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CAG-20-065 - Duvall - Gravel Borrow INCL. Haul
..1. Washington State •/ Department of Transportation Request for Apiproval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 01/28/2022 Section/Tifle of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor This form shall be completed prior to submittal. If this form is not compete at time of submittal it may For WSDOT Use Only be returned for information that was omitted. RAM# 081 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL Hdgtr.IQPI HQ Use Nc. Product/Type Manufacturer or Pit Number Reference Code Code A27 A44-A52 Gravel Borrow Icon Materials-Auburn A-464 7-04 1, 2 , B6-B9 A44-A52 B6-69 CSTC Icon Materials-Auburn A-464 7-04 1, 2 A44-A52 CSBC Icon Materials-Auburn A-464 7-04 1, 2 B6-B9 Project Engineer/Representative - --X Date State Materials Engineer/Representative Date ,Z`.K,--, 1/31/2022 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 21. Acceptance Criteria: Acceptance based upon Satisfactory Test Report for samples of materials to be incorporated into project. 2. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment', 'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 10. Approval Wthheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Provide Scale Cert. Delivery Ticket shall show bid item number and description Gravel Borrow may be used for Gravel Borrow and Bank Run Gravel for Trench Backfill Remarks (HQ): CSTC may be used for CSTC, Bank Run Gravel for Trench Backfill and Gravel Backfill for Pipe Zone Bedding CSBC may be used for Bank Run Gravel for Trench Backfill and Gravel Backfill for Pipe Zone Bedding DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor DRegion Operations Engineer 0 Fabncation Inspection ORegion Materials ❑State Materials Lab-MS 47365 ICON Summary Report Sample Information Sample No 1264637438 100- ♦ . Product Id 2380 Product Name Gravel Borrow B0' Specification WSDOT 9-03.14.1 Gravel Borrow BD- Date Sampled 01/07/2022 09:00 70- Sampled By Skye Southward 60. Sample Type Investigative 60 Sample Method Surge Pile • 10• Notes 30. 2022 Submittal (B) 20. 10. .. 1 . . 1...... 1 . .r...TI 1' 1' - 1 'T'I 3 5 5 • 'S.'sa 's. �. ANe00+m"O lmml D0lESi 016 D. 056 060 1 t2 060 2.0 016O66 002 Cu 144,Cs 079 Gradation Results Quality Results Date Tested Tested By Skye Southward Sieve %Passing Tolerances Test Result Unit Tolerances 4"(100mm) 100 99-100 FM 3.88 AASHTO T27/T11 3"(75mm) 100 SE 62 % ?50 AASHTO T176 2"(50mm) 100 75-100 -#200(75um) 6.7 % 1"(25mm) 98 Grad Loss 0.0 % 3/4"(19mm) 94 Wash Loss(#200/75um) 4.5 1/2"(12.5mm) 88 3/8"(9.5mm) 82 #4(4.75mm) 71 50-80 9-03.12(3) Gravel Backfill for #10(2mm) 57 Pipe Zone Bedding Slave Size Parer*Passing #40(.425mm) 25 0-30 1%" 99-100 #100(.15mm) 9 %Passing No.200 1" 75-100 #200(75pm) 6.7 0-7 Dust Ratio: %Passing No.40 %" 50-100 No.4 0 80 No.40 3-24 X No.200 10.0 max. Sand Equivalent 35 min. 9-03.14(1) Gravel Borrow Sieve She Percent Pamir 9-03.19 Bank Run Gravel for Trench Backfill 4" 99-100 2" 75-100 No.4 50-80if/ Peg 75.100 No.40 30 max. J . , No.4 22.100 No.200 0-10 No.200 7.0 max. Dust Ratio: t max. Sand Equivalent 50 min. 1 Sand Equivalent 30 min. StonemontQC 01/10/2022 CRH Americas Materials(AMAT) ICON Summary Report Sample Information Sample No 303028092 too- F.4.--4--4 Product Id 2350 Product Name 5/8"CS TC 90: Specification 9-03.9(3)Crushed Surfacing TC as- Date Sampled 01/08/2022 10:00 7: f Sampled By Randy Mattson so- f Sample Type Investigative so- / Sample Method Surge Pile W- Notes 7Submittal 2022 x 20- 10- 61.. t i .i . t.... t . 1 . r v•1,: i i r i ' i Z4 I?, g + rb 51 - 1.. a a SA. '. S. Swn0om1"q Man 0i01E51.023 030 1 06 OW 112 010 403 0150115 004 C¢2123 Cc 100 Gradation Results Quality Results Date Tested Tested By Randy Mattson Sieve %Passing Tolerances Test Result Unit Tolerances 1 1/2"(37.5mm) 100 SE 66 % >_40 AASHTO T176 1"(25mm) 100 Fractured Faces(>1) 95.0 % 275 AASHTO T-335 3/4"(19mm) 100 99-100 Unfractured Faces(>1) 5.0 % AASHTO T-335 5/8"(16mm) 99 -#200(75um) 4.2 % 1/2"(12.5mm) 94 80-100 Grad Loss 0.0 3/8"(9.5mm) 82 Wash Loss(#200/75um) 3.6 % 1/4"(6.3mm) 67 #200/#40 0.25 #4(4.75mm) 60 46-66 9-03.12(3) Gravel Backfill for #8(2.36mm) Pipe Zone Bedding #16(1.18mm) 32 Sieve Size Percent Pasts # 1s," 99-100 f/ 30(.6mm) 21 96 Passing No.200 1" 75-100 #40(.425mm) 17 8-24 Dust Ratio' %Passing No.40 _ %" 50-100 #50(.3mm) 12 No.4 20-80/ #100(.15mm) 6 No.40 3-24 #200(75um) 4.2 0-10 No.200 lO.Omax./� 9-03.9(3) Crushed Surfacing Sand Equivalent 35 min.,/! Base Course ( Top course nd Keystone A. Sieve Size Percent Passing 1%" 99-100 1" 80-100 9-03.19 Bank Run Gravel for y," 99-1001F- Trench Backfill ip� " 50-80 J — Siee1/ZR e99'sf s )5" 80-100 ,/ 2• 75-1CC1 No.4 25-45 46-66 J No.4 22.100 No.40 3-18 8-24 / No.200 0-10 l No.200 7.5 max. 10.0 max., Dust Ratio. %max Sand Equivalent 30 min. %Fracture 75 min. 75 min. / Sand Equivalent 40 min. 40 min. 1 ............_....._ .....,,,._,.__ .......................Materials(AMAT) ICON Summary Report Sample Information Sample No 655576787 100- f--1-J Product Id 2379 Product Name 1 1/4"CS BC " Specification 9-03.9(3)Crushed Surfacing BC so- Date Sampled 01/04/2022 11:05 -°- Sampled By James Begley 60. 1 Sample Type Process Control i .: ,. Sample Method Surge Pile Notes b- 2022 Submittal S�..0.11100mn1 DINES)04 OM 2114 D50 755 D60 1052 D16956 D0,Cu 2,51 Cc 157 Gradation Results Quality Results Date Tested Tested By James Begley Sieve %Passing Tolerances Test Result Unit Tolerances 2 1/2"(63mm) 100 SE 73 % 240 AASHTO T176 2"(50mm) 100 Fractured Faces(>1) 98.0 % 275 AASHTO T-335 1 1/4"(31.5mm) 100 99-100 Questionable Faces(>1) 4.1 % AASHTO T-335 1"(25mm) 96 80-100 -#200(75um) 2.0 % 3/4"(19mm) 86 Grad Loss 0.0 5/8"(16mm) 77 50-80 Wash Loss(#200/75um) 1.3 % 1/2"(12.5mm) 66 #200/#40 0.23 3/8"(9.5mm) 56 9-03.12(3) Gravel Backfill for #4(4.75mm) 37 25-45 Pipe Zone Bedding #10(2mm) 25 SbveSiaxr Percent Pales #40(.425mm) 9 3-18 SX" 99.100 1 %Passing No.200 1" 75 300Y / #100(.15mm) 3 Dust Ratio, %Passing No.40 %" 50-100 #200(75pm) 2.0 0-7.5 No.4 20.80t/ No.40 3-24 t No.200 10.0 max. J 9-03.9(3) Crushed Surfacin Sand Equivalent 35 min. Top Come and Keystone Sieve Size • - Party{ 1%" 99-100 1" 80-100 i 9-03.19 Bank Run Gravel for %" 99-100 Trench Backfill %" So eo '1 h" 8011 -100 Slif2, 75-100 No.4 25-45 46-66 No.4 22-100 J / No.40 3-18 vf/ 8-24 No.200 0-10 No.200 7.5 max. 1Jr 10.0 max. Dust Ratio: i max. 1, %Fracture 75 min.y 75 rain. Sand Equivalent 30 min. Sand Equivalent 40 min. f 40 min. StonemontQC 01/08/2022 CRH Americas Materials(AMAT) Aggregate Source Approval Report. https://www.wsdot.wa.gov/bizlmats/ASA/ASAReport.cfm?prefix=A&pi... WSDOT MATERIALS LAB 01/31/2022 Aggregate Source Approval Report Owner: La Pianta Limited Partnership Aggregate Source: PS-A-464 Lessee: Icon Materials, Inc. Known as: Auburn Pit Located in: SW1/4 S S1/4 SEC 28 8429 Section 28,29, T21N RSE County: King Remarks: Mineral Agg.and Surfadng: Test Date: 10/17/2018 Expiration Date: 10/17/2023 Absorption:1.26 Apparent Sp.G.:2.744 Bulk Sp.G.(SSD):2.686 Bulk Sp.G.:2.652 Deg:57 LA 14 Remarks: Currently approved as a source of aggregate for: ATB Balast BST Crushed Cover Stone BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing Key Stone Crushed Surfacing Top Course Gravel Backfill for Foundation Class A HMA Other Courses HMA Wearing Course Maintenance Rock Permeable Ballast Acceptance tests need to be performed as necessary. Aggregates for Concrete: Test Date: 10/24/2018 Expiration Date: 10/24/2023 ASR-14 Day: ASR-One Year:0.037 CCA Absorption:1.24 CCA Sp.G:2.68 Deg:72 FCA Absorption:2.18 FCA Organics:3 FCA Sp.G:2.624 LA11 Remarks: Current 1 Year ASR(ASTM C1293)results: 0.037%.Results expire on 12/9/2025 Currently approved for: Coarse Concrete Aggregates Fine Concrete Aggregates Acceptance tests need to be performed as necessary Acceptance tests need to be performed as necessary Riprap,Quarry Spals,Rock for Rock Wail,Erosion and Scour Protection: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA Remarks: I of 2 1/31/2022,9:43 AM Aggregate Source Approval Report. https://www.wsdot.wa.gov/bizimats/ASA/ASAReport.cfm?prefix=A&pi... NOT Approved for: Quarry Spells Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(6) Streambed Aggregates: Test Date: 10/24/2018 Expiration Date: 10/24/2023 Absorption:1.24 Apparent Sp.G.:2.736 Bulk Sp.G.(SSD):2.68 Bulk Sp.G.:2.647 Deg:72 LA 11 Remarks: Currently Approved for: Stream bed Aggregate Gravel Borrow for Structural Earth Walls: Test Date: 10/24/2018 Expiration Date: 10/24/2023 Bulk Sp.G.(SSD):2.68 Deg:72 LA 11 Remarks: For geosynthetic reinforcement,the gravel borrow shall be tested for pH prior to placement. For metallic reinforcement,the gravel borrow shah be tested for pH,resistivity,chlorides,and sulfates prior to placement.ff the resistivity of the backfill material equals or exceeds 5,000 ohm-cm,the specified chloride and sulfate limits may be waived.If the aggregate source has variable quality,additional testing may be required.Contact the Regional Materials Engineer or the State Geotechnical Engineer for direction. Currently Approved for: Gravel Borrow for Str Earth Walls ALL OTHER PIT RUN MATERIALS: Project Engineer may request preliminary samples but Aggregate Source Approval is not requred. AGGREGATE MATERIALS NOT REQUIRING ASA APPROVAL: Aggregate for Gravel Base 9-03.10 Gravel Backfill for Foundation Class B 9-03.12(1)B Gravel Backfill for Walls 9-03.12(2) Gravel Backfill for Pipe Zone Bedding 9-03.12(3) Gravel Backfill for Drains 9-03.12(4) Gravel Backfill for Drywells 9-03.12(5) Backfill for Sand Drains 9-03.13 Sand Drainage Blanket 9-03.13(1) Gravel Borrow 9-03.14(1) Select Borrow 9-03.14(2) Common Borrow 9-03.14(3) Native Material for Trench Backfill 9-03.15 Foundation Material Class A and B 9-03.17 Foundation Material Class C 9-03.18 Bank Run Gravel for Trench Backfill 9-03.19 Commercial Concrete Aggregate 6-02.3(2)B 2 of 2 1/31/2022,9:43 AM v\%�%'jar v v v\e% •\o/%v v v v v\�%\�%.v ice,v\`�%v 0-_\�%\�%\a%;Go\Q%'op,Vim%\Q%\�/�` O, - I Hill 1 U I l I l 1 I l 11 I i 1 1 1 1 i 1 1 i 1 1 1 1 1 1 1 1 1 1 1 I I I I IJ I I 1 1 1111mllu L LI1 I I_I I I I 111 11 1 111 1 111 11 I_I I_I II l tLI I LL1.1 I I I I II LIL I I.L1J 11 1il I I I I I I I I I l I l I I I. 111111 _ Cp 1 - UNITEC Corporation A i ei 0 1 0 IN 11.1 No•isi 1m 1.imami = 11% l)till ec 1 •iill II IF 358 Upland Urive • Seattle,Washington 98188 - Co; 105. Qiirtifiratr 0f ,JYt,i3rzctiott i c ..) E:,o' _ This is to certify i-y.��e c ,e scale(s) _ Co, �� = Located at: s4L V—) ..aJ-ic� 33) c�!d (- C�nc,�/rn,!i vJJ ' lf 4 = was (were) serviced on this ?y A day of ij,le-A),_,A.4 20 2 1 , by an authorized representative of F. Co; 0 = the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. - Cam" 'o, _ A record of said inspection is on file at the above address an 'I the offices of UNITEC CORPORATION. =_ /Co o1 ' S S . # 1 _ (206) 575-1100 Co . =111 I III!11111111.1IJIIII Ill I III 11111111111 111111III mil 1111-111 piI 1II 111I11 II li.11f 11111.11111II.II 1 III1111111111 mill milli lylI II.11111111111W 11!minim'1111.1.11 -.- II ° 'V" (4194 JO" tdr:'") 'AP`4.016 jr.11, iirelk 0111511 <4171>in iirli.1 4011).al.": II> .41496 411011. .iiir91 411.01:11)'dri: ii>.del,k 411.9 (4911.111711). 4411311h R 0 4.011. /+�� N _ , , ,. , , .. . vvvvvvvv.....vvviv►vvvvvvvvvvvvvvC p� = 11i11111111111111111111111111 11111111111111111111111111 111111 IIII.... Ifii111111111J111 U 1111111111J1111111111111111 U 1111111111111111111111111 Illlllllllll....- - = Cp .1 ,... 1 = UN ITEC Corporation - G 1 E U�, �� 358 Upland Drive • Seattle,Washington 98188 = Co off =g. _- 05 .1 g i..= c ,1 E Tertinratt in .inspriction ..-2 ty q; ' This is to certify that / k?� o((vn v, f er..:1 t tfc scale(s) = Co 1 = Located at: u..anf�ie c�� — ke,,1„t j �r = Co 1 If-. was (were) serviced on this 2 G day of P ` 20 2( , by an authorized representative of = C' the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. _ 4 E. A record of said inspection is on file at the above address and in the offices of UNITEC CORPORATION. = Co; �' = BY: G� = Cam. off _ � _ Co. V _ (206) 575-1100 = C 4 = 11111111111111111111111i11111111111111111111111111 III 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 = C 0 Analytical Resources, Incorporated Analytical Chemists and Consultants 15 October 2021 Greg McKinnon Gary Merlino Construction Co Inc 9125 10th Avenue South Seattle,WA 98108 RE:Black River Quarterly Please find enclosed sample receipt documentation and analytical results for samples from the project referenced above. Sample analyses were performed according to ARI's Quality Assurance Plan and any provided project specific Quality Assurance Plan.Each analytical section of this report has been approved and reviewed by an analytical peer,the appropriate Laboratory Supervisor or qualified substitute,and a technical reviewer. Should you have any questions or problems,please feel free to contact us at your convenience. Associated Work Order(s) Associated SDG ID(s) 21.10007 N/A I certify that this data package is in compliance with the terms and conditions of the contract,both technically and for completeness,for other than the conditions detailed in the enclose Narrative.ARI,an accredited laboratory,certifies that the report results for which ARI is accredited meets all the requirements of the accrediting body.A list of certified analyses,accreditation,and expiration dates is included in this report. Release of the data contained in this hardcopy data package has been authorized by the Laboratory Manager or his/her designee,as verified by the following signature. Analytical Resources,Inc. The results in this report apply to the samples analyzed in accordance with the chain of custody document This analytical report must be reproduced in its entirety. 'rf/) al o�N.ccoac� be Kelly Bottem,Client Services Manager Cert6 10000E-012 4611 S. 134th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 Chain of Custody Record & Laboratory Analysis Request ARI Assigned Number Turn-around Requested: Page: of Analytical Resources,Incorporated Y\0097 Analytical Chemists and Consultants ARI Client Company: Phone: Date: Ice 4611 South 134th Place,Suite 100 6:#6:1#uu� �1C re* ` Present? //0 Tukwila,WA 98168 206-695-6200 206-695-6201(fax) Client Contact::, '' // / No.of Cooler I b / www.arilabs.com t"-. 14 6.xrehN r"1.,�inn '-/25-ZZE-:COC Coolers: Temps: b 1 10 Client Project Name: —.IAnalysis Requested Notes/Comments tP/ Client Project#: ampl€rs: J Sample ID Date Time Matrix No.Containers ,:jr: 41 gee I i0- ) 5: 30 ge0 Z 10. 1 3:39 c Q 3 co-I S 36 j3eG W 10.1 8:39 0e0 5 iv- i $ Stu / Comments/Special Instructions Rsvnquisl,ed by: Received by: — Reiinquisned by'. Received by (Signature) "_ISgnaturel_ (Signature) (Signature) Printed Nam. Pn9tetl / / prinlad Name: Printed Name. S�-� Ni#.�M. % Company_ Company: -Company: Company: s112r7#'D.y �inr cctz' �/��}/Qgf-- Date 8 lime: t Date 8 Time: Dale 8 Time: Dale 8 Time: /a-i zf S WO l:r., tv/&f'a/ Cgfv Limits of Liability: ARI will perform all requested services in accordance with appropriate methodology following ARI Standard Operating Procedures and the ARI Quality Assurance Program. This program meets standards for the industry. The total liability of ARI,its officers,agents,employees,or successors,arising out of or in connection with the requested services,shall riot exceed the Invoiced amount for said services. The acceptance by the client of a proposal for services by ARI release ARI from any liability in excess thereof,not withstanding any provision to the contrary in any contract,purchase order or co- signed agreement between ARI and the Client. Sample Retention Policy: All samples submitted to ARI will be appropriately discarded no sooner than 90 days after receipt or 60 days after submission of hardcopy data,whichever is longer,unless alternate retention schedules have been established by work-order or contract. 0 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlino Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 ANALYTICAL REPORT FOR SAMPLES Sample ID Laboratory ID Matrix Date Sampled Date Received BRQ 1 21J0007-01 Solid 01-Oct-2021 08:30 01-Oct-2021 08:40 BRQ 2 21J0007-02 Solid 01-Oct-2021 08:30 01-Oct-2021 08:40 BRQ 3 21J0007-03 Solid 01-Oct-2021 08:30 01-Oct-2021 08:40 BRQ 4 21J0007-04 Solid 01-Oct-2021 08:30 01-Oct-2021 08:40 BRQ 5 21J0007-05 Solid 01-Oct-2021 08:30 01-Oct-2021 08:40 4611 S. 134th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlino Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 Work Order Case Narrative Total Metals-EPA Method 6010D The sample(s)were digested and analyzed within the recommended holding times. Initial and continuing calibrations were within method requirements. The method blank(s)were clean at the reporting limits. The blank spike(BS/LCS)percent recoveries were within control limits. The matrix spike(MS)percent recoveries and the duplicate(DUP) relative percent difference (RPD)were within advisory control limits. 4611 5. 134th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax:(206) 695-6202 OhAnalytical Resources,Incorporated 11, Analytical'Chemists and Consultants Cooler Receipt Form. • ARI Client: V �� Project Name: �.. i €C L K,-L"ems K Vim ` COC No(s): Delivered by:Fed=Ex UPS.Courier HagDelive?ga Other: Assigned ARI Job No: 9 110007 Tracking No: 9 Preliminary Examination Phase:. . Were intact,properly signed and dated custody seals attached to the outside of the cooler? YES Were custody papers included with the•cooler?...............................................,:......... 1�E'S NO . L` Were custody papers properly filled out(ink,signed,etc.)............................................ 'E,,S.. NO ' Temperature of Cooler(s)(°C)(recommended 2.0=6.0°C-forchemistry). - Time 01?-0 • 1 g v If"cooler temperature is out of compliance fill out form'00070F J Temp Gun ID#: DOO S7 Cooler Accepted by: 3 L_- /Date: d 6( � -•�Time: 0�'�C� . Complete custody forms and attach all shipping documents Log-In Phase: Was a temperature blank included in the cooler? , , YES f4 - What kind of packing material was used? Bubble Wrap Wet Ice Gel Packs Baggies Foam Block Paper Other:. i' Was sufficient ice used(if appropriate)? - - NA 'YES How were bottles sealed in plastic-bags? • - - Individually Grouped a,, Did-all bottles arrivein good condition(unbroken)? -4 NO Were all bottle labels complete and legible? ._ XE NO Did the number'of"containers listed on COC match with the number of containers received?. NO Did alfbottle labels_and tags agree with custody papers? • - -- ' NO Were all bottles used correct for the requested analyses? • ' NO Do any of-the analyses(betties)require preservation?(attach preservation sheet,excluding VOCs)... YES NO Were all VOC vials free of air bubbles? - •6 YES NO Was sufficient amount Of sample sent in each bottle? . , - NO Date VOC-Trip Blank was made at ARI - .,. Were the sample(s).split YES DateTme: Equipment: b by ARI? SplitYt Samples Logged by: / Date:. -I e)'/©i hi lime: I/d J Labels checked by: 7'1-_-- *'Notify Project Manager of discrepancies or-concerns" - - Sample ID on Bottle- . Sample ID on COC Sample ID on Bottle Sample ID on COC Additional Notes,Discrepancies,&Resolutions: By: Date: 0016F Cooler Receipt Form Revision 014A 01/17/2018 Cooler Ter erature Analytical Resources,Incorporated p Analytical Chemists and Consultants Compliance Form . ARl Work Order: a'7 1 me;fl 7 . Cooler#: Temperature(°C): (K, 6. Sample ID Bottle Count Bottle Type • • • • Cooler#: Temperature(°C): - Sample ID. Bottle Count Bottle Type • Cooler#: Temperature(°C): Sample ID • Bottle Count Bottle Type • Cooler#: - Temperature(°C): Sample ID . Bottle Count Bottle Type Completed by: iilf Date: !a io/ / Time: e yO 00070F Cooler Temperature Compliance Form Version 000 3/3/09 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlino Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 BRQ 1 21J0007-01(Solid) Metals and Metallic Compounds Method:EPA 6010D Sampled:10/01/2021 08:30 Instrument:ICP2 Analyst:MVP Analyzed:10/07/2021 16:08 Sample Preparation: Preparation Method:SWC EPA 3050B Extract ID:21J0007-01 A Preparation Batch:BJJ0140 Sample Size:1.044 g(wet) Dry Weight:0.90 g Prepared:10/06/2021 Final Volume:50 mL %Solids:86.56 Detection Reporting Analyte CAS Number Dilution Limit Limit Result Units Notes Lead 7439-92-1 5 0.664 5.53 12.4 mg/kg D 4611 S. 1 34th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 0 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlin Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 BRQ 2 21J0007-02(Solid) Metals and Metallic Compounds Method:EPA 6010D Sampled:10/01/2021 08:30 Instrument:ICP2 Analyst:MVP Analyzed:10/07/2021 16:16 Sample Preparation: Preparation Method:SWC EPA 3050B Extract ID:2110007-02 A Preparation Batch:BJJ0140 Sample Size:1.08 g(wet) Dry Weight:0.98 g Prepared:10/06/2021 Final Volume:50 mL %Solids:90.35 Detection Reporting Analyte CAS Number Dilution Limit Limit Result Units Notes Lead 7439-92-1 5 0.615 5.12 14.4 mg/kg D 461 1 S. 1 34th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 • 0 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlin Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 BRQ 3 21J0007-03(Solid) Metals and Metallic Compounds Method:EPA 6010D Sampled:10/01/2021 08:30 Instrument:ICP2 Analyst:MVP Analyzed:10/07/2021 16:19 Sample Preparation: Preparation Method:SWC EPA 3050B Extract ID:21J0007-03 A Preparation Batch:BJJ0140 Sample Size:1.076 g(wet) Dry Weight:0.96 g Prepared:10/06/2021 Final Volume:50 mL %Solids:89.57 Detection Reporting Analyte CAS Number Dilution Limit Limit Result Units Notes Lead 7439-92-1 5 0.623 5.19 10.7 mg/kg D 461 1 S. 1 34th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlin Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 BRQ 4 21J0007-04(Solid) Metals and Metallic Compounds Method:EPA 6010D Sampled:10/01/2021 08:30 Instrument:ICP2 Analyst:MVP Analyzed:10/07/2021 16:22 Sample Preparation: Preparation Method:SWC EPA 3050B Extract ID:21J0007-04 A Preparation Batch:BJJ0140 Sample Size:1.037 g(wet) Dry Weight:0.93 g Prepared:10/06/2021 Final Volume:50 mL %Solids:90.01 Detection Reporting Analyte CAS Number Dilution Limit Limit Result Units Notes Lead 7439-92-1 5 0.643 5.36 16.2 mg/kg D 4611 S. 134th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 • 0 Analytical Resources,Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlin Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 BRQ 5 21J0007-05(Solid) Metals and Metallic Com pounds Method:EPA 6010D Sampled:10/01/2021 08:30 Instrument:ICP2 Analyst:MVP Analyzed:10/07/2021 16:25 Sample Preparation: Preparation Method:SWC EPA 3050B Extract ID:21J0007-05 A Preparation Batch:BJJ0140 Sample Size:1.079 g(wet) Dry Weight:0.95 g Prepared:10/06/2021 Final Volume:50 mL %Solids:88.16 Detection Reporting Analyze CAS Number Dilution Limit Limit Result Units Notes Lead 7439-92-1 5 0.631 5.26 11.0 mg/kg D 461 1 S. 1 34th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 0 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlin Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 Metals and Metallic Compounds-Quality Control Batch BJJ0140-SWC EPA 3050B Instrument:ICP2 Analyst:MVP Detection Reporting Spike Source %REC RPD QC Sample/Analyte Result Limit Limit Units Level Result %REC Limits RPD Limit Notes Blank(BJJ0140-BLK1) Prepared:06-Oct-2021 Analyzed:07-Oct-2021 15:09 Lead ND 0.240 2.00 mg/kg U LCS(BJJ0140-BS1) Prepared:06-Oct-2021 Analyzed:07-Oct-2021 15:12 Lead 228 0.240 2.00 mg/kg 200 114 80-120 Duplicate(BJJ0140-DUP1) Source:21J0007-01 Prepared:06-Oct-2021 Analyzed:07-Oct-2021 16:05 Lead 12.1 0.667 5.55 mg/kg 12.4 2.95 20 D Matrix Spike(BJJ0140-MS1) Source:21J0007-01 Prepared:06-Oct-2021 Analyzed:07-Oct-2021 16:11 Lead 244 0.663 5.53 mg/kg 221 12.4 105 75-125 D Recovery limits for target analytes in MS/MSD QC samples are advisory only. 461 1 S. 1 34th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlino Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 Certified Analyses included in this Report Analyte Certifications EPA 6010D in Solid Lead NELAP,WADOE,DoD-ELAP,ADEC Code Description Number Expires ADEC Alaska Dept of Environmental Conservation 17-015 03/28/2023 DoD-ELAP DoD-Environmental Laboratory Accreditation Program 66169 02/28/2022 NELAP ORELAP-Oregon Laboratory Accreditation Program WA100006-012 05/12/2022 WADOE WA Dept of Ecology C558 06/30/2022 WA-DW Ecology-Drinking Water C558 06/30/2022 4611 S. 134th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206)695-6200 • Fax: (206) 695-6202 0 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Report Gary Merlin Construction Co Inc Project: Black River Quarterly 9125 10th Avenue South Project Number: [none] Reported: Seattle WA,98108 Project Manager: Greg McKinnon 15-Oct-2021 17:41 Notes and Definitions D The reported value is from a dilution J Estimated concentration value detected below the reporting limit. U This analyte is not detected above the reporting limit(RL)or if noted,not detected above the limit of detection(LOD). DET Analyte DETECTED ND Analyte NOT DETECTED at or above the reporting limit NR Not Reported dry Sample results reported on a dry weight basis RPD Relative Percent Difference [2C] Indicates this result was quantified on the second column on a dual column analysis. WIWashington State Department of Transportation Request for A roval of Material Contract Number FA Number NSA SR Duvall Ave NE Date CAG 20-065 01/12/2022 Section/Title of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor This form shall be completed prior to submittal. If this form is not compete at time of submittal it may For WSDOT Use Only be returned for information that was omitted. RAM# 074 & 075 PE Use Bid Item Material or Name and Location of Fabricator, Specification PE)QPL Hdgtr.IQPL HQ Use Nc. Product/Type Manufacturer or Pit Number Reference Code Code A27 2"Gravel Borrow Frankline Rdge 2-03 1, 2 Project Engineer/Representative Date State Materials Engineer/Representative Date 1/20/2022 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 10 Acceptance Criteria: Acceptance based upon"Satisfactory'Test Report for samples of materials to be incorporated into project. 20. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment', 'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 10. Approval Wthheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Provide Scale Cert. and Daily Scaleman's Reports. Delivery Ticket shall show bid item number and description. Remarks (HCG): Ballast substituted for gravel borrow for embankment construction, per WSDOT 9-03.14(1) . DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ©Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materials Lab.MS 47365 AMC,. MATERIALS TESTING CONSULTING,INC. Sieve Report Project:City of Renton-Duvall Ave NE Project Date Received: 14-Jan-22 1 nified Soil Classification Systems,ASTM-2437 Project k:2113042.02 Sampled By:N.Curtis-Duguay (iW,Well-graded Gravel with Sand,Crushed Client:Gray&Osborne,Inc. Date Tested: 14-Jan-22 Sample Color: source: Franklin Ridge Sand&Gravel(Ballast) Tested By:K.Mendez Brown ADt an Sam Irk: B22-0035 Cardficataa:1166.01 ASTM D2216,ASTM D2419,ASTM D4318,ASTM D52D1 D,,, II 085 mm ".,l,ratcl- 63.4"-e Colt.of t.unaturr,C,= I67 Specifications D„u,-0.651 mm y.Sand-31.8% Coati:of Uniti,rmity.(',,- 18.62 21)20 W SDOT 9-03.9(1)Ballast 13,,,,- 1311 nun %Silt&Clay 4.8% Fineness Modulus..5.77 Sams**Mack Spsea 7 V.s D,w,=3.631 mm Liquid Limn=nlu Plrnc Limit=ma D,,,,=8.531 mm Plasticity Index=nia 1 Moisture"a,as sampled=0.5% D,,,,,,=12.114 min Sand Equivalent=42 I R vi'd Sand Equivalent=35 I),,,,, 33 928 non Fracture",,,1 tare nia Rey'd Fracture°'a I Face- I)u,t nail.. 21 t• Ft;Actor:",,.2.•Foe. tin Ray'd Fnr.nn:'4,.:,Faces- _, ASTM C136,ASTM D6913.ASTM C117,ANrM D/14e AIL- ,,,,,., I mcrpnlattd / txm,Sae nwmuactr I umulatn e I.amulativr Sieve Size Percent Percent Specs Specs b ro a.:, __'r N. •- ,� s q 4 9Sa� US Metric Passing Passing star Min ,a)s I inn 12.00" 300.00 100°. , 10,00" 250.00 100% 8.00" 200.00 100% '° - vat 6.00' 150.00 100% 1 1 4.00' 100.00 100% on -VOX 3.00" 75.00 100% 100% 2.50" 63.10 / 100% 101t11% 99.0% 2.00" 50.00 100% I 100% 100.0% 65.0% on ii . I! 1 I oat 1.75" 45.00 97% • I.SO' 37.50 92% 1.23" 31.50 / 885E 10R (, 1 % 10.01 1.00" 25.00 84%1 84% 0.0"„ 50.0% 1 t� I 3/4" 19.00 73% 73% is‘ ! 518" 16,00 68% sus• ,, . 12" 12.50 61% 61% 3/8" 9.50 53% 53% a \ r- IN4" 4,75 37•,.1 37% 44.0% 26.0°„ i \ 48 236 23% oa 1 1,1 MI 2.00 20°„ 20% 0 N16 1.18 14% a1 > H.% t ,.,. k20 0.850 II.,, 11% N30 0.600 10% \ 1 N40 0.425 8%/ 8% 16.0."-, 00'„ 'OK \ a... 450 0300 7% ` N60 0.250 7% 7% _ _ "s N80 0.180 7% mac mom „ ,-m una OM, 0100 0.150 6% 6% M140 0.106 5% N170 0.090 1/ 5% x200 0.075 4.8°%. 9.0% _-._ . \ Continents: Sample meets%SDOT Specification Section 9-03.9(11 for Ballast Reviewed hr: • Medhanie Tecle Environmental•Geotechnical Engineering•Special Inspection•Non-Destructive Testing•Materials Testing Burlington I Olympia I Bellingham I Silverdale I Tukwila 360.755.1990 www.mtc-inc.net • I wnww s s 11211100110111111.111111.011C., Proctor Report Project:City of Renton-Duvall Ave NE Project Date Received: 14-Jan-22 Unified Sulk ClasslBcatioa System,ASTM D-2487 I ASTM C136 Project O:210042-02 Sampled By:N.Curtis-Dug GW,Well-graded Gravel with Sand,Crushed Sieve She Percent Specifications Client:Gray&Osborne,Inc. Date Tested: 14-Jan-22 Sample Cuter US ® Passing Alas %lin Source:Franklin Ridge Sand&Gravel(Ballasts Tested By:K.Mendez Brown 12.181" 300.00 Sumpicd: 1322-0035 10.00" 250.00 Sample Prepared: Moist:X Manual: 8.00' 200.00 Dry: Mechanical:X 6.00' 150.00 Test Standard: ASTM D698: AASHTO T 99: Method 4.00' 100.00 ASTM D 1557:X AASHTO T IRO: C 3.00" 75.00 100% Assumed Sp.Gr. Point Percent Dry Uncorrected Proctor Value 2.50" 63.00 100% yy"« 2.65 Number Moisture Density Max.Dry Density Optimum Moist 2.00' 50.00 100% 100% 65". 1 2.8% 127.2 133.4 Ibs/8' 6.6'% 1.75' 45.00 2 4.8% 130.4 1.50" 37.50 3 6.6% 134.R Value w/Oversize Correction Applied 1.25' 31.50 4 8.5% 131.4 Max.Den Density Optimum Moist 1.00" 25.00 84% 85% 50'. aCCtriDlTRD 140.6 lbs/ft' 5.0"%. 3/4" 19.00 73% Ceit1acexe.:1fi01 518" 16.00 1/2" 12.50 61% M•isture Density Relationship 3/8" 9.50 53% DU• 1/4" 6.30 WA 4.75 37% 44% .6"., #R 2.36 Sad 0 #10 2.110 20 #16 1.18 sr• / /� �� ^'''� #20 0.850 11%#30 0.600 S� on.., / 40 0.425 8% I6 D' #so 0.300 ❑A, 060 0.250 7% \ 080 0.180 urn • #100 0.150 6% r. 1% s.s 1% ••• s.• •a w te% oo"• tr• #140 0.106 Percept Sias-tare .170 0.090 • obWM.p. Ate Air Vat.Cunt -sp.ew #200 0.075 4.6%. 9.0"0 0.0'" ASTM D4718.Misc.Oversize Correction Values Specs:2020 WSDOT 9-03.911)Ballast Meets Specs?Yes %Oversize Marl:27% %Gravel:63.4% Cs.: 1.67 D,ion:0.651 ",.0..a>irr Corrected Optimum %Sand:31.8% Cu:18.62 Dom.3.631 Retained Density Moisture %Silt&Clay:4.8% FM:5.77 Die,: 12.114 5% 134.7 6.3% I0 136.0 6.0% LL:rda PL:Na PI:n/a 15% 137.4 5.7% 20% 138.8 5.4% Sand Equivalent:42 Req'd Sand Equivalent:35 25% 1402 5.1% 30% 141.6 4.8% Fracture%,I Face: n a Req'd Fracture%.1 Face: -on,.y.sn..r r...e••r,.r..,;�....-... Fracture°,.2+Faces - ; Iteq'd Fracture"..2 t Faces: ,i!,.r,yAt-d.pods,pen.r.s...;,"-ar.,,,."�reK.,3..3'.-h.,..e,v;te..,m in...mm,�..r.rn.sa.....„...;"yin rm,....,3.,..;.,.n.,...,...,........,t,.en.,•.,i;,.m...,. ,,..,,..3.4.n;.,m,",..,.'.,..a rm.n.p.m.m st.".� Commode.: Started to bleed water at 6%added moisture.on the Ird lill. �115rst Reviewed by: P Medhanie Tale Environmental•Geotechnical Engineering•Special Inspection•Non-Destructive Testing•Materials Testing Burlington I Olympia I Bellingham I Silverdale I Tukwila 360.755.1990 www.mtc-inc.net NATIRtALS TINTING&CONSULTING,INC. Sand Equivalent Report Project:City of Renton-Duvall.Ave NE Project Date Received: I4-Jan-22 1Unified Soil Classification System,AST%l-2487 Project#:21B042-02 Sampled By: N.Curtis-Du-�GW.Well-graded Gravel with Sand,Crushed Client:Gray&Osborne,Inc. Date Tested: 14-Jan-22 I S:r mple Color Source:Franklin Ridge Sand&Gravel(Ballast) Tested By:K.Mendez !Brown Ss :B22-0035 —Wilk Temperature of Solution: cr.r.t.f..,r 1166 01 Sand Equivalent=(Sand Reading/Clay Reading)x 100 p 1 02 03 Clay Reading: 8.3 8.1 N/A Sand Reading: 3.5 3.3 N/A Time: 20 mins 20 mina 20 mins Sand Equivalent: 43 41 n/a Average Sand Equivalent: 42.11 Adjusted Sand Equivalent: 42 Required Sand Equivalent: 35 An eodn arpy.vly"o n,6.arvm.,..i..m.n.I.e.ed.a..moon rannanv.enwa.tYrntli.andonnh,..11rn.ns we Admitted me awfdnnal l.ope..v.K iian and nelnnn..a for p,blurs.ndranmr.av,.on--lusaw«nano.Inn..rtpd•r r y.,m.rni.n.d r ntin,,.n.nkn mrnnnl. Comments: Sample meets minimum requirement. Reviewed by: Medhanie Tecle Environmental•Geotechnical Engineering•Special Inspection•Non-Destructive Testing•Materials Testing Burlington I Olympia I Bellingham I Silverdale Tukwila 360.755.1990 www.mtc-inc.net Aggregate Source Approval Report. •https://www.wsdot.wa.gov/bizlmats/ASA/ASAReport.cfm?prefix=A&pi... • • WSDOT MATERIALS LAB 01/12/2022 Aggregate Source Approval Report Oivner: Franklin Ridge Sand and Gravel(Green Section 30,LLC.). Aggregate"Source: PS-A-514 • Lessee: Known as r Franklin Pit Located in: SW 1/4 Section 30 T21N R7E County: King . • Remarks: • • Mineral•Agg.and,Surfachig: Test Date: 09/30/2011 Expiration Date:09/30/2.026 • • Absorption:1.08 Apparent Sp.G.:2.79 Bulk Sp.G.(SSD):2.738 Bulk Sp.G.:2.708 Deg:36 LA:13 Remarks: Currently approved:as.a source of aggregate for: • ATB Ballast . BST Crushed,Cover Stone. BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing.Key Stone Crushed Surfacing Top Course. Gravel Backfill for Foundation Class A HMA Other Courses • HMA Wearing Course Maintenance Rock Permeable Ballast • • • .Acceptance tests need to be performed as-necessary., Aggregatesfor.Concrete: Test.Date: Expiration•Date:: ASR-14 Day: ASR-One Year: CCAAbsorption: : CCASp.G: Deg: FCAAbsorption: FCAOrganics: FCASp:G: LA: Remarks: • • NOT approved for: Coarse Concrete Aggregates Fine Concrete Aggregates Rlprap,Quarry Spans,Rock for Rock Wall,.Erosion and-Scour Protection: Test-Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA Remarks: • 1 of 2 1/12/2022,8:29 AM • a. . ,�... Aggregate Source Approval Report. https://www.wsdot.wa.gov/bizfmats/ASA/ASAReport.cfm?prefix=A&pi... NOT Approved for: Quarry Spatls Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(6) • Streambed Aggregates: Test,Date: 09/30/2021 Expiration Date:09/30/20.26 Absorption:1.08 Apparent Sp.G.:2.79 Bulk Sp.G.(SSD):2.738 Bulk Sp.G.:2.708 - Deg:36 LA 13 Remarks: .Currently Approved for: Streambed Aggregate Gravel.Borrow.for Structural Earth Walls: Test Date:09/30/2021 Ezpiration•Date;.09/30/2026 Bulk Sp.G.(SSD):2.738 Deg:36 LA 36 Remarks:. Forgeosynthetic-reinforcement;tile'gravel,borrow shallbe.tested for pH prior to placement.-For metallic reinforcement,.the gravel borrow shall be tested-for pH,resistivity,chlorides;and sulfates prior to placement...li the resistivity of the backfill material equals or exceeds 5,000.ohm-cm,the-specified chloride and sulfate limits may,be waived.If the aggregate source has variable quality,additional testing maybe required.Contact the,Regional Materials Engineer or the State Geotectinical Engineer for•direction: • • NOTApproved'for: Gravel Borrow for Str Earth Walls ALL OTHER PIT RUN MATERIALS: Project Engineer may request preliminary samples but Aggregate Source Approval is not required. AGGREGATE,MATERIALS NOT REQUIRING ASA APPROVAL: Aggregate for Gravel Base 9-03.10 Gravel Backfill for Foundation Class B 9-03.12(1)B Gravel Backfill for Walls 9-03.12(2) • Gravel Backfill for Pipe Zone Bedding 9-03.12(3) Gravel Backfill for Drains 9-03.12(4) - Gravel Backfill for Drywells 9-03.12(5) Backfill for Sand Drains 9-03.13 Sand Drainage Blanket 9-03.13(1) Gravel Borrow 9-03.14(1) Select Borrow 9-03.14(2) Common Borrow 9-03.14(3) - Native Material for Trench Backfill 9-03.15 - Foundation Material Class A and B 9-03.17 Foundation Material Class C 9-03.18 Bank Run Gravel for Trench Backfill 9-03.19 - Commercial Concrete Aggregate 6-02.3(2)8 2 of 2 1/12/2022,8:29 AM t A '��� WashingthriDePaltmentStsteofTM '" Request for Approval of Material Contract Number FA Number SR Date CAG 20-065 N/A DUVALL AVE NE 01/06/2022 Section/Title of Project County DUVALL AVE NE KING Contractor Subcontractor REED TRUCKING&EXCAVATING.INC This form shall be completed prior to submittal. If this form is not compete at time of submittal it may For WSDOT Use Only be returned for information that was omitted. RAM# 029B PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL Hdqtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code B17 ALL THRD ROD STS INDUSTRIAL Std. Plan- 10 106 A49-A53 SPEEDCRETE/REDUNE EUCLID CHEMICAL Std. Plan - 10 l 310.1 A43-A48, B6-B8, ETHAFOAM SHEETS ULINE B17S.P.7-04.2 3 and B18 Project Engineer/Representative L _ x-- Date State Materials Engineer/Representative Date K'� 1/20/2022 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 1. Acceptance Criteria: Acceptance based upon"Satisfactory"Test Report for samples of materials to be incorporated into project. 2. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑X Yes ❑No Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment', 'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 4111)•pproval Withheld: See Remarks 11. Miscellaneous Acceptance Criteria. Remarks (PE): COR-TEN Steel Tie Rods per COR Std. Plan -310.1 Remarks Mortar for pipe joints and grade rings and casting for CB (HQ): Type 1 shall meet requirements of AASHTO M 85, Type I or Type II, per Std. Plan -200.00&WSDOT 9-04.3 Mortar for Manhole Risers shall meet requirements of ASTM C270 Type S, per COR Std Plan -106 DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ©Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials 0 State Materials Lab-MS 47365 A307 All Thread Rod.Galvanized P1D ITEM 817 FOR HYDRANT RUNS The ASTM A307 specification covers carbon steel bolts and studs ranghg from 1/4 through 4 diameter A307=.s an economical low carbon material often manufactured using A36 round bar.Dimensional specifications 01.11.11.11111 are governed by ASME 818.31.3.A307 all thread rod Is available in hot dip galvanized finish,which provides a corrosion resistant zinc coating.The all thread sod listed on this page is domestic,metted and manufactured In the USA. Q a• PRODUCTS GOVERNING STANDARDS MECHANICAL PROPERTIES CHEMICAL PROPERTIES GOVERNING STANDARDS ,:ek"i u'i SUBMITTAL REVIEW No Exceprwns Turn Make Conmcurc Not. M+!na s Rosubnit AST.AJp7 Covers Me mechanical ur and material reqemenm inc h ch settslasfd da tera h anneters Rom R Rolected-See Re mark: i,a'throtgh a"mane of cannon Peel having a inns Olm tensile semen or snood psi IMPORTANT NOTICE tiros rm.., dtAtti not mils.Ira Contractor from reaponrtOty to comply 6 whom Naito 1111411.3 covers the genera WO mmrntstonal data tar inch !Meade,'era s r COR-TEN Stahl Tie Rods the Plena.SpaoRnaxns and Rode Fen Dodo ttoo d m«as COR Old Plan-J+s.+ ASME 81.t UNC& Seethes the thread f nT'l nnneS class aeoerance tdkrarie,artl desgrrammn tar united screw (d.7 Nr Claume.o.Treas I.n. UNF Class 2A threads ertr,e..E-.5. nv gR1E Sal,Ilill$2 oianNr Thread Pied + A307 All Thread Rod,Galvanized Sr I The Euclid Chemical Company SPEED CRETE RED LINE ED RAPID SETTING REPAIR MATERIAL EUCLID CHEMICAL DESCRIPTION SPEED CRETE RED LINE is a rapid-setting,cement-based concrete and masonry repair mortar.SPEED CRETE 0 RED LINE is a proprietary formulation of blended portland cements,finely processed selected aggregates, and specific chemical additives that undergo a chemical"hyper hydration"and produces a stable, low permeability, cementitious matrix. SPEED CRETE RED LINE can be"shaved"for detailed repairs. rn 73 PRIMARY APPLICATIONS • Interior and exterior • Vertical and overhead repairs • Used at no slump consistency • Outstanding repair material for concrete pipe,formed and precast concrete FEATU RES/B EN EFITS • Initial set in 8 to 20 minutes • High strength • Final set within 30 minutes • Excellent durability • Can be "shaved"to desired shape • Compatible with galvanic anodes TECHNICAL INFORMATION v7 The following are typical values obtained under laboratory conditions. Expect reasonable variation under field conditions. Compressive Strength, psi (MPa) ASTM C109 Freeze Thaw Durability Factor ASTM C666 m 24 Hour 2,550(17.6) 300 Cycles 96.75% 7 Day 4,000(27.6) 28 Day 5,700(39.3) Shrinkage 50%RH ASTM C157(3-x3"x11"specimens r were removed from molds @ 24 hours) Set Time, ASTM C266 Z Initial 8 20 Min 28 Day -0.069% Final 15-30 Min Expansion 100% RH ASTM C157(3"x3"x11"specimens Split Tensile Strength,psi (MPa) ASTM C496 were removed from molds @ 24 hours) 7 Day 240(1.7) 28 Day 0.142% 28 Day 290(2.0) Flexural Strength, psi (MPa) ASTM C348 Scaling Resistance ASTM C672 7 Day 700 (4.8) 50 Cycles 0%loss 28 Day 918 (6.3) Volumetric Resistivity 5,250 ohm-cm Appearance: Available in 6 shades of gray 0 'i PACKAGING O XI SPEED CRETE RED LINE is packaged in 50 lb (22.7 kg) poly-lined bags, and 50 lb(22.7 kg) pails o 0 3 SHELF LIFE "• 18 months in original, unopened packaging COVERAGE One 50 lb (22.7 kg) bag yields approximately 0.47 ft3 (0.013 m3)when mixed with 5.5 qt(5.2 L) water 19215 Redwood Road • Cleveland,OH 44110 www.euclidchemical.com 800-321-7628 t • 216-531-9596 f DIRECTIONS FOR USE Surface Preparation:Concrete surfaces must be structurally sound,free of loose or deteriorated concrete and free of dust,dirt,paint,efflorescence,oil and all other contaminants. Mechanically abrade the surface to achieve a surface profile equal to CSP 6- 8 in accordance with ICRI Guideline 310.2. Properly clean profiled area. Priming& Bonding (Saw Cut&Chipped Out Repairs): Thoroughly clean any exposed reinforcing steel,and apply DURALPREP A.C.to the concrete and the reinforcing steel within the repair area.Refer to the DURALPREP A.C. technical data sheet for full instructions. Alternatively, application of a scrub coat of SPEED CRETE RED LINE to the saturated surface dry(SSD) concrete surface may be used for bonding.The repair material must be placed on the scrub coat before the scrub coat dries out. Mixing: SPEED CRETE RED LINE will require approximately 5 to 5.5 qt (4.7 to 5.2 L) of potable water per 50 lb (22.7 kg) bag to achieve the proper mix consistency. Pour the measured amount of water into a clean mixing container, then add the SPEED CRETE RED LINE, and thoroughly mix for no more than 60 seconds to a stiff, no slump, putty-like consistency. Mix small quantities of SPEED CRETE RED LINE in a clean pail with a hand trowel. Use a rotary mixer with rubber tip blades for mixing quantities up to 100 lbs. (45.4 kg). To fill patches 2" (5.1 cm) deep or greater, add clean, pre-dampened,3/8" (0.96 cm) size pea gravel. DO NOT USE LIMESTONE AGGREGATE.The mix ratio must not exceed 40 lbs. (18 kg) of pea gravel to each 50 lb (22.7 kg) bag or pail of SPEED CRETE RED LINE. Mixing procedure:Start mixer,load water,load pea gravel,and then load the SPEED CRETE RED LINE. MIX FOR NO MORE THAN 60 SECONDS. Application: For vertical repairs, place SPEED CRETE RED LINE in 1/8" -2" (3.2mm-50.0 mm) lifts.To ensure a complete bond with the entire surface,force the SPEED CRETE RED LINE firmly into the SSD area by hand or with a trowel. Slightly overfill the repair,and following initial set, shave the material to conform to the contour of the surrounding surface. Always shave SPEED CRETE RED LINE toward the common bonding edge between the repair mortar and the existing surface. Cure material using standard curing practices. Cold Weather Installation: Application at temperatures below 40°F (4°C) extends the set time. Heating the repair area until warm, using warm water for mixing, and tenting/insulating the repair area after application will increase strength development. Do not use direct heat on the repair after it is installed. CLEAN-UP Clean application tools and mixing equipment with water immediately following use. PRECAUTIONS/LIMITATIONS • Keep in covered storage away from all moisture. • Mix no more than 60 seconds. • Use only potable water with SPEED CRETE RED LINE. • Mix to a stiff, putty-like, no slump consistency. Do not add more water than recommended. • Do not apply SPEED CRETE RED LINE as a horizontal topping or as a tile setting mortar. • When necessary,follow the recommendations in ACI 305R "Guide tj9ITT or yr ACI 306R "Guide to Cold Weather Concreting". "" AL r v • Do not re-temper or add sand to SPEED CRETE RED LINE. No Exceptions Taken • In all cases, consult the Safety Data Sheet before use. Make Corrections Noted Amend & Resubmit Rejected-See Remarks Mortar for pipe joints and grade rings and casting for CB Type 1 shall meet requirements of AASHTO M 85,Type I IMPORTANT NOTICE:This review or Type II, per Std. Plan -200.00 &WSDOT 9-04.3 does not relieve the Contractor from responsibility to comply&conform Mortar for Manhole Risers shall meet requirements of with the Plans, Specifications. and ASTM C270 Type S, per COR Std Plan -106 Contract Documents. IWO 4C3rap&OsLc.me,Lao. CONSULTING ENGINEERS Rev.03.19 By: DRS Date-1/11/2022 WARRANTY The Euclid Chemical Company("Euclid')solely and expressly warrants that its products shall be free from defects in materials and workmanship for one(1)year korr the date of purchase.Unless authorized in writing by an officer of Euclid.no other representations or statements made by Euclid or its representatives.in writing or orally.shall alter the warranty,EUCUD MAKES NO WARRANTIES.IMPLIED OR OTHERWISE. AS TO THE MERCHANTABILITY OR FITNESS FOR ORDINARY OR PARTICULAR PURPOSES OF ITS PRODUCTS AND EXCLUDES THE SAME.If any Euclid product fails to conform wan this warranty.Euclid will replace the product at no cost to Buyer Replacement of any product shall be the sole and exclusive rernecy available and buyer shall have no clam for incidental or consequential damages.Any warranty claim must oe made within one(II year from the date of me darned breach.Euclid does not authorize anyone on its behalf to make any written or oral statements which in any way after Euclid's installation mfotmation or instructions in its product literature or on its packaging labels.Any instaltat,on of Euclid products which tails tc conform with such installation information or instructions shall void this warranty.Product demonstrations,if any are done for illustrative purposes only and do not constitute a warranty or warranty alteration of any kind.Buyer shall be solely responsible for determining the suitability of Euclid's products for the Buyer s intended purposes. ULINE 700 Uline Way Allentown, PA 18106 • PHONE (800)295-5510 • WEB uline.com • FAX(800)295-5571 January 4, 2022 Ferguson Waterworks 2042 112th St S Tacoma, WA 98444 Hello Mark, This is the Specification Sheet for S-12856- Plank Foam without Adhesive- Non- Perfed, White, 48 x 96 x 2". • Flexible low-density polyethylene foam is highly resilient, shatter proof and tear resistant. • Water, fungi and mold-resistant closed cell foam. • FDA compliant for indirect food contact. • Non-perfed sheets, no adhesive. • Temp Range--78° a +101°C (-110° to +215°F) Please contact our Customer Service Department at 1-800-295-5510 if you have any additional questions. Sincerely, Andrea N. Customer Service SUBMITTAL REVIEW Pennsylvania X No Exceptions Taken Make Corrections Noted Amend & Resubmit Rejected-See Remarks IMPORTANT NOTICE: This review does not relieve the Contractor from responsibility to comply&conform with the Plans, Specifications, and Contract Documents. Gray 8z Osborne,Ino. CONSULTING ENGINEERS By: DRS Date: 1/20/22 CHICAGO ATLANTA DALLAS LOS ANGELES MINNEAPOLIS • NYC/PHILA • RENO • SEATTLE • MEXICO • CANADA Washington State �/ Department of Transportation Request for Approval of Material Contract Number FA Number NSA SR Duvall Ave NE Date CAG 20-065 01/11/2022 Section/Title of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor This form shall be completed prior to submittal. If this form is not compete at time of submittal it may For WSDOT Use Only be returned for information that was omitted. RAM# 066/066A PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL Hdqtr./QPL HQ Use Nc. Product/Type Manufacturer or Pit Number Reference Code Code A27 Arifti3dr Sand Egwv.CSBS Squak Mountain9-03.14(1) Gravel Borrow 2 6-03.21(1)C 10 A32 Gravel Backfill Squak Mountain - Issaquah, WA 9-03.12(2) 10 for Walls 9-03.21(1)C Bank Run 9-03.19 B4.02 Gravel for Squak Mountain -Issaquah, WA 1, 2 Trench Backfill 9-03.21(1)C A43.03.02 Pipe Zone 9-03.12(3) to Bedding Squak Mountain -Issaquah, WA 9-03.21(1)C 1, 2 A48.03.02, B6.04 to B8.04, 89.05 Project Engineer/Representative Date State Materials Engineer/Representative Date 1/13/2022 --------- ------- Acceptance Action Codes for use by Project Engineer and State Materials Laboratory OAcceptance Criteria: Acceptance based upon"Satisfactory'Test Report for samples of materials to be incorporated into project. 0 Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material. Catalog Cut Approved D Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment', 'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 0 Approval Withheld: Approval Withheld: not approved for Gravel Borrow or Gravel Backfill for walls 11. Miscellaneous Acceptance Criteria. Remarks Prior to use, provide toxicity testing and certification of (PE): toxicity characteristics in accordance with Section 9-03.21(1). Remarks Provide Scale Cert. and Daily Scaleman's Reports. (HO): Delivery Ticket shall show bid item number and description. CSBC material can be used for Gravel Backfill for Pipe Zone Bedding (9-03.12(3)) — — — — a — S S DOT Form 350-071 Project Engineer Distnbution Revised 03/2021 O Contractor ❑Region Operations Engineer 0 Fabncation Inspection ❑Region Materials ❑State Matenale Lab.MS 47365 9-03.12(3)Gravel Backfill for Pipe Zone Bedding 9-03.9(1) Ballast(for use as Gravel Borrow) Sieve Size j Percent Passing Sieve Size Percent Passing 2/:" 99-100 t Di" 99 100 / 2" 65-100 1 1" 75-100 Y 16" 50-100 1" 50-85 No.4 26.44 No.4 20-80 J No.40 16 max. r No.40 3-24 No.200 9.0 max. r No.200 10.0 rnax.if Dust Ratio: %max. J Sand Equivalent 35 min.1 Sand Equivalent 35 min. 1^ U.S.Standard Sieve Opening in Inches U.S.Standard Sieve Numbers Hydrometer Results 100% zo v a s iv 'A Y. 514 1016 20 30 40 50 too zoo 0% 90% I ♦ 10`1/0 , - 4 80% \\\........1.6.1‘ 20% vt 70% . . , . 30% 13 60°!° 40% 3g, 50% ♦ ♦ 50% E 2▪ 40% � � 60% ig n . al• 30% ♦ �% ' ' 70% 20% ` •y_♦� 80% 4446 10% .. - �'� 4. 90% 100% 1000 100 10 1 0.1 0.01 0.001 Grain Size in Millimeters Gravels Sands Cobbles Silts Clays Coarse I Fine Coarse I Medium I Fine Date:01/06/22 Di0=0.19 1 SC'S Classification "o Gravel "'o Sand Sample#:20-198 D30=3.25 GP-GM,Poorly graded Gra 61.8",. 31.3% Sample ID:Squak Mm CSBC D°„= 11.87 Specifications Source:Stock Pile Cc=4.57 WSDOT 9-03.9(3)Base Course Project: Cu-61.02 Sample Meets Specs %Silt&Clay Location:Squak Mm Liquid Limit=n/a Yes 6.9% Boring#: Plastic Limit= n.'a Fineness Modulus SE 56 Depth: Plasticity Index- n.`a 5.46 Coarse Actual Interpolated Fines Actual Interpolated Section Cumulative Cumulative Section Cumulative Cumulative Sieve Size Percent Percent Specs Specs Sieve Size Percent Percent Specs Specs US Metric Passing Passing Max Min US Metric Passing Passing Max Min 6.00" 150.00 100.0% #4 I 4.750 38.2% 38.2% 45.0% 25.0% 4.00" 100.00 100.0% #8 2.360 25.2% 3.00" 75.00 100.0% . #10 2.000 23.2% 23.2% 2.50" 63.00 100.0% #16 1.180 19.5% 2.00" 50.00 100.0% #20 0.850 17.9% 1.75" 45.00 100.0% • #30 0.600 16.811/0 1.50" 37.50 100.0% #40 0.425 16.0% 16.0% 18.0% 3.0% 1.25" 31.50 100.0% 100.0% 100.0% #50 0.300 12.7% 1.00" 25.00 94.3% 94.3% 100.0% 80.0% #60 0.250 11.4% 7/8" 22.40 88.0% #80 0.180 9.6% 3/4" 19.00 79.9% #100 0.150 8.8% 5/8" 16.00 72.7% 72.7% . 80.0% 50.0% #140 0.106 7.7% 1,2" 12.50 61.9% #170 0.090 7.3% 3/8" 9.50 52.7% #200 0.075 6.9% 6.9°10 7.5% 0.0% 1/4" 6.30 42.9% #270 0.053 #4 4.75 38.2% 38.2% 45.0% 25.0% Coprnbt Spear.I'ngincering&Technical S.r.ce;PS, I996-2015 9-03.14(1) Gravel Borrow 9-03.12(2) Gravel Backfill for Walls 9-03.19 Bank Run Gravel Sieve Size Percent Passirg Sieve Size Percent Passing for Trench Backfill 4" 99-100 t 4" 99.100 1 Sieve Size Percent Passing .. 2" 75-100 J 2" 75-100 It 2" 75-100 J No.4 22-66 No.4 SO-80 x---- No.200 5.0 max. X No.4 22-100 tl No.40 30 max. t/ - No.200 0-10 %Passing No.200 %max. No.200 7.0 max. f Dust Ratio: S.Passing No.40 Dust Ratio: %max. Sand Equivalent 50 min. J Sand Equivalent 60 min. X Sand Equivalent 30 min. A. Washington State • %I Department of Transportation Request for.Ap roval of Material Contract Number - FA Number N/A SR Duvall Ave NE Date CAG 20-065 . _ ._ 01/03/2022. Section 1 Title of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor This form shall be completed prior to submittal.If this form is not compete at time of submittal it may For WSDOT Use Only be returned for Information that was omitted. RAM 6 062A PE Use Bid Iteern. Material or Name and Location of Fabricator, Specification PE/QPL HdgtrJQPL HQ Use No. Product/Type Manufacturer or Pit Number . Reference Code Code A27, ire4 Gravel Barrow Kargley Rock&Recycling 2-03 943.14(1) — 2 _ - .9-03.21(1)C �' See RAM.062 for approval of BI A32$B4. ' • • • • • • Project Engineer/Representative Date State Materials Engineer/Representative Date• 1/4/2022 . Acceptance Action Codes for use by Project Engineer and State Materials Laboratory iO•Acceptance Criteria; Acceptance based upon"Satisfactory'Test Report for samples of materials to be incorporated,into project. 3 Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment'.WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 10. Approval Withheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Prior to use, provide toxicity testing and certification of toxicity characteristics in accordance with Section 9-03.21(1). Remarks (HQ): Provide Scale-Cert. and Daily Scaleman's Reports.. Delivery Ticket shall show bid.item number and description. DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor ❑Region Operations Engineer 0 Fabrication Inspection ❑Region Materials 0 Slate Materials Lab-MS 47385 Stoneway Concrete Technical Services Aggregate Sieve Analysis PROJECT: Internal Testing • DATE: 1/3/2022 LOCATION: Black River Quarry SAMPLE SOURCE: A-51.6 SAMPLE DESCRIPTION: RCA Gravel Borrow AGGREGATE SIZE: 2" TESTER: Sean SPECIFICATION SIEVE WEIGHT PERCENT PERCENT WSDOT 9-03.14(1) SIZE RETAINED RETAINED PASSING Gravel Borrow 6" 0.0 0 100 J ; 4" 0.0 .0 100 99 - 100 3" 0.0 0 100 2" 0.0 0 100J 75 - 100 1" 11.5 25 75 3/4" 12.5 28 72 1/2" 14.8 33 67 J #4 21.7 48 52 50 - 80 #10 30.7 68 32 #40 40.4 89 111 0 - 3.0 #200 44.6 98 2 J 0 - 7- Pan 45.3 100 0 WET SAMPLE: 48.5 TOTAL MOISTURE: 7% DRY SAMPLE: 45.3 DUST RATIO: 15% SE: 80%, 'The minimum percent passing the No.50 and No.100 sieves may be reduced to 5 and 0,respectively,if the aggregate is to be used in air-entrained concrete containing more than 400 lb of cement per cubic yard or In noneir-entrained concrete containing more than 500 lb of cement per cubic yard(C 33 6.2) 9-03.14(1) Gravel Borrow Sieve Size. Percent Passing 4" 99-100 2" 75-100 No.4 50-80 No.40 30 max. • No.200 7.0 max. Sand Equivalent 50 min. ASTM C 136 ASTM C 33 El WSDOT MATERIALS LAB 12/16/2021 Aggregate Source Approval Report Owner: Kangley Rock&Recycling, Black River Aggregate Source:t`S-A-S1E) Lessee: Known as: Kangley Rock&Recycling,Black River Located in: T23N, RANGE4E,SECTION14 Section 14 T23N R4E County: King Remarks: Tier 1 & 2 Recycled Concrete Aggregates (RCA). Acceptance is based on Toxicity Test Report & Certification of Toxicity Characteristics per 9-03.21(1) & Field Testing for Grading, Sand Equivalency and/or Dust Ratio per 3-04&9-03.See QPL for further info. Mineral Agg.and Surfacing: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA Remarks: NOT approved as an aggregate source for: ATB Ballast BST Crushed Cover Stone BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing Key Stone Crushed Surfacing Top Course Gravel Backfill for Foundation Class A HMA Other Courses HMA Wearing Course Maintenance Rock Permeable Ballast Aggregates for Concrete: Test Date: Expiration Date: ASR-14 Day: ASR-One Year. CCA Absorption: CCA Sp.G: Deg: FCAAbsorption: FCAOrganics: FCASp.G: LA: Remarks: NOT approved for: Coarse Concrete Aggregates Fine Concrete Aggregates Riprap,Quarry Spells,Rock for Rock Wall, Erosion and Scour Protection: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: lA: Remarks: NOT Approved for: Quarry Spalls Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(6) Streambed Aggregates: Test Date:. Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA: Remarks: NOT Approved for: Streambed Aggregate Streambed Aggregate Gravel Borrow for Structural Earth Walls: Test Date: ,Expiration Date: Bulk Sp.G.(SSD): Deg: LA: NOT Approved for: Gravel Borrow for Str Earth Walls ALL OTHER PIT RUN MATERIALS: Project Engineer may request preliminary samples but.Aggregate Source Approval is not required. AGGREGATE MATERIALS NOT REQUIRING ASA APPROVAL: Aggregate for Gravel Base 9-03.10 Gravel Backfill for Foundation Class B 9-03.12(1)B Gravel Backfill for Walls 9-03.12(2) Gravel Backfill for Plpe Zone Bedding 9-03.12(3) Gravel Backfill for Drains 9-03.12(4) Gravel Backfill for Drywalls 9-03.12(5) Backfill for Sand Drains 9-03.13 Sand Drainage Blanket 9-03.13(1) Gravel Borrow 9-03.14(1) Select Borrow 9-03.14(2) Common Borrow 9-03.14(3) Native Material for Trench Backfill 9-03.15 Foundation Material Class A and B 9-03.17 Foundation Material Class C 9-03.18 Bank Run Gravel for Trench Backfill 9-03.19 Commercial Concrete Aggregate 6-02.3(2)B WSDOT-Materials Laboratory https://www.wsdot.wa.gov/bizJmats/QPL/QPLProdinfo.cfm?Product n... VWastltngton State Department at hansportat1on Qualified Product List Product Information Manufacturer : Kangley Rock & Recycling, Black River, Renton - WA Product Name : Tier 1 and Tier 2 - Recycled Concrete Aggregate (RS- A-516) Standard Spec : 9-03.21(1)C, Recycled Concrete Aggregate . Product Description : Tier 1 and Tern - Recycled Concrete Aggregate is approved for the following aggregate materials; 9-03.1(4) Coarse Aggregate for Commercial Concrete (Class 3000), 9-03.10 Aggregate for Gravel Base, 9-03.12(1)B Gravel Backfill for Foundations Class B, . 9-03.12(2) Gravel Backfill for Walls, 9-03.12(3) Gravel Backfill for Pipe Zone Bedding, 9-03.14(1) Gravel Borrow, 9-03.14(2) Select Borrow, 9-03.1,4(2) Select Borrow (greater than 3 feet below subgrade and side,slope), 9-03.14(3) Common Borrow, 9-03.14(3) Common Borrow (greater than 3 feet below subgrade and side slope), 9-03.17 Foundation Material Class A and Class B, 9-03.18 Foundation Materials Class C, and 9-03.19.Bank Run Gravel for Trench Backfill. ********** For Tier 2 only- 9-03.9 Ballast and Crushed Surfacing; 9-03.12(1)A Gravel Backfill for Foundations Class A. See ASA for additional information. . Product Restriction Need to provide toxicity testing and certification of toxicity characteristics in accordance with Section 9-03.21(1), Acceptance Code : 1175 0 Code Description : Acceptance is based on Toxicity Test Report and Certification of Toxicity Characteristics in accordance with Section 9-03.21(1) and Field Testing for Grading, Sand Equivalency and/or Dust Ratio in accordance with Sections 3-04 and 9-03. Last Updated : Sep 25, 2018 Contractors with WSDOT Click here for Contractor Product Info Page . . Copyright WSDOT©2016 1 of 1 12/20/2021,8:53 AM Washington State IV Department of Transportation Request for Approval of Material Contract Number FA Number NIA •SR Duvall Ave NE Date CAG 20-065 12/16/2021 Section/Title of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor This form shall be completed prior to submittal.If this form is not compete at time of submittal it may For WSDOT Use Only be returned for information that was omitted. RAM#062 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL HdqtrJQPL HQ Use No. Product/l'ype , Manufacturer or Pit Number Reference Code Code A27 Gravel Borrow Black River Quarry 2-03 10 Gravel Backfill A32 for wall Black River Quarry 9-03.12(2) 1, 2, 1175, ASA B4 ImParted Trench BackfiuI Black River Quarry 9-03.12(2) 1, 2, 1175, ASA i - Project Engineer/Representative --—. - Date State Materials Engineer/Representative Date '>s 12/20/2021 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 0 Acceptance Criteria: Acceptance based upon"Satisfactory"Test Report for samples of materials to be incorporated into project. V Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks. 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria:. Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment',WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 0 Approval Withheld: Failed #4 sieve for gravel borrow 11. Miscellaneous Acceptance Criteria. Remarks (PE): Prior to use, provide toxicity testing and certification of toxicity characteristics in accordance with Section 9-03.21(1). Remarks (HQ): Provide Scale Cert. and Daily Scaleman's Reports. Delivery Ticket shall show bid item number and description. DOT Form 350-071 Protect Engineer Distribution Revised 03/2021 �X Contractor ®Region Operations Engineer ❑Fabrication Inspection El Region Materials El Slate Materials Lab-MS 47365 Stoneway Concrete Technical Services Aggregate Sieve Analysis PROJECT: Internal Testing DATE: 12/15/2021 LOCATION: Black River Quarry SAMPLE SOURCE: A-516' SAMPLE DESCRIPTION: RCA COS Type 17 AGGREGATE SIZE: 2" TESTER: Sean SPECIFICATION SIEVE WEIGHT PERCENT PERCENT COS 9-03.10 SIZE RETAINED RETAINED PASSING Type 17 4" 0.0 0 '/ 100 // 3" 0.0 0 100 95 - 100 2" 0.0 . 0 .4 100 1" - 4.9 14 86 1/2" 12.0 35 65 #4 22.4 66 C- 34 ) 24- 71 #40 30.5 89 J 11 #200 33.4 98 ,/ 2 4 0 - 5 Pan 34.1 100 • 0 WET SAMPLE: 36.2 TOTAL MOISTURE: 5.8% DRY SAMPLE: 34.1 DUST RATIO: 19% •/ SE: 61% 'The minimum percent passing the No.50 and No.100 sieves may be reduced to 5 and 0,respectively,if the aggregate is to be used in air-entrained concrete containing mom than 400 lb of cement per cubic yard or in nonair-entrained concrete containing more than 500 lb of cement per cubic yard(C 33 6.2) Material meets requirement for gravel backfill for walls & Trench Backfill Failed #4 sieve for gravel borrow ASTM C 136 ASTM C 33 ® WSDOT MATERIALS LAB 12/16/2021 Aggregate Source Approval Report Owner: Kangley Rock&Recycling,Black River Aggregate Source: RS-A_5.6 Lessee: Known as: Kangley Rock&Recycling, Black River Located in: T23N,RANGE4E,SECTION14 Section 14 T23N R4E County: King Remarks: • Tier 1 & 2 Recycled Concrete Aggregates (RCA). Acceptance is based on Toxicity Test Report & Certification of Toxicity Characteristics per 9-03.21(1) & Field Testing for Grading, Sand Equivalency and/or Dust Ratio per 3-04 &9-03.See QPL for further info. Mineral Agg.and Surfacing: Test Date: Expiration Date: Absorption: • Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA: • Remarks: • NOT approved as an aggregate source for: ATB Ballast BST Crushed Cover Stone BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing Key Stone Crushed Surfacing Top Course 'Gravel Backfill for Foundation Class A HMA Other Courses HMA Wearing Course Maintenance Rock Permeable Ballast Aggregates for Concrete:- Test Date: Expiration Date: ASR-14 Day: ASR-One Year: CCA Absorption: CCA Sp.G: Deg: FCAAbsorption: FCA Organics: FCA Sp.G: LA: • Remarks: NOT approved for: Coarse Concrete Aggregates Fine Concrete Aggregates Riprap,Quarry Spalls,Rock for Rock Wall,Erosion and Scour Protection: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA: Remarks: • NOT Approved for: Quarry Spalis Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(6) Streambed Aggregates: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp,G.: Deg: LA: Remarks: NOT Approved for: Streambed Aggregate Streambed Aggregate • Gravel Borrow for Structural Earth Walls: Test Date: Expiration Date: Bulk Sp.G.(SSD): Deg: LA: NOT Approved for: - Gravel Borrow for Str Earth Walls ALL OTHER PIT RUN MATERIALS: Project Engineer may request preliminary samples but Aggregate Source Approval is not required. AGGREGATE MATERIALS NOT REQUIRING ASA APPROVAL Aggregate for Gravel Base 9-03.10 Gravel Backfill for Foundation Class B 9-03.12(1)B Gravel Backfill for Walls 9-03.12(2) Gravel Backfill for Pipe Zone Bedding 9-03.12(3) Gravel Backfill for Drains 9-03.12(4) Gravel Backfill for Drywalls 9-03.12(5) Backfill for Sand Drains 9-03.13 Sand Drainage Blanket 9-03.13(1) Gravel Borrow 9-03.14(1) Select Borrow 9-03.14(2) Common Borrow 9-03.14(3) Native Material for Trench Backfill 9-03.15 Foundation Material Class A and B 9-03.17 Foundation Material Class C 9-03.18 Bank Run Gravel for Trench Backfill 9-03.19 Commercial Concrete Aggregate 6-02.3(2)B VSDO:?.-Materials Laboratory nips:Jrwww.wsuoL.wa.guvfviu L..rtuuu,Lu.4,u,:L..,u.. .•••• VWashington State Department of Transportation Qualified Product List Product Information Manufacturer : Kangley Rock & Recycling, Black River, Renton - WA Product Name : Tier 1 and Tier 2 - Recycled Concrete Aggregate (RS- A-516) Standard Spec : 9-03.21(1)C, Recycled Concrete Aggregate Product Description : Tier 1 and Tier 2.- Recycled Concrete Aggregate is approved for the following aggregate materials; 9-03.1(4) Coarse Aggregate for Commercial Concrete (Class 3000), 9-03.10 Aggregate for Gravel Base, 9-03.12(1)B Gravel Backfill for Foundations Class B, 9-03.12(2) Gravel.Backfill for Walls, 9-03.12(3) Gravel Backfill for Pipe Zone Bedding, 9-03.14(1) Gravel Borro , 9-03.14(2) Select Borrow, 9-03.14(2) Select Borrow (greater than 3 feet below subgrade and side slope), 9-03.14(3) Common Borrow, 9-03.14(3) Common Borrow (greater than feet below subgrade and side slope), 9-03.17 Foundation Material Class A and Class B, 9-03.18 Foundation Materials Class.C, and 9-03.19 Bank Run Gravel for Trench Backfill. ********** For Tier 2 only - 9-03.9 Ballast and Crushed Surfacing; 9-03.12(1)A Gravel Backfill for Foundations Class A. See ASA for additional information. Product Restriction : Need to provide toxicity testing and certification of toxicity characteristics in accordance with Section 9-03.21(1). Acceptance Code : 1175 Code Description : Acceptance is based on.Toxicity Test Report and Certification of Toxicity Characteristics in accordance with Section 9-03.21(1) and Field Testing for Grading, Sand Equivalency and/or Dust Ratio in accordance with Sections 3-04 and 9-03. Last Updated : Sep 25, 2018 - • Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 • 1 of 1 12/20/2021,8:53 AM