffic-VOC-Compliant Solvent-borne

483.03

4183.02

 

 

Approved Brand Name Source

 

 

Paint, Traffic Waterborne

483.03

4183.03

 

 

Approved Brand Name Source

Subcontr.

 

Paint, Waterborne Acrylic Finish (Bridge Paint)

482.05

S. Sommer

4182.03

 

 

Approved Brand Name Source /Certification Statement

 

 

Paint, Zinc-rich Epoxy

482.02

4182.02

 

 

Approved Brand Name Source /Certification Statement

 

 

Paint, Zinc-silicate Solvent-borne

482.05

4182.02

 

 

Approved Source/Certification Statement

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Patch Material, Rapid-set Concrete

491.20

C. Ouyang

 

 

 

Approved Source

 

 

Piling, Concrete

570

M. Khoda

4166

 

 

Approved Source, Fabricator’s 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. Sommer

4149.02

 

 

Approved Source/Certification Statement

Source

 

Pipe, Concrete Apron Guard

443.03

M. Khoda

DR-213

 

 

Approved Source, Certification Statement

 

 

Pipe, Concrete

445

M. Khoda

4145

 

 

Approved Source, Fabricator’s 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, Fabricator’s 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, Fabricator’s 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. Sommer

4146.02

4143.01

 

 

Approved Source

Source

 

Pipe, Corrugated Polyethylene 12-36 in.

446

S. Sommer

 

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. Sommer

4146.03

 

 

Approved Source/Certification Statement

Source

 

Pipe, Concrete Subdrain Tile

448

S. Sommer

4148

 

 

Approved Source/Certification Statement

Source

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Pipe, Corrugated Metal Subdrain Outlet

441

M. Khoda

4143.01, B

 

 

Approved Source/Certification Statement

Fabricator

 

Pipe, Corrugated Polyethylene Subdrain

443

S. Sommer

4143.01, B

 

 

Approved Source

Source

 

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

 

K. Frame

 

 

 

 

 

 

Pipe, Horizontal Subdrain

443

S. Sommer

4143.01, A

 

 

Approved Source

Source

 

Plant Material, Fertilizer

469.03

S. Sommer

4170.09, B

 

 

Bagged: Bag label analysis.

Bulk:  Blend ticket/sheet Approved Source

 

If material is suspect, DME will sample

Plant Material, Mulch

470

S. Sommer

 

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 Source

 

 

Sealant, Traffic Loop-See Lighting Material

 

 

 

 

 

 

 

 

Seed-See Erosion Control

 

 

 

 

 

 

 

 

Signing Material, Delineator Posts

486.10

S. Sommer

4186.10, C

 

4186.10, C

Certification Statement1 each supplier

DME

Test Report

Signing Material, Delineators

486.07

S. Sommer

4186.11

 

 

Approved Brand Name Source

Project

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Signing Material, Finished Sign

486

S. Sommer

4186

 

 

Shipping Report/Approved Source/Certification Statement

Source

 

Signing Material, Fasteners

 

S. Sommer

4186.09

 

 

Inspection Report

 

 

Signing Material, Reflective

486.03

S. Sommer

4186.03

 

 

Approved Brand Name Source

Source

 

Signing Material, Sign Panels

 

S. Sommer

4186.02

 

 

Approved Shop Drawing & Shipping Report

 

 

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

 

1 per size per proj.

DME

Approved Source/Mill Certification

Project

 

Signing Material, Perforated Square Steel Tube, PSST and anchor

486.10

K. Frame

4186.10

 

 

Approved Source/Certification Statement

 

 

Signing Material, Steel Posts

 

K. Frame

4186.10

 

 

Approved Shop Drawing & Shipping Report

 

 

Signing Material, Wood Posts

462

C. Ouyang

4186.10

 

 

Approved Source/Certification of Grade/Certified Treatment Test Report

 

 

Signing Material, Galvanized Items

 

K. Frame

4100.07

 

 

Test Report by District Materials

 

 

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

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

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/Certification Statement

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

 

 

 

 

 

Steel Mechanical Splicers for Reinforcement

451

M. Khoda

 

 

 

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

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

Tape, Pavement Marking

483.06

S. Sommer

2527.02, D

 

 

Approved Source

 

 

Torque Calibration Machine (Skidmore)

 

K. Frame

2408.03, S

Verified every 12 mo.

CTRL

Approved Brand Name Source

 

 

Torque Wrench

 

K. Frame

2408.03, S

Verified every 12 mo.

CTRL

Test Report

 

 

 

 

 

 

 

 

 

 

 

Traffic Signalization, Electrical Tests

 

K. Jones

2525.03, E

2525.03, H

 

Contractor

Test Report (Contractor) Form #820928

 

 

Water

 

S. Sommer

4102

1 qt. per source

DME

Test Report or City Water Supply

 

 

Wire & Cable-See Lighting Material

 

 

 

 

 

 

 

Watermain, Appurtenances

 

K. Frame

4150.05

 

 

Catalog Cut/ Mill Manufacturer Certification of Buy America IM 107

 

 

Watermain, Ductile Iron Pipe

 

4150.02

 

 

Mill Manufacturer Certification of Buy America IM 107

 

 

Watermain, Ductile Iron Pipe Fittings

 

4150.02

 

 

Catalog Cut/ Mill Manufacturer Certification of Buy America IM 107

 

 

Watermain, Fire Hydrant Assembly

 

4150.04

 

 

Catalog Cut/ Mill Manufacturer Certification of Buy America IM 107

 

 

Watermain, PVC Pipe

446

S. Sommer

 

4150.02

 

 

Catalog Cut

 

 

Watermain, PVC Pipe Fittings

446

4150.02

 

 

Catalog Cut

 

 

Watermain, Valves

 

4150.03

 

 

Catalog Cut/ Mill Manufacturer Certification of Buy America IM 107

 

 

Wood, Hardware for Timber Structure

462

S. Sommer

4153.07

1 ea. type

 

Test Report

 

 

Wood, Treated Posts

462

C. Ouyang

4164

 

 

Approved Source/Certification of Grade/Certified Treatment Test Report

 

 

 

Sampling & Testing Guide-Minimum Frequency

October 17, 2017

SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE

Matls. IM 204

Supersedes April 18, 2017

 

Appendix Z

Material

IM

Contact

Spec.

Sample Size

Sampled By

Basis of Acceptance

Verification

Other Details

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