Sampling & Testing Guide-Minimum Frequency |
||||||||||
April 16, 2023 |
SUPPLEMENTAL GUIDE – BASIS OF ACCEPTANCE |
Matls. IM 204 |
||||||||
Supersedes October 17, 2023 |
|
Appendix Z |
||||||||
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
||
Admixture-Air Entraining |
T. Hanson |
1 pt. |
DME or RCE |
Approved Brand Name (Lot) |
Project |
Contact District Matls. |
||||
Admixture-Corrosion Inhibitor |
T. Hanson |
1 pt. |
DME or RCE |
Approved Brand Name (Lot) |
Project |
Contact District Matls. |
||||
Admixture-Retarder |
T. Hanson |
1 pt. |
DME or RCE |
Approved Brand Name (Lot) |
Project |
Contact District Matls. |
||||
Admixture-Water Reducer |
T. Hanson |
1 pt. |
DME or RCE |
Approved Brand Name (Lot) |
Project |
Contact District Matls. |
||||
Aggregates-Non-proportioned |
B. Gossman |
DME/PROD. |
Approved Source/Certified Truck Tickets, (Form #821278) |
Source |
Certified Ticket for pay items by weight |
|||||
Aggregates-Proportioned |
B. Gossman |
CONTR, RCE, DME |
Approved Source/Certified Truck Tickets, (Form #821278) |
Source Project |
|
|||||
Aluminum, Structural |
|
K. Frame |
|
|
Approved Shop Drawing & Inspection Report |
|
|
|||
Anchor Bolts & Swedge Anchor |
|
K. Frame |
1 bolt, nut & washer per size, per source, per year |
DME |
Approved Source/Test Report/Mill Certification |
Project |
|
|||
Anchors, Concrete |
T. Hanson |
|
|
|
Approved Brand Name |
|
|
|||
Anti-Strip Agent |
C. Brakke |
|
|
|
Approved Brand Name |
|
|
|||
Arrow Boards, Solar-Assisted (Interstate) |
C. Burke |
|
|
Approved Brand Name |
|
|||||
Arrow Boards, Smart |
C. Burke |
|
|
Approved Brand Name |
|
|
||||
Asphalt Binder |
C. Brakke |
1 4-oz. tin |
CONTR/DME |
Approved Source/Certification Statement /Test Rpt. |
Source Project |
|
||||
Asphalt, Cutback |
C. Brakke |
1 qt. tin |
RCE |
Approved Source/Certification Statement /Test Rpt. |
Source |
|
||||
Asphalt, Emulsified |
C. Brakke |
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 |
||||||||||
Backer Rod for Cold Pour Joint Seal |
S. Sommers |
|
|
Approved Brand Name |
|
|
||||
Backer Rod for Hot Pour Joint Seal |
S. Sommers |
|
|
Approved Brand Name |
|
|
||||
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Barrier Rail, Permanent Precast Concrete |
M. Khoda |
|
|
Approved Source/DOT Stamp/Inspection Report/Certification Statement |
Source |
|
||
Bearing, Bronze |
|
K. Frame |
1/project |
DME |
Test Report |
Project |
|
|
Bearing, Lead |
|
K. Frame |
|
|
Mill Certification |
|
|
|
Bearing, Neoprene |
S. Sommers |
1/100 plain or laminated pads |
DME |
Approved Source |
Source |
|
||
Bentonite Clay |
|
J. De Vries |
|
|
Visual Approval by RCE |
|
|
|
Bolts, Nuts & Washers, Structural |
K. Frame |
Per IM 453.06B |
DME |
Mill Certification/Rotational Capacity Test/Test Report per IM 453.06B |
Project |
|
||
Calcium Chloride Solution |
S. Sommers |
4 lbs. or 1 qt. |
RCE |
Test by RCE |
|
|
||
Caulking Compound |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
|
Concrete, Mechanically Stabilized Earth Panels (MSE) |
M. Khoda |
|
|
Approved Source/Certification Statement/Shop Drawing |
Source |
|
||
Concrete, Modular & Segmental Block (Dry Cast/Wet Cast) |
M. Khoda |
|
|
Approved Source/Certification Statement |
|
|
||
Concrete, Noise Wall, Precast |
M. Khoda |
|
|
Approved Source/Certification Statement/Shop Drawing |
Source |
|
||
Concrete, Precast Box Culvert |
M. Khoda |
|
|
Approved source, Approved Shop Drawing, Fabricator’s trademark, Date of Manufacture, Certified stamp, Certification Statement |
Source |
|
||
Concrete, Prestressed, Precast Units |
M. Khoda |
|
|
Approved Source, Fabricator’s trademark, Date of Manufacture, DOT Inspection stamp, Inspection Report/Certification Statement |
Source |
|
||
Concrete Sealer |
T Hanson |
|
|
Approved Brand Name |
|
|
||
Conduit – See Lighting Material |
||||||||
Curing Matls., Burlap |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
|
Curing Matls., Clear |
S. Sommers |
|
|
Approved Brand Name |
|
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Curing Matls., Dark-colored |
C. Brakke |
|
|
Approved Source |
Source |
|
||
Curing Matls., Plastic Film |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
|
Curing Matls., White Pigmented |
S. Sommers |
1 qt. |
|
Batch (Lot) Accept |
Source |
|
||
Delineators – See Signing Material. |
||||||||
Detectable Warning Panels |
M. Khoda |
|
|
Approved Source/Certification Statement |
|
|
||
Dowel – See Steel Reinforcement |
||||||||
Drainage Trough, Elastomeric Bridge Joints |
S. Sommers |
|
|
|
Approved Brand Name |
|
|
|
Drains, Floor |
|
K. Frame |
|
|
Approved Shop Drawing & Inspection Report |
|
|
|
Drums, Channelizing |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Epoxy-coated Steel – See Steel Reinforcement |
|
|
|
|
|
|
||
Epoxy Injection Resin |
T. Hanson |
|
|
|
Approved Brand Name |
|
|
|
Erosion Control, Fertilizer |
M. Serio |
|
|
Bagged: Bag label analysis. Bulk: Blend ticket/sheet |
|
If material is suspect, DME will sample |
||
Erosion Control, Mulch, Hydraulic |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Erosion Control, Mulch, Straw |
|
S. Sommers |
|
|
Weed Free Certification |
|
|
|
Erosion Control, Perimeter & Slope Sediment Control Devices- Sediment Logs, Wattles & Filter Socks |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Erosion Control, Seed |
S. Sommers |
|
|
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 |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Erosion Control, Silt Fence Wire & Posts |
|
S. Sommers |
|
|
|
Visual Approval by RCE |
|
|
Erosion Control, Sod |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
|
Erosion Control, Sod Stakes |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
|
Erosion Control, Sticking Agent |
|
S. Sommers |
|
|
Seed Manufacturing Recommendation |
|
|
|
Erosion Control, Wire Staples |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Erosion Control Mats |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Expansion Device, Steel |
|
K. Frame |
|
|
Approved Shop Drawing & Inspection Report |
|
|
|
Fence, Chain Link Fabric |
M. Khoda |
|
|
Approved Source/ Certification Statement |
|
|
||
Fence, Chain Link Fittings |
M. Khoda |
|
|
Certification Statement |
|
|
||
Fence, Chain Link Posts, Braces, & Rails |
M. Khoda |
|
|
Approved Source/ Certification Statement |
|
|
||
Fence, Field Fence Fabric |
M. Khoda |
|
|
Certification Statement |
|
|
||
Fence, Gate |
M. Khoda |
|
|
Certification Statement |
|
|
||
Fence, Orange Mesh Safety |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Fence, Silt – See Erosion Control |
||||||||
Fence, Staples |
M. Khoda |
|
|
Visual Approval by RCE |
|
|
||
Fence, Steel Line Posts and Braces |
M. Khoda |
|
|
Approved Source/ Certification Statement |
|
|
||
Fence, Wood Fence Post |
J. De Vries |
|
|
Approved Source/Certification of Grade/Certified Treatment Test Report |
|
|
||
Fertilizer – See Erosion Control |
||||||||
Fly Ash |
T. Hanson |
15 lbs. |
DME |
Approved Source/ Certification Statement |
Project Source |
Verification on paving only |
||
Galvanized Items |
K. Frame |
|
DME |
Test Report per IM 410.01/Certification Statement |
Project |
|
||
GGBFS |
T. Hanon |
|
DME |
Approved Source/ Certification Statement |
Source Project |
|
||
Grating (Aluminum) |
|
K. Frame |
|
|
Approved Shop Drawing & Inspection Report |
|
|
|
Grout, Hydraulic Cement |
T. Hanon |
|
|
|
Approved Brand Name |
|
|
|
Grout, Polymer |
T. Hanon |
|
|
|
Approved Brand Name |
|
|
|
Guardrail, High Tension Cable |
J. De Vries |
|
|
Approved Source/ Certification Statement |
|
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Guardrail, Formed Steel Beam and Terminals |
J. De Vries |
|
|
Approved Source |
|
|
||
Guardrail, Steel Posts |
J. De Vries |
|
|
Approved Source/ Mill Certification |
|
|
||
Guardrail, Wood Posts |
J. De Vries |
|
|
Approved Source/Certification of Grade/Certified Treatment Test Report |
|
|
||
Iron Castings, Utility Access Covers, etc. |
|
K. Frame |
|
|
Certification Statement & Proper Identification Imprint |
|
|
|
Joint Filler, Bituminous |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Joint Sealer for Concrete Sewer Pipes |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Joint Sealer, Elastomeric (Neoprene) |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Joint Sealer, Poured |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Keyway |
|
K. Frame |
|
|
Visual Approval by RCE |
|
|
|
Lighting Material, Aluminum Poles |
K. Frame |
|
|
Approved Shop Drawing/Approved Source/Certification Statement/Inspection Report |
|
|
||
Lighting Material, Circuit Test |
|
J. De Vries |
|
Contractor |
Test Report (Contractor) Form #820928 |
|
|
|
Lighting Material, Connectors |
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
|
Lighting Material, Contactors |
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
|
Lighting Material, Control Cabinet |
|
S. Sommers |
|
|
Approved Shop Drawing & Catalog Cut |
|
|
|
Lighting Material, Conduit & Fittings, Plastic |
|
S. Sommers |
4’-Plastic |
DME |
Test Report |
Project |
|
|
Lighting Material, Conduit & Fittings, Steel |
S. Sommers |
|
|
Approved Source |
|
|
||
Lighting Material, Ground Rods & Clamps |
|
S. Sommers |
|
|
Visual |
|
|
|
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
||
Lighting Material, Handhole and Cover, HDPE |
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
|
Lighting Material, Handholes, Precast |
M. Khoda |
|
|
Approved Source, Fabricator’s trademark, Date of Manufacture, Certified stamp, Certification Statement |
Source |
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Lighting Material, Junction Boxes |
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
|
Lighting Material, Lighting Tower |
K. Frame |
|
|
Approved Shop Drawing/Approved Source/Certification Statement/Inspection Report |
|
|
||
Lighting Material, Luminaries |
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
|
Lighting Material, Photoelectric Control |
|
S. Sommers |
|
|
Approved Catalog Cut |
|
|
|
Lighting Material, Sealant for Traffic Loop Detectors |
S. Sommers |
|
|
|
Approved Brand Name |
|
|
|
Lighting Material, Steel Poles |
K. Frame |
|
|
Approved Shop Drawing/Approved Source/Certification Statement/Inspection Report |
|
|
||
Lighting Material, Underground Warning Tape |
|
S. Sommers |
|
|
Visual Approval by RCE |
|
|
|
Lighting Material, Wire & Cable |
|
S. Sommers |
|
|
Approved Catalog Cut & Certification Statement |
|
DME may obtain verification samples |
|
Lighting Material, Fasteners for Poles |
T. Hanson |
1 each type |
DME |
Test Report & Approved Shop Drawing |
|
|
||
Lighting Material, Mastarms |
K. Frame |
|
|
Approved Shop Drawing/Approved Source/Certification Statement/Inspection Report |
|
|
||
Lighting Material, Slip Base |
K. Frame |
|
|
Approved Shop Drawing/Approved Source/Certification Statement |
|
|
||
Lighting Material, Wood Poles |
J. De Vries |
|
|
Approved Source/Certification Statement |
|
|
||
Lighting Material, Transformer Base |
K. Frame |
|
|
Approved Shop Drawing/Approved Source/Certification Statement |
|
|
||
Markers (reflective) for Guardrail & Concrete Barrier Rail |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Markers, Raised Pavement |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Mastarms – See Lighting Materials |
||||||||
Paint, Epoxy Aluminum |
S. Sommers |
|
|
|
Approved Brand Name/Certification Statement |
|
|
|
Paint, Traffic-VOC-Compliant Solvent-borne |
S. Sommers |
|
|
Approved Brand Name |
|
|
||
Paint, Traffic Waterborne |
S. Sommers |
|
|
Approved Brand Name |
Subcontr. |
|
||
Paint, Waterborne Acrylic Finish (Bridge Paint) |
S. Sommers |
|
|
Approved Brand Name/Certification Statement |
|
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Paint, Zinc-rich Epoxy |
S. Sommers |
|
|
Approved Brand Name/Certification Statement |
|
|
||
Paint, Zinc-silicate Solvent-borne |
S. Sommers |
|
|
Approved Source/Certification Statement |
|
|
||
Patch Material, Rapid-set Concrete |
T. Hanson |
|
|
|
Approved Source |
|
|
|
Piling, Steel |
K. Frame |
|
|
Approved Source/Mill Certification |
Project |
|
||
Pipe, PVC Sewer |
S. Sommers |
|
|
Approved Source/Certification Statement/IM 107 Certification |
Source |
|
||
Pipe, Concrete Special Sections |
M. Khoda |
|
|
Approved Source, Fabricator’s trademark, Date of Manufacture, Certified stamp, Certification Statement |
Source |
|
||
Pipe, Corrugated Aluminized |
M. Khoda |
|
|
|
Approved Source/Certification Statement |
|
|
|
Pipe, Corrugated Polyethylene 3-10 in. |
S. Sommers |
|
|
Approved Source/IM 107 Certification |
Source |
|
||
Pipe, Corrugated Polyethylene 12-36 in. |
S. Sommers |
|
|
Approved Source/Certification Statement/IM 107 Certification |
Source |
|
||
Pipe, Corrugated Steel |
M. Khoda |
|
|
Approved Source/Certification Statement |
Fabricator |
|
||
Pipe, Ductile Iron Sewer |
M. Khoda |
|
|
Certification Statement |
|
|
||
Pipe, Polyethylene Sewer |
S. Sommers |
|
|
Approved Source/Certification Statement/IM 107 Certification |
Source |
|
||
Pipe, Concrete Subdrain Tile |
S. Sommers |
|
|
Approved Source/Certification Statement |
Source |
|
||
Pipe, Corrugated Metal Subdrain Outlet |
M. Khoda |
|
|
Approved Source/Certification Statement |
Fabricator |
|
||
Pipe, Corrugated Polyethylene Subdrain |
S. Sommers |
|
|
Approved Source/IM 107 Certification |
Source |
|
||
Pipe, Welded Steel for Bridge Rail (See Railing, Bridge) |
|
K. Frame |
|
|
|
|
|
|
Pipe, Horizontal Subdrain |
S. Sommers |
|
|
Approved Source/IM 107 Certification |
Source |
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
|
|||||||
Plant Material, Fertilizer |
S. Sommers |
|
|
Bagged: Bag label analysis. Bulk: Blend ticket/sheet |
|
If material is suspect, DME will sample |
|
|||||||||
Plant Material, Mulch |
S. Sommers |
|
RCE |
Field Review Report |
|
|
|
|||||||||
Plant Materials, Plants |
S. Sommers |
|
Roadside Development |
Field Review Report |
|
Rpt. Issued-Roadside Development |
||||||||||
Portland Cement Concrete Premix Pack |
T. Hanson |
|
|
|
Approved Source/Certification Statement |
Source |
|
|
||||||||
Release Agent |
C. Brakke |
|
|
Approved Brand Name |
|
|
|
|||||||||
Sealant, Traffic Loop – See Lighting Material |
|
|||||||||||||||
Seed – See Erosion Control |
|
|||||||||||||||
Signing Material, Delineators, Prismatic Reflectors |
S. Sommers |
|
|
Approved Brand Name |
|
|
|
|||||||||
Signing Material, Finished Sign |
S. Sommers |
|
|
Shipping Report/Approved Source/Certification Statement |
Source |
|
|
|||||||||
Signing Material, Fasteners |
|
S. Sommers |
|
|
Inspection Report |
|
|
|
||||||||
Signing Material, Post, Delineator |
J. De Vries |
|
|
Certification Statement |
|
|
|
|||||||||
Signing Material, Post, Perforated square steel tube |
J. De Vries |
|
|
Approved Source/Certification Statement |
|
|
|
|||||||||
Signing Material, Reflective |
S. Sommers |
|
|
Approved Brand Name |
Source |
|
|
|||||||||
Signing Material, Sign Panels |
|
S. Sommers |
|
|
Approved Shop Drawing & Shipping Report |
|
|
|
||||||||
Signing Material, Sign Support Structures |
K. Frame |
|
|
Approved Source/Approved Shop Drawing/ Inspection Report/Mill Certification |
|
|
|
|||||||||
Signing Material, Stainless Steel Fasteners |
K. Frame |
|
|
|
Approved Source/Mill Certification |
Project |
|
|
||||||||
Sod – See Erosion Control |
|
|||||||||||||||
Steel Castings |
K. Frame |
|
|
Approved Source/Catalog Cut |
|
|
|
|||||||||
Steel Masonry Plates |
|
K. Frame |
|
|
Mill Certification |
|
|
|
||||||||
Steel Pipe, Welded |
K. Frame |
|
|
Approved Shop Drawing & Inspection Report |
|
|
|
|||||||||
Steel, Pins/Rollers, Cold Finished |
K. Frame |
|
|
Approved Source/Catalog Cut |
|
|
|
Material |
IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
Steel, Pins/Rollers, Forged |
K. Frame |
|
|
Approved Source/Catalog Cut |
|
|
||
Steel Reinforcement, Basket Assemblies |
M. Khoda |
|
|
Approved Source/Certification Statement |
|
|
||
Steel Reinforcement, Epoxy-coated Tie Bars |
M. Khoda |
1 bar |
DME |
Approved Source/Certification Statement |
Project |
1 per source per year |
||
Steel Reinforcement, Galvanized |
M. Khoda |
3 ft. |
DME |
Mill Certifications & Test Report for Galvanizing |
Project |
|
||
Steel Reinforcement, Stainless |
M. Khoda |
6 ft. |
DME |
Approved Source/Mill Certification |
Project |
Sample when project quantity >=1ton. |
||
Steel Reinforcement, Uncoated |
M. Khoda |
|
DME |
Approved Source/Mill Certification |
Project |
Sample when project quantity >=45ton. |
||
Steel Reinforcement, Wire Mesh |
M. Khoda |
|
|
|
|
|
||
Steel Mechanical Splicers for Reinforcement |
M. Khoda |
|
|
DME |
Approved Source/Mill Certification/Epoxy Certification |
Project |
Need: Certification Statement, Project #, Quantity, Heat # |
|
Steel Structural, Main Members (Except Bearing Devices) |
K. Frame |
|
|
Approved Source/Approved Shop Drawing/Fabrication Report/Mill Certifications |
|
|
||
Steel Structural, Bridge Components |
K. Frame |
|
|
Approved Source/Approved Shop Drawing/Inspection Report/Mill Certifications |
|
|
||
Steel Structural, Engineered Truss Trail Bridge |
K. Frame |
|
|
Approved Source/Approved Shop Drawing |
|
|
||
Step Irons for Utility Access |
M. Khoda |
|
|
Inspection Report |
|
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Structural Items, Other |
K. Frame |
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Approved Shop Drawing & Inspection Report |
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Structural Plate (Arches) |
M. Khoda |
Visual |
RCE |
Approved Source/Certification Statement |
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Studs, Shear |
K. Frame |
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Approved Source/ Mill Certification |
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Tape, Pavement Marking |
S. Sommers |
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Approved Source |
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Torque Calibration Machine (Skidmore) |
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K. Frame |
Verified every 12 mo. |
CTRL |
Approved Brand Name |
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IM |
Contact |
Spec. |
Sample Size |
Sampled By |
Basis of Acceptance |
Verification |
Other Details |
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K. Frame |
Verified every 12 mo. |
CTRL |
Test Report |
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Traffic Signalization, Electrical Tests |
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J. De Vries |
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Contractor |
Test Report (Contractor) Form #820928 |
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Wire & Cable – See Lighting Material |
S. Sommers |
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Catalog Cut/ IM 107 Certification |
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Watermain, Fire Hydrant Assembly |
S. Sommers |
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Catalog Cut/ IM 107 Certification |
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Watermain, PVC Pipe |
S. Sommers |
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Catalog Cut |
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Watermain, PVC Pipe Fittings |
S. Sommers |
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Catalog Cut |
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Watermain, Valves |
S. Sommers |
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Catalog Cut/ IM 107 Certification |
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Wood, Hardware for Timber Structure |
S. Sommers |
1 ea. type |
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Test Report |
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Wood, Treated Posts |
J. De Vries |
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Approved Source/Certification of Grade/Certified Treatment Test Report |
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Wood, Treated Timber & Lumber |
J. De Vries |
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Approved Source/Certification of Grade/Certified Treatment Test Report |
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Wood, Untreated Timber & Lumber |
J. De Vries |
Visual |
RCE |
Quality grad mark or certification of grade on items requiring grade |
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