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HomeMy WebLinkAboutCAG-20-065 - Duvall - Gravel Backwell For Wall o vvvvvvvvvvvvvvvyivvvvvvvvvvvvvvv o 1 IIlllllllllltm i litlllllll11111111111111111.11tllll m illlllllllllllllll[Illlllllillsitl[1Ii1111I1IllltlLilI11111111111IIlllil111lllllllllllllililllllllllllllilltwill L_ CO. �� _ cam, o� = UNITEC ITEC Corporation _ cam; o' = ijilaC 358 Upland Drive • Seattle, Washington 98188 = o :0 - = cam c .1 3 Trrtifiratr in Ansprritint c.,- _ . .1 _=_ .. 1 .--,: Ei co -1 E-. r1 c o' This is to certify that �h)��0� y � V���� scale(s) Co` * = Located at: iiLa, c i e t--c,(�� — ,j,,L , 'J - c o = J was (were) serviced on t is 7�G day of�Pcyti, 20 2( , by an authorized representative of = co" o' _ `o o' the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. = c 1; _ A record of said inspection is on file at the above address and in the offices of UNITEC CORPORATION. = Co; 0_ = BY:���i� #ccz_LL, 5 C bvt 1- :: .4 = ' (206) 575-1100 1= co 9' -111 III lTlTTTTIl llll nT11 T11T111111111111111111 1I11111i111111IT1.11ll II I I ll11I111111 I IIIIITTI 111111111111111 I IllIl11111111111111111111111111111111T1111111111 I1ll1 11111 ITi- Co J������ioh����Ao,-�����/o�io�io�wo�io�/o�io�/o�io�/o�io�%�io,/o� 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 fmd 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) 21J0007 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,accreditations,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. 0 0X ACCONpi KellyBottem,Client Services Manager rerta i0000F-oiz 4611 S. 134th Place. Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 e Chain of Custody Record & Laboratory Analysis Request ARI Assigned Number: Turn-around Requested: Page: of Analytical Resources,Incorporated \0007 Analytical Chemists and Consultants ARI Client Company: Phone: Date: Ice 4611 South 134th Place,Suite 100 64.0K�� G,icrefe ` Present? /1/(7 Tukwila,WA 98168 206-695-6200 206-695-6201 (fax) Client Contact: I / No.of Cooler www.arilabs.com t.�- f'14e ae._ L3rc} r1,16nna, N 2 J-Z 2 E- 00C Coolers: Temps: (s-( of Client Project Name: J Analysis Requested Notes/Comments Qlzvh 1e O. ,. ..-14 Client Project#: amplbrs: Gy Sample ID Date Time Matrix Na containers Q. -. — Lia1 'Q 1ir,- l 5: 30 Ijl2Q 2 ir,- 1 3:30 aR o 3 (r.( 8.3G 13e0 N p-i Es••Jj t.Q 5 iv- i $•30 /> Comments/Special Instructions RMinquptned by: Receive4Pflflt.d by: - Relinquished by. Received by. (Signature) (Signatui Sara) (Signature) Primed Nam Name: Printed Name: Hr4Ma/.- e c,, Company Company: Compaq: Company: Date a lime: Date a Tine: Date a Time: Date a Time: %y7-t ^2f S HO w/V/ / re"(v 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 not 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 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 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 BRQ2 21J0007-02 Solid 01-Oct-202108:30 01-Oct-2021 08:40 BRQ 3 21J0007-03 Solid 01-Oct 202108:30 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 202108:30 01-Oct-2021 08:40 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 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 S. 134th Place, Suite 100 • Tukwila, WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 grillk Analytical Resources,Incorporated Cooler Receipt Form 4411, Analytical Chemists and Consultants p ARI Client: ch tV (G'1C-7e Project Name: !rJ(Qc Z. ,' •L-e/ a-CVO-/-e (J COC No(s): Delivered by:Fed-ExDel UPS Courier Ha iyega Other: Assigned ARI Job No: 9110007 Tracking No: e/19 Preliminary Examination Phase:V Were intact,properly signed and dated custody seals attached to the outside of the cooler? YES U Were custody papers included with the cooler?................................................: ES' NO Were custody papers properly filled out(ink,signed,etc.) �ES.. NO Temperature Of Cooler(s).(°C)(recommended 2.0-6.0°C for chemistry): �3. /���/� Time OIZ U r' 6 1 If cooler temperature is out'of compliance fill out form 00070F Temp Gun ID#: DOO O..S-.1 Cooler Accepted by: :--� . Date: / 0 4( 2/Time: ©E teCi Complete custody forms and attach all shipping documents Log-In Phase: Was a temperature blank included in the cooler? YES What kind of packing material.was used?... Bubble Wrap Wet Ice Gel Packs Baggies Foam Block Paper Other: `-------- Was sufficient ice used(if appropriate)?....................................•..........:........................ NA YES C How were bottles sealed inplastic bags? Individually Grouped Loa ' Did all bottles arrive in good condition(unbroken)? . S NO Were all bottle labels complete and legible? • e) NO Did the number of containers listed on COC match with,the number Of containers received? NO Did all bottle labels and'tags agree with custody papers? - NO Were all bottles used correct for the requested analyses? • E NO Do any of the analyses(bottles)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 >0 YES Date/Time: Equipment: Slit b by ARI? ({� 1 p ,yt Samples Logged by: J Date:. ((�'I(7/j a P.-1 Tirrie:. v Labels checked by: T'J---- "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 A } Analytical Resources,Incorporated Cooler Temperature 11, Analytical Chemists and Consultants Compliance Form ARI Work Order: t? 1 7 0 7 - Cooler#: Temperature(°C): b. 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: mil( Date: Jo4/ 062ai Time: ( Lf 00070F Cooler Temperature Compliance Form Version 000 3/3/09 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 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 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 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:21J0007-02 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. 134th Place. Suite 100 • Tukwila. WA 98168 • Ph: (206) 695-6200 • Fax: (206) 695-6202 Analytical Resources, Incorporated Analytical Chemists and Consultants Analytical Rep0rt 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 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 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 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. 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 5 21J0007-05(Solid) Metals and Metallic Compounds 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 Analyte 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. 4611 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 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. Washington State I'/ Department of Transportation Request for Ap • royal 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 1 066A PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL Hdgtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code A27,A-3 b6' Sand Equiv.CSBS Squak Mountain 9-03.14(1) Gravel Borrow `9-03 21(1)C 10 A32 Gravel Backfill Squak Mountain - Issaquah,WA 9-03.12(2) for Walls 9-03.21(1)C 10 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, B9.05 1 Project Engineer/Representative Date State Materials Engineer/Representative I Date v'= _ 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 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. ()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)) DOT Form 350-071 Project Engineer Distribution Revised 0312021 [j Contractor Region Operations Engineer Fabncation Inspection Region Materials ❑State Materials Lab-MS 47365 9-03.12(3)Gravel Backfill for Pipe Zone Bedding 9-03.• 1 Ball. t f•r u-e • - r• = iki •w) , 11111=0111111111=7-:.4111111 .: 215" I 99-100 MillE 99 100 2" 65-100 MI 75-100 1" 50-85 y." 50-100 No.4 I III 111 I I I I IMI 1_ No.4 20-80 No.40 16 max. MI No.40 No.200 9.0 max. iiM No.200 I 10.0 max. Dust Ratio: Sand Equivalent 35 min. Sand Equivalent , 35 min. - U.S.Standard Sieve Opening in Inches U.S.Standard Sieve Numbers Hydrometer Results 10 0% 20 a s lv i x as 10 16 20 30 50 tm 200 0% 90% _- 10% 80% iti \\\............. 20% ✓ 70% \ 30% md3 r60% 40%.n `50% - 4` 50%`.is40% .� - so°i°• 30% �• " . 70% 11 `+W 0% ' ••ri 100% 1000 100 10 1 0.1 0.01 0.00 1 Grain Size in Millimeters Gravels Sands Cobbles . Silts Clays Coarse I Fine Coarse I Medium I Fine Date: 01/06'22 Dtr=0.19 ISCS Classification "a Gravel Sand Sample#:20-198 D30= 3.25 GP-GM.Poorly graded Gra 61.8% 31.3% Sample ID:Squak Mtn CSBC Ds°= 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 Mtn Liquid Limit= n/a Yes 6.9% Boring#: Plastic Limit=n/a Fineness Modulus SE 56 Depth: Plasticity Index- Ma 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 1 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 16.8% 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% 7.5% 0.0% 14" 6.30 42.9% #270 0.053 #4 4.75 38.2% 38.2% 45.0% 25.0% i Copvnght Spear,Engineering&Technical Services PS,1996-2i os 9-03.14(1) Gravel Borrow 9-03.12(2) Gravel Backfill for Walls 9-03.19 Bank Run Gravel Sieve Size i Percent Passi/ig Sieve Size Percent Passing for Trench Backfill 4" 99-100 Y 4 99-100 1 Sig Size Percent Passing, 2" 75-100 1 2" 75-100 Ili2" 75-100 r No.4 - 22-66 f ---- --. No.4 50-80 X No.200 S.Omax. X No.4 22-100 1 No.40 30 max. i No.200 0-10 r r %Passing No.200 No.200 7.0 max. I Oust Ratio:%Passing No.40 �' ` Dust Ratio: %max. Sand Equivalent 50 min. r Sand Equivalent 60 min. X Sand Equivalent 30 min. J • Washington State �11 Department of Transportation Request for Approval of Material Contract Plumber FA Number N/A 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. IataM.#062 PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL Hdgtr./QPL HQ Use { No. Product/Type — Manufacturer or Pit Number Reference Code Code A27 Gravel Borrow Black River Quarry 2-03 10 A32 or� l Gravel Black River Quarry 9-03.12(2) 1, 2, 1175, ASA B4 Trench Backfill°ItedBlack River Quarry 9-03.12(2) 1, 2, 1175, ASA • • Project Engineer/Representative — — Date State Materials Englneer/Representative Date G 12/20/2021 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. QAcceptance 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. 6. 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). (HQ)rks 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 0 Contractor El Region Operations Engineer ❑Fabrication Inspection ❑Region Materials El State 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 J too 3„ 0.0 0 100 95 - 100 2" 0.0 0 .410oJ 1" 4.9 14 86 1/2" -12.0 35 65 #4 22:4 66 34-1D 24 - 71 #40 30.5 89 J 11_ #200 33.4 . 98 . ,/ 2 J 0 - 5 Pan .34.1 100 0 WET SAMPLE: 36.2 TOTAL MOISTURE: 5.8% • DRY SAMPLE: 34.1 DUST RATIO: 19% SE: 61% 4 '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 ib 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-516 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: FCA Absorption: FCA Organics: FCA Sp.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 Spalis Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(8) • 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 ISDOT.-Materials Laboratory https://www.wsdot.wa.gov/biz/mats/QPL/QPLProdinfo.cfm?Product n... � Washington Stato way Department of Ttranaportation 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 Borrow; 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 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 • 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