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HomeMy WebLinkAboutCAG-20-065 - Duvall - A51-Catch Basin Type 1L o T\%V Aar, ;,;gam%tea%\V%\t%\%\%\1'';;>; I\%\%gla%\`'%iikt%via.li %\w%4.130\t%'el.4%\%\'iVV*TAO `� 1 _ 1111111 III1 111111iiiiriI1111111111 �iiiiiiLLIIflr�7T i i lhllii ii1111�� IlI111111111���������� O' = C �� = iiiil UNITEC Corporation = C4; �� �' � 358 U land Drive • Seattle,Washin on 98188 = .0— Ni-..4) .27 ' (1,4.ertifiratt of 31nsprrtion = 0,. . = •••• -,:€) E - .c. �b = 1 f� - Ca. ..) = This is to certify that Gynr7ce_e_, -c �� scale(s) _ Cd; ,i = Located at: ,$2(,f( /ft 1 Your-) 4. a 1•s ` 55 Ja4/w A = , - -was (were) serviced on this 2() day of ,'74-tvu,tjii 20 27, by an authorized representative of E- Co;, o . CQ: - the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. ,3 = A record of said inspection is on file at the above address and in the offices of UNITEC CORPORATION. F.a Cam• :oO ' Y. • = Ca.. •0 - (206) 575-1100 g Ca;- 0 Mitimetti►I11111l llIIl11I►►►1►I1i11►llll►l1111►1►11111.1111 U 1U11 1111111111111111111 III 111111IlIJil 111111l1l111 llllll►l11T1111111111111111►111 l llllllllll l►11111111 I CO•. e/8�/\4Or40\/dr/\!4r/\/\�0\/��/\���/0\49\/0�/0�./\r/D�erp.e0.���%l.op.or3��0\drG�0,,,��7 ����< 0 AIWEST Am Test Inc. LABOR AT OR IES Professional 13600 NE 126TH PL Analytical Suite C Services Kirkland, WA 98034 (425) 885-1664 Mar 2 2022 SQUAK MOUNTAIN MATERIALS 10430 RENTON ISSAQUAH RD Attention: DMARYE DEDRICK Dear DMARYE DEDRICK: Enclosed please find the analytical data for your SQUAK project. The following is a cross correlation of client and laboratory identifications for your convenience. CLIENT ID MATRIX AMTEST ID TEST (1)5/8 Soil 22-A002567 MET (2)5/8 Soil 22-A002568 MET (3)5/8 Soil 22-A002569 MET (4)5/8 Soil 22-A002570 MET (5)5/8 Soil 22-A002571 MET (1)1 1/4 Soil 22-A002572 MET (2)1 1/4 Soil 22-A002573 MET (3)1 1/4 Soil 22-A002574 MET (4)1 1/4 Soil 22-A002575 MET (5)1 1/4 Soil 22-A002576 MET Your samples were received on Thursday, February 24, 2022.At the time of receipt, the samples were logged in and properly maintained prior to the subsequent analysis. The analytical procedures used at AmTest are well documented and are typically derived from the protocols of the EPA, USDA, FDA or the Army Corps of Engineers. Following the analytical data you will find the Quality Control (QC) results. Please note that the detection limits that are listed in the body of the report refer to the Practical Quantitation Limits(PQL's), as opposed to the Method Detection Limits(MDL's). If you should have any questions pertaining to the data package, please feel free to contact me. Sincerely, Aaron W. Young Vice President PO Number: NWA12756 BACT = Bacteriological MET = Metals NUT=Nutrients MIN=Minerals CONV= Conventionals ORG = Organics DEM=Demand P.1 Am Test Inc. Professional 13600 NE 126TH PL Analytical SuitelC AMTEST Services Kirkland, WA 98034 (425) 885-1664 L A BORAT O RIES www.amtestlab.com ANALYSIS REPORT SQUAK MOUNTAIN MATERIALS Date Received: 02/24/22 10430 RENTON ISSAQUAH RD Date Reported: 3/2/22 , WA 98027 Attention: DMARYE DEDRICK Project Name: SQUAK PO Number: NWA12756 All results reported on an as received basis. AMTEST Identification Number 22-A002567 Client Identification (1) 5/8 Sampling Date Total Metals PARAMETER RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050B KF 02/27/22 Lead 9.01 ug/g 1.1 EPA 6010D KF 03/01/22 P.2 1 r SQUAK MOUNTAIN MATERIALS Project Name: SQUAK AmTest ID: 22-A002568 AMTEST Identification Number 22-A002568 Client Identification (2)5/8 Sampling Date Total Metals PARAMETER RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050B KF 02/27/22 Lead 8.87 ug/g 1.0 EPA 6010D KF 03/01/22 AMTEST Identification Number 22-A002569 Client Identification (3)5/8 Sampling Date Total Metals PARAMETER r RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050B KF 02/27/22 Lead 8.70 ug/g 0.84 EPA 6010D KF 03/01/22 P.3 SQUAK MOUNTAIN MATERIALS Project Name: SQUAK AmTest ID: 22-A002570. AMT EST Identification Number 22-A002570 Client Identification (4)5/8 Sampling Date Total Metals PARAMETER RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050E KF 02/27/22 Lead 8.89 ug/g 0.80 EPA 6010D KF 03/01/22 AMT EST Identification Number 22-A002571 Client Identification (5)5/8 Sampling Date Total Metals PARAMETER RESULT UNITS Q D.L. METHOD ANALYST DATE. Acid Digestion Y SW-846 3050E KF 02/27/22 Lead 10.1 ug/g 1.0 EPA 6010D KF 03/01/22 P.4 • SQUAK MOUNTAIN MATERIALS Project Name: SQUAK AmTest ID: 22-A002572 • AMTEST Identification Number 22-A002572 Client Identification (1) 1 1/4 Sampling Date Total Metals PARAMETER RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050B KF 02/27/22 Lead 13.6 ug/g 0.55 EPA 6010D KF 03/01/22 AMTEST Identification Number 22-A002573 Client Identification (2) 1 1/4 Sampling Date Total Metals PARAMETER RESULT UNITS Q Di. METHOD ANALYST DATE Acid Digestion Y SW-846 3050E KF 02/27/22 Lead 13.9 ug/g 0.85 EPA 6010D KF 03/01/22 • P.5 w. , SQUAK MOUNTAIN MATERIALS Project Name: SQUAK AmTest ID: 22-A002574 • AMTEST Identification Number 22-A002574 Client Identification (3) 1 1/4 Sampling Date Total Metals PARAMETER RESULT UNITS Q '. D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050E KF 02/27/22 Lead 15.4 ug/g 1.1 EPA 6010D KF 03/01/22 AMTEST Identification Number 22-A002575 Client Identification (4) 1 1/4 Sampling Date Total Metals PARAMETER , RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050B KF 02/27/22 Lead 15.9 ug/g 0.84 EPA 6010D KF 03/01/22 P.6 SQUAK MOUNTAIN MATERIALS Project Name: SQUAK AmTest ID: 22-A002576 AMTEST Identification Number 22-A002576 Client Identification (5) 1 1/4 Sampling Date Total Metals PARAMETER RESULT UNITS Q D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050E KF 02/27/22 Lead 11.5 ug/g 0.66 EPA 6010D KF 03/01/22 Aar n . Young Vice President P.7 Am Test Inc. Professional 13600 Suite C NE 126th PL EST Sery iAnalyce / Kirkland, WA, 98034 (425) 885-1664 LABOR ATO RIES www.amtestlab.com QC Summary for sample numbers: 22-A002567 to 22-A002576 DUPLICATES SAMPLE# ANALYTE UNITS SAMPLE VALUE DUP VALUE RPD 22-A002337 Lead ug/g 4.52 4.29 5.2 22-A002576 Lead ug/g 11.5 13.9 19. MATRIX SPIKES SAMPLE# ANALYTE UNITS SAMPLE VALUE SMPL+ SPK SPK AMT RECOVERY 22-A002337 Lead ug/g 4.52 21.2 20.0 83.40% 22-A002576 Lead ug/g 11.5 37.0 35.0 72.86% STANDARD REFERENCE MATERIALS ANALYTE UNITS TRUE VALUE MEASURED VALUE RECOVERY Lead ug/g 0.80 0.79 98.8 % BLANKS ANALYTE UNITS RESULT Lead ug/g < 0.02 P.8 • . .._:- .:,. . .. EST AmTest Chain of Custody Record 13600 NE 126t.h PL,Suite C, Kirkland,WA 98034 • LABO' RATO [ilea Ph(425)885-1664 Fx(425)820-0245 • ,' www.amtestlab.com ' r • - • ' A. Chain of Custody No. '— — .,. Client Name &Address: A ' Invoice To: ‹.-..,-i --- tilip.,-,:n•ialti Fil-K/70/,5 i - ,i.,•-ti,:'," s,-.-I•• ,'' ii"V, , 4,-,p.,. /..) L--?..,7i;re-( ...? . i , i 1,,, ... •._,:-, 111,-q. ... i , ,,/ .. 'A-I i,:.:','i l'• ,'-il--'6:il. - "4' ''' I'4'-' ..- '..?t".::'/) 1 f'/:;:,.!;It . _ .., •.. , t. p",..) q r ";.•t C 61a 14 istOe:;'(t EVP.*E.:Z/ t LI 0 I/ ,-. i (,,,**1 7. 1.7 1,:;.:..:E,ffivg.tr.! .;L.,li cr,` —"" • •• ,,vit.,/ '.71.-• rE7q let,/ ,..•-- c f, . • • • 1 Contact Person: 1)../ ., v- ,,„,:t•,. ' Invoice Contact: r) . ,, • e f4. "if- ; ip 1-1{4.f ic, 1/c-cl y i ., I/ MN)r ,./(:. 1, f y\ _ , Phone No: r-) .,i i.I al I, ,<7. 1,,-,.--) PO Number: 7:•:(..??.... ''t ill./ -' Z)i'l 4 / ;,, / i Fax No: Invoice Ph/Fax: • . E-mail: .:':2 , :,,v.,i no i , , /,,, .0"iff./ya,..,/ /if z:„, Invoice E-mail:ect,ik (..-., Report Delivery: (Choose)lthatapply) Data posted to online account; YES / NO • Mail / Fax /(..._ Emajl-, / Posted Online Web Login ID: Special Instructions: . . . . - Requested TAT:,(Rush must be pre-approved by lab) Temperature upon Receipt: 14-5 rSiandard.—) RUSH ( 5 Day / 3 Day / 48 HR / 24 HR' ) Projealailie: .... •i Analysis Requested Project Number: 16 EE x ..i.., Va ea 113 g u) u) co u a Client ID +, CO E ° u AmTest ID al I= a (35 characters max) • . CY • ' . Z,_-(0-7 1 .•.- 51s (L7C S • . (40 1 • . 10 LI • . . . . -7z I , Nil 7'1 3 . • • IS 1-1- • _. . 760 5 . - . collectecyfOinquished By: Date Time Received By: , Date Time /./( fr•LitZ. ((IS Relinquished By: Date Time Received By: • • Date Time Relinquished By: Date Time Received By: Date Time COMMENTS: . . P.9 Truck Scale Report & Certification C�p Date Tested: January 14,2022 CO i► , NG f' Company Icon Materials E-mail raysscatederek@yahoo.com Name and Asphalt Scale Po Box 8282 Address: 4040 Kersey Way SE Bonney Lake,WA 98391 Balance on 0 Min Grad: 20 lbs Size 120' x 10' Arrival: Platform: Capacity: 60 ton CLC: 35 ton Scale: Unibridge Make: Rice Lake Serial#: 1514200059 County: King Number of Scale Serial Reg Sections: 12 #: N/A Element: 820i Loaded Test Scale Load Test Scale Postion Weights Indication ERROR Position Weights Indications ERROR As Found Section 10 Test Truck 32,840 0 Section 1 Test Truck 32,880 0 Section 11 Test Truck 32,860 0 Section 2 Test Truck 32,860 0 Section 12 Test Truck 32,880 0 Section 3 Test Truck 32,880 0 Section 4 Test Truck 32,840 0 Section 5 Test Truck 32,880 0 Section 6 Test Truck 32,860 0 Section 7 Test Truck 32,880 0 Section 8 Test Truck 32,840 0 Section 9 Test Truck 32,860 0 Strain Load Test Empty Truck Weight Test Weights Total Error 20,880 12,000 32,880 0 Condition upon Inspection Stands Good Deck Good Indicator Good Cables Good Cell Good Bolts Good Printer N/A 1-Boxes Poor Links Fair Guide Rails Good Scoreboard N/A Coping Good Remarks and/or Instructions Scale Technician na d Agent#): Owner/Operator: Derek Larsen 6705 Truck Scale Report & Certification Date Tested: January 14,2022 C"):: Company Icon Materials E-mailw raysscalederek@yahoo.com Name and Inbound Scale Po Box 8282 Address: 4040 Kersey Way SE Bonney Lake,WA 98391 Balance on 0 Min Grad: 20 lbs Size 80'x 10' Arrival: Platform: Capacity: 60 ton CLC: SO ton Scale: Murphy Make: Rice Lake Serial#: B34429 County: King Number of Scale Serial Reg 6 N/A I 710 Sections: #: Element: Q Loaded Test Scale Load Test Scale Postion Weights Indication ERROR Position Weights Indications ERROR As Found As Left Section 1 Test Truck 33,000 100 Section 1 Test Truck 32,900 0 Section 2 Test Truck 32,880 0 Section 2 Test Truck 32,880 0 Section 3 Test Truck 32,900 0 Section 3 Test Truck 32,920 0 Section 4 Test Truck 32,880 0 Section 4 Test Truck 32,880 0 Section 5 Test Truck 32,900 0 Section 5 Test Truck 32,880 0 Section 6 Test Truck 32,980 80 Section 6 Test Truck 32,900 0 Section 1 Section 1 12,000 12,000 0 Strain Load Test Empty Truck Weight Test Weights Total Error 20,880 12,000 32,880 0 Condition upon Inspection Stands Good Deck Good Indicator Good Cables Good Cell Good Bolts Good Printer N/A 1-Boxes Good Levers Fair Guide Rails Good Scoreboard Good Coping Good Remarks and/or Instructions Scale Technician (Si tur and Agent#): Owner/Operator: Derek Larsen ���'----j 16705 Truck Scale Report & Certification irii. Date Tested: January 14,2022 c :Vi,,• 4 N6 Company Icon Materials E-mail"" Name and Outbound Scale raysscalederek@yahoo.com Po Box 8282 Address: 4040 Kersey Way SE Bonney Lake,WA 98391 Balance on Size 0 Min Grad: 20 lbs 80'x 11' Arrival: Platform: Capacity: 60 ton CLC: 50 ton Scale: Suvivor Make: Rice Lake Serial#: B34435 County: King Number of Scale Serial Reg 5 Sections: #: 8QEH Element: IQ 710 Loaded Test Scale Load Test Scale Postion Weights Indication ERROR Position Weights Indications ERROR As Found As Left Section 1 Test Truck 32,860 0 Section 1 Test Truck 32,860 0 Section 2 Test Truck 32,880 0 Section 2 Test Truck 32,880 0 Section 3 Test Truck 32,760 -100 Section 3 Test Truck 32,880 0 Section 4 Test Truck 32,880 0 Section 4 Test Truck 32,860 0 Section 5 Test Truck 32,860 0 Section 5 Test Truck 32,880 0 Section 1 Section 1 12,000 12,000 0 Strain Load Test Empty Truck Weight Test Weights Total Error 20,880 12,000 32,880 0 Condition upon Inspection Stands Excellent Deck Excellent Indicator Fair Cables Excellent Cell Excellent Bolts Excellent Printer N/A 1-Boxes Excellent Levers N/A Guide Rails Excellent Scoreboard N/A Coping Excellent Remarks and/or Instructions Scale Technician (Signature and Agent#): Owner/Operator. Derek Larsen # 16705 0`DiV vvvviv v v v vv Vvv Vvv Vvvvvvv V v__ . '• O 1 -1111.111111L11!111JIII JAI IIIIIt1I11111ll1JIIIlIII1111111JIIIt111111L1JJlIIl1.I11111II11111L IIIIIIlll-11 i li oi o i i o n o t n o l 1 of 111 I111111-U III JIIIIIIIL11I1111It1II1I11= O �� U N ITEC Corporation o ‘..1.°..71.-- .."1"441/Tilli-e--tr 358 Upland Drive • Seattle,Washington 98188 _ �o; Trrtifiratt at .Attprrtiritt _ . = c, _ . :0 1-;.1 - co _ = • • v) _ = C _ This is to certify that is#L /b/ 90 SO /ch /r C�I scale(s) _ Co., o' =1 Located at: d�pl�- G,.'�C✓'� ' J �l — 4)Ykvi/Ler• - C� o = was (were) serviced on this 1 dayof vC r 20 , by an authorized representative of = ,C � ^z.>) the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. Co' .o', _I C . 0 = A record of said inspection is on file at the above address and in the offices of UNITEC CORPORATION. '_' ��„ •o� = BY: S Z—lv �C4--.�L� _ Co 1 c ;_ C o, (206) 575-1100 1 CO. O' 1.1_111 I11111111111III II IItTTTIII_ JTI l 111TTTIII1 II11T1TILJ1i I.TUi II1--.TI11 IIIT[n illiIt-1 IIITTTiIIII III 11111ILTTTT1I11II1 !I!Li LTTlT1if11.11111111-II I!1111ti CI C /o\io\/o\ /o\/o\ /3116/o\/o\AVP./o\ %\/o\/o�/o\/o.../o\/o\/o../o�/o\ion/o�/o�/o\ie.ion 0 Washington State �/ Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 01,'28a022 Section I 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# 80 PE Use Bid Item Material or Name and Location of Fabncator, Specification PEIQPL Hdgtr.IQPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code A44-A52 CSTC si&•Natural Sumner Pit B-231 7-04 1 , 2 B6-89 A44-A52 rear 1 rre•rv.turo 6 rn. rSe 7-04 13b-My A43-A52 ?ranch Ba wiu.e1 f or Sumner Pit B-231 9-03.19 1, 2 A43-A52 sank Run Gravel for Trench Backfill Sumner Pit B-231 9-03.19 1, 2 A43-A48,Gravel Backfill for B6-B9 Pipe Zone Bedding Sumner Pit B-231 9-03.12(3) 1, 2 A43-A48 Gravel Backfill for B6-B9 Pipe Zone Bedding Sumner Pit B-231 9-03.12(3) 1, 2 Project Engineer/Representative Date 1/31/2022 State Materials Engineer/Representative Date 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. 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 Withheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Provide Scale Cert. Delivery Ticket shall show bid item number and description Remarks (HO): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 El Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑Slate Materials Lab-MS 47365 Stoneway Concrete Technical Services Aggregate Sieve Analysis PROJECT: Internal Testing DATE: 1/26/2022 LOCATION: Sumner Sand & Gravel SAMPLE SOURCE: B-231 SAMPLE DESCRIPTION: 5/8" Crushed Surfacing Top Course Type 1G AGGREGATE SIZE: 5/8" TESTER: Sean SIEVE WEIGHT PERCENT PERCENT SPECIFICATION SIZE RETAINED RETAINED PASSING 9-03.9(3) 3/4" 0.0 0 100 / 99 - 100 5/8" 0.0 0 • 100 \/ 1/2" 0.9 8 92 80 - 100 3/8" 2.7 27 73 1/4" 4.7 46 54 #4 5.5 54 46 J 46 - 66 #40 9.0 89 11 qi 8 - 24 #200 9.7 96 4 J 0 - 10 PAN 10.1 100 0 WET SAMPLE: 10.6 TOTAL MOISTURE 5.0% DRY SAMPLE 1: 10.1 SE: 64% FRACTURE: 100% %Passing No.200 Dust Ratio: %Passing No.40 'The mnmum percent pasang the No.50 and No.100 sieves may be reduced to 5 and 0,respectively,it the aggregate a to be used in air-entrained concrete containing more than 400 lb of cement per cubic yard or in nonair-entrained concrete containing more than 500 b of cement per cubic yard(C 33 6.2) 9-03.12(3) Gravel Backfill for Pipe Zone Bedding Slay.Size Percent Passing 1%" 99-100$ 1" 75-100 %" 50-100 1 9-03.9(3) Crushed Surfacing No.4 20-80) Course � Base Cose Top Courses No.40 3.24'/ Sieve Size Pert:ertt No.200 10.0 max, Sand Equivalent 35 min. J 1%" 99-100 1" 80-100 i4" 99-100 4 %" 50.80 9-03.19 Bank Run Gravel for x" 80-1oo 1- Trench Backfill No.4 25-45 46-66 4 Sieve Size le No.40 3-18 8-24 Zitsing 21rr 75-f No.200 7.5 max. 10.0 max.4 No.4 22.1001 %Fracture 75 min. 75 min. J No.200 0-10 Sand Equivalent 40 min. 40 min. J Dust Ratio: %max. Sand Equivalent 30 min. 4 ASTM C 136 ASTM C 33 PROJECT: Internal Testing DATE: 1/26/2022 LOCATION: Sumner Sand & Gravel SAMPLE SOURCE: B-231 SAMPLE DESCRIPTION: 1-1/4" CSBC /Type 2G AGGREGATE SIZE: 1-1/4" TESTER: Sean SPECIFICATION SIEVE WEIGHT PERCENT PERCENT COS9-03.9 SIZE RETAINED RETAINED PASSING Type 2G 1-1/4" 0.0 0 100 , 99 - 100 1" 0.3 3 97 -" 80 - 100 3/4" 1 1.8 18 82 5/8" 2.7 27 73 `"l' 50 - 80 1/2" 3.8 38 62 3/8" 4.5 45 55 #4 6.1 61 39 V 25 - 45 #40 9.4 95 5 J 3 - 18 #200 9.7 98 2 J 0 - 7.5 PAN 9.9 100 0 _ WET SAMPLE: 10.3 TOTAL MOISTURE: 3.9% , DRY SAMPLE: 9.9 S.E.: 64% ,+ FRACTURE: 98% %Passing No.200 Dust Ratio: %Passing No.40 the rnlnimum percent passing the No.50 and No '00 sieves may be reduced to 5 and 0,respectively it the aggregate is to be used in ar-entrained concrete _ovainu y PMore hail 47C lb of:pr.,I per cubic yaN or IIfx,,, ntrafned f<YR rete r_rrr 1,1,y'11,11, hap 5C0 lb of_.,rient per fAft,tc,yard tC 33 6 2? 9-03.12(3) Gravel Backfill for Pipe Zone Bedding Sieve Size Percent Passing 1%" 99.100 J_-- 9-03.9 3 Crushed Surfacing1^ 75-100 4 ( ) x^ so-too 4 (Base Course)-1 Top Course and Keystone No.4 20-80 Sieve Size ' Percent Passing No.40 3 24 1%" 99-100 'r No.200 10.0 max. 1" 80-100 If --" Sand Equivalent 35 min., %" 99-100 Si" 50-80 1 W' 80-100 9-03.19 Bank Run Gravel for No.4 25-45 t• 46-66 No.40 3-184 8-24 Trench Backfill No.200 7.5 max.'' 10.0 max. 51eeg PertifirMi %Fracture 75 min. 75 min. _ 2 75-100 v , Sand Equivalent 40 min. 40 min. -- No 4 22-100_ 4 r No 200 410 4I Dust Ratio: %max 1 Sand Equivalent 30 min.d . . r1--r'Ywr�-_r-r r r �-V�r- v�-� Page added by engineer UI WSDOT MATERIALS LAB o1/28/2022 Aggregate Source Approval Report Owner: Cava Materials Aggregate Source: P5-B-231 Lessee: Known as: Cava Materials Pit Located in: S 1/2 NW 1/4 Section 18 T2ON R5E County: Pierce Remarks: Mineral Agg.and Surfacing: Test Date: 04/15/2021 Expiration Date: 04/15/2026 Absorption:1.01 Apparent Sp.G.:2.745 Bulk Sp.G.(SSD):2.697 Bulk Sp.G.:2.67 Deg:66 LA:14 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. Aggregates for Concrete: Test Date: 02/01/2018 Expiration Date: 02/01/2023 ASR-14 Day:0.56 ASR-One Year:0.04 CCA Absorption:1.18 CCA Sp.G:2.681 Deg:70 FCA Absorption:2.04 FCA Organics:1 FCA Sp.G:2.627 LA:12 Remarks: 1-Year ASR Results expire 12/19/2023 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 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: Page added,by engineer Remarks: 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:'02/01/2018 Expiration Date: 02/01/2023 Absorption:1.18 Apparent Sp.G.:2.735 Bulk Sp.G.(SSD):2681 Bulk Sp.G.:2.65 Deg:70 LA:12 Remarks: Currently Approved for: Streambed Aggregate • Gravel Borrow for Structural.Earth Walls: Test Date: 02./01/2018 Expiration Date:.02/01/2023 Bulk Sp.G.(SSD):2.681 Deg:70 LA:12 Remarks: Forgeosynthetic reinforcement,the gravel borrow shall be tested for pH.prior to placement.For metallic reinforcement,the gravel borrow'shall be tested for pH,resistivity,chlorides,and sulfates prior tO.placement.If 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 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) Page added,by engineer 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 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/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# 081 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL Hdgtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code A27 A44-A52 Gravel Borrow Icon MaterialsAuburnA-464 7-04 , B6-B9 - 1, 2 A44-A52 Icon Materials-Auburn A-464 B6-B9 CSTC 7-04 1, 2 A44-A52 CSBC Icon Materials-Auburn A-464 7-04 1, 2 . B6-B9 Project Engineer/Representative -D l - Date State Materials Engineer/Representative Date 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 0 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) 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 (HO): 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 Ei Region Operations Engineer ❑Fabncalion Inspection ❑Region Materials El State Materials Lab-MS 47365 ICON Summary Report Sample Information Sample No 1264637438 100- Product Id 2380 //// Product Name Gravel Borrow 90' Specification WSDOT 9-03.14.1 Gravel Borrow 80- Date Sampled 01/07/2022 09:00 Sampled By Skye Southward so- Sample Type Investigative w. Sample Method Surge Pile 40- Notes 30- 2022 Submittal (B) 20- 10- .- t • . 1...•^ I • .p...T I r t- ' t •T'I S�40y.nm01mml 13t0.ES 016 030066 C150 142 060:240 010060 002 C"1491 CO.0.79 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 % 250 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 Sim Pasant 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: 94 Passing No.40 %" 50-100—) No.4 20-80 No.40 3-24 X No.200 10.0 max. Sand Equivalent 35 min. 9-03.14(1) Gravel Borrow Sieve Size Percent 4" 99-Z9-03.19 Bank Run Gravel for Trench Backfill 4" 99-100 2" 75.1001/0 No.4 50-80 1 2" 75.100 1711 J No.4 22.100 No.40 30 max.tr �.200 0-10 No.200 7.0 max. Dust Ratio: '1 max. J Sand Equivalent 50 min. V Sand Equivalent 30 min. J StonemontOC 01/10/2022 CRH Americas Materials(AMAT) ICON Summary Report Sample Information Sample No 303028092 100- Product Id 2350 Product Name 5/8"CS TC 9D Specification 9-03.9(3)Crushed Surfacing TC °°- Date Sampled 01/08/2022 10:00 ro- Sampled By Randy Mattson so. Sample Type Investigative s„ /7//i Sample Method Surge Pile e o- Notes Submittal 2022 307 io ° ••• I ' t '1 . 1•••• I • 1 • • rT'9• IIPt ' I 0P71ESi.733 037 t°°010 IQ 010 4113 0+4015 00a C.12123 Cc I tO 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 % 240 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) 44 Pipe Zone Bedding sirmstra #16(1.18mm) 32 Percent Pasts #30(.6mm) 21 1%" 99.100r %Passing No.200 1" 75-100 Dust Ratio: #40(.425mm) 17 8-24 %PassingNo.40 %" 50-100 #50(.3mm) 12 No.4 20-80/ #100(.15mm) 6 No.40 3-24 #200(75 pm) 4.2 0-10 No.200 10.0 max 9-03.9(3) Crushed Surfacing Sand Equivalent 35 mina Base Course (rop Course rid Keystone ifen fiber Percent Parsing 1%" 99-100 1" 80-100 9-03.19 Bank Run Gravel for %~ 99-100 i Trench Backfill %" so•so �P K" 80-100 J 2" 75.100 171 No.4 25-45 46-66 No.4 22.100/ No.40 3-18 8-24 �/ NO.200 0-i0 max. / Dust Ratio: 35 t/ No.200 7.5 max. 10.0 max./ Sand Equivalent 30 min. 1 %Fracture 75 min. 75 min. Vi Sand Equivalent 40 min. 40 min. V __________ -..-._.,__ -.........-..--..Materials(AMAT) ICON Summary Report Sample Information Sample No 655576787 Product Id 2379 100 Product Name 1 1/4"CS BC xP Specification 9-03.9(3)Crushed Surfacing BC BD- Date Sampled 01/04/2022 11:05 ro" Sampled By James Begley 60- Sample Type Process Control 5- Sample Method Surge Pile e - .0- Notes 00- 2022 Submittal 20- 10 0 '" t - - 1" " i " I""T t t r i 1 ' i 1 8 o 4..c.i...=. a. 5u".Oo6n"0 two 210E51 049 0)0 2141 050.7 58 050 1053 MOW 00.Cu 2151 Cc 167 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 Pipe Zone Bedding #4(4.75mm) 37 25-45 #10(2mm) 25 Si She Pastor Pals 1%" 99.100 #40(.425mm) 9 3-18 %Passing No.200 1" 75-100� / #100(.15mm) 3 Dust Ratio: %Passing No.40 %" 50 500/ #200(75pm) 2.0 0-7.5 No.4 20.801/ No.40 3-24 1 No.200 10.0 max.J 9-03.9(3) Crushed Surfacin, Sand Equivalent 35 min. , - - Course Top Course and Keystone Sieve Sloe • - . Pasdasi 1'/." 99-100 1" 80-100 i 9-03.19 Bank Run Gravel for %" 99-100 Trench Backfill K" 80-100 2" 75-100 No.4 25-45 46-66 No,4 22-100 1 No.40 3-181� 8-24 No.200 0-10 No.200 7.5 max. ) 10.0 max. Dust Ratio: ii max. {� %Fracture 75 min.y 75 min. Sand Equivalent 30 min. 1l Sand Equivalent 40 min. J 40 min. StonemontQC 01/08/2022 CRH Americas Materials(AMAT) Aggregate Source Approval Report. https://www.wsdot.wa.gov/biz'mats/ASA/ASAReport.cfrn?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 SW1/4 SEC 28&29 Section 28,29,T21N R5E County: King Remarks: Mineral Agg.and Surfacing: 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 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. 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 LA 11 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'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: 1 of 2 1/31/2022,9:43 AM Aggregate Source Approval Report. https://www.wsdot.wa.gov/biz/mats/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: Streambed 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.Far metallic reinforcement,the .gravel borrow shall be tested for pH,resistivity,chlorides,and sulfates prior to placement.If 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 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)B 2 of 2 1/31/2022,9:43 AM AMIlk Washington State �/ Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 1/26/2022 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# 029C PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL Hdgtr./QPI HQ Use Nc. Product/Type Manufacturer or Pit Number Reference Code Code Jii-kr Mortar Speedcrete 3 A49-A53 Project Engineer/Representative Date State Materials Engineer/Representative Date ` '1_ 1/26/2022 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 ®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): Remarks (HO): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ❑X Contractor Region Operations Engineer Fabncation Inspection Region Materials El State Materials Lab-MS 47365 e The Euclid Chemical Company SPEED CRETE PM ED SINGLE COMPONENT, VERTICAL/OVERHEAD MORTAR EUCLID CHEMICAL WITH CORROSION INHIBITOR DESCRIPTION SPEED CRETE PM is a single-component,polymer-modified,ready-to-use,cement based concrete and masonry repair mortar that requires only potable water for mixing. SPEED CRETE PM is a proprietary formulation of O portland cement, finely graded aggregates and special polymer modifiers used to increase adhesion,strength, and aid in curing. rri PRIMARY APPLICATIONS v • Repair of numerous interioriexterior,above/below grade,vertical/overhead structural surfaces without forming FEATURES/BENEFITS • Compatible with galvanic anodes • Repairs from featheredge to 3" (7.6 cm) • Excellent workability • Develops high strength and tenacious bond • Contains an integral corrosion inhibitor • Excellent resistance to freeze-thaw conditions • After initial set, may be shaved to conform to contours of the surrounding surface TECHNICAL INFORMATION The following are typical values obtained under laboratory conditions. Expect reasonable variation under field conditions. Set Time,ASTM C266,Gilmore Initial Set approx 15 min Flexural Strength psi(MPa)ASTM C78 Final Set approx 40 min 7 Day 650 (4.5) Working Time 10 to 15 min 28 Days 1,300 (9.0) Compressive Strength psi(MPa)ASTM C109 Shear Bond Strength psi(MPa)ASTM C 882 1 day 2,500 (17.2) 28 Day 2,650 (18.3) 7 days 6,500(44.8) Splitting Tensile Strength psi(MPa)ASTM C496 28 days 7,000(48.3) 7 day 450 (3.1) 28 day 550(3.8) r^ Volumetric Resistivity 7,980 ohm-cm Freeze Thaw Resistance ASTM C666 m 320 cycles 99.0%RDF -o PACKAGING SPEED CRETE PM is packaged in 50 lb (22.7 kg) poly-lined bags. SHELF LIFE 1 year in unopened package COVERAGE/YIELD One 50 lb (22.7 kg) bag yields approximately 0.5 ft3(0.014 m3). DIRECTIONS FOR USE Surface Preparation: Concrete surfaces must be structurally sound,free of loose or deteriorated concrete and o,, m free of dust,dirt,paint,efflorescence,oil and all other contaminants. Mechanically abrade the surface to achieve _o a surface profile equal to CSP 6-8 in accordance with ICRI Guideline 310.2. Properly clean profiled area. w o Primingo &Bonding (Saw Cut&Chipped Out Repairs): Thoroughly clean any exposed reinforcing steel, and � 3 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 EUCOWELD 2.0 to a dry substrate or a scrub coat of SPEED CRETE PM 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. Priming & Bonding (Vertical &Overhead Skim Coatsiloppings): Apply EUCOWELD 2.0 to a dry substrate or a scrub coat of SPEED CRETE PM to the saturated surface dry (SSD) concrete surface. The repair material must be placed on the scrub coat before the scrub coat dries out. 19215 Redwood Road • Cleveland, OH 44110 800-321-7628 t • 216-531-9596 f www.euclidchemical.com Mixing: SPEED CRETE PM will require approximately 4.0 to 4.25 qt (3.8 to 4.0L) of potable water per 50 lb bag (22.7 kg) to achieve the proper mix consistency. Pour the measured amount of water into a clean mixing container,slowly add the SPEED CRETE PM,and thoroughly mix for 2 to 3 minutes to a stiff,no slump,putty-like consistency. Use a rotary mixer with rubber tip blades for mixing quantities up to 100 lb (45.4 kg). Application: Apply a scrub coat of neat mortar to the prepared SSD substrate. Before the scrub coat dries, apply SPEED CRETE PM. To ensure complete bond with the entire surface,force the SPEED CRETE PM firmly into the repair area by hand or with a trowel. Place the SPEED CRETE PM so that the material conforms to the contours of the surrounding surface. Always finish the SPEED CRETE PM toward the common bonding edge between the repair material and the existing surface. For repairs deeper than 3" (7.6cm) apply in multiple lifts. Score surface between lifts. Cure material using standard curing practices. Curing: Follow standard ACI guidelines for curing. In case of high temperature, high wind, or low humidity causing rapid surface drying, use wet burlap/plastic or a water-based curing compound. CLEAN-UP Clean application tools and mixing equipment with water immediately following use. PRECAUTIONS/LIMITATIONS • Use only potable water with SPEED CRETE PM. • Do not re-temper or add sand to SPEED CRETE PM. • Do not over-work or over-trowel the repair material. • Do not apply at temperatures below 45°F(7°C). • When necessary,follow the recommendations in ACI 305R "Guide to Hot Weather Concreting" or ACI 306R "Guide to Cold Weather Concreting". • In all cases, consult the Safety Data Sheet before use. Rev.07.20 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 Sion"the date of purchase.Unless authonzed ;r writing by ar officer of Euclid no other representations or statements made by Euclid or its representatives in wnttrg or orally shall alter the warranty.EUCLID MAKES NO WARRANTIES IMPLIED OR OTHERWISE. AS TO THE MERCHANTABILITY OR rITNESS"OR ORDINARY OR PARTICULAR PURPOSES OF ITS PRODUCTS AND EXCLUDES THE SAME.If any Euclid prodr,ct fails to conform with this warranty.Euclid wd replace the product at no cost to Buyer Replacement of any product shall be the sole and exclusive remedy available and buyer shall have no clam for incidental or consequential damages.Any warranty claim must oe made wrthrn one(1)year'rem the care of the caxned breach.Euci p does not authorize anyone on its behalf to make any written or oral statements which in any way after Euclid's installation information or instructions in its product 'derature or on its packaging labels.Any installation of Euclid products which tads to conform with such-rstaliahon information or Instructions shall void this warranty.Product demonstrations,1 any are done to illustrative purposes only ano do not constitute a warranty or warranty alteration of any kind.Buyer shall be solely responsible for determining.he suitability of Euclid s products for the Buyer s intended purooses Qualified Product List https:/iwsdot.wa.gov/biz/mats/QPLiQPLPrint.cfm?Product_no=201700... Washington State January 26,2022 Qualified Product List Contractor Product Information Contractor: Contract No: Sub Contractor: Date: Bid Item: Manufacturer: Euclid Chemical Co. - Cleveland, OH Product Name: Speed Crete PM Standard Spec : 9-20.4(3), Mortar Type 2 for Masonry Applications Product Description : Mortar for Masonry Applications Product Restriction : Acceptance Code : 3113 Code Description : Visually verify the product delivered to the job site is the product that was originally submitted by the Contractor and approved from the QPL and conforms to the Standard Specification blending ratio. Last Updated : Mar 25, 2017 To be completed by the field inspector: Quantity: Verified By: Date: of 1 1 26;2022.2.24 PM Ilk /71 "'O'n leftn*Portation Request for Apiproval of Material Contract Number FA Number SR Date GAG 20-065 N/A DUVALL AVE NE 01/06/2022 Section I 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 Hdgtr./OPL HO Use No. Product/Type Manufacturer or Pit Number Reference Code Code B17 ALL THRD ROD STS INDUSTRIAL Std. Plan- 10 106 A49-A53 5PEEDCRETE/REDLNE EUCLID CHEMICAL Std. Plan- 10 1 - 310.1 A43-A48, B6-B8, ETHAFOAM SHEETS ULINE S.P. 7-04.2 3 B17 and B18 Project Engineer/Representative ( Date State Materials Engineer/Representative Date -)--,„- _— 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. c:)Acceptance 2. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. 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. Q•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 El Region Materials ❑State Materials Lab.MS 47365 44 • / A307 All Thread Rod.Galvanized BID ITEM B17 FOR HYDRANT RUNS•/0.000, The ASTM A307 specification corers carbon steel bobs and studs ranging from 1/4'through 4'diameter A307 is an economical low carbon matenal often manufactured using A36 round bar Dimensional specifications are governed by ASME B18.31.3.A307 all thread rod is available in hot dip galvanized finish,which provides a corrosion resistant zinc coating,The all thread rod listed on ens page is domestic melted and manufactured In the USA. q a. r. PRODUCTS GOVERNING STANDARDS MECHANICAL PROPERTIES CHEMICAL PROPERTIES GOVERNING STANDARDS - SUBMITTAL REVIEW No Gsprc+s T»rn Make Co.'rcuo s Nol. Amend&des.. ASTM 4307 CO..the eietlantal and material regumnlentl few OMWhet1 WIMPS le dlaletehlrshterl x Rnleck:d-Snn Remo. 1l4'ensign 4',made of carbon Steel naming a minimum tensile strength 060.000 psi IMPORTANT NOTICE TMs revwx do.hot rare.ow cortrawa fr., rommranty a=awy a cont. Af wen ns Plans.Spenscadond and YE ate.al.i COWS ine general taelHaailal dae bahcn Series Weeded rode cat-TEr el a trr : heel lane,. ` cat bd.Plan-m atei s.l a NM a1.1 tide A Speoles the thread forth sewn.Gass arowaece.tolerance.and destine Tor unwed scree 4 7~ ucr_ w I... IMF Class 24 thread1 as ass Lisle 1111/1002 Dimmest + Theta Plldl + V A307 All Thread Rod.GaMnlzed °• The Euclid Chemical Company SPEED CRETE RED LINE ED RAPID SETTING REPAIR MATERIAL EUCLID CHEMICAL rn n DESCRIPTION r— SPEED CRETE RED LINE is a rapid-setting,cement-based concrete and masonry repair mortar.SPEED CRETE O 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 PRIMARY APPLICATIONS -- - rn • Interior and exterior D • Vertical and overhead repairs • Used at no slump consistency • Outstanding repair material for concrete pipe,formed and precast concrete FEATURES/BENEFITS • 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 u' m m The following are typical values obtained under laboratory conditions. Expect reasonable variation under field conditions. m Compressive Strength, psi (MPa) ASTM C109 Freeze Thaw Durability Factor ASTM C666 24 Hour 2,550 (17.6) 300 Cycles 96.75% 7 Day 4,000(27.6) rn Shrinkage 50%RH ASTM C157(3"x3"x11"specimens 28 Day 5,700(39.3) Set Time,ASTM C266 were removed from molds @ 24 hours) Initial 8 20 Min 28 Day -0.069% r*+ 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) Scaling Resistance ASTM C672 Flexural Strength, psi (MPa) ASTM C348 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 o � PACKAGING m oxP SPEED CRETE RED LINE is packaged in 50 lb (22.7 kg) poly-lined bags,and 50 lb (22.7 kg) pails wo a v ; 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. PRECAUTI ONS/LIMITATI ONS • 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 t 9 �j o r t,Vi r,ACI 306R "Guide to Cold Weather Concreting". ��+�mA� GY'G�Y • 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 —X— 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. Gray 8r COaborris,Itno. CONSULT1NG ENGINEERS Rev.03.19 By. DRS Date 1/11/2022 WARRANTY:The Euclid Chemical Company("Euclid')solely and expressly warrants that its products shalt be tree from defects in rrateriats and r,u'kinar ship'or inc(1)year°om the date of purchase.Unless authonzed in writing by ar officer of Euclid.no other representations or statements made by Euclid or its representatives,in writing or orally.shall after the warranty.EUCUC 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 with this warranty.Euclid will replace the product at no cost to Buyer.Replacement of arty product shall be the sole arid exclusive remeey avertable and buyer shall have no clam for incidental or consequential damages.Any warranty claim must Se made within one It)year from the date of the claimed breach.Euclid does not authorize anyone on its behalf to make any written or oral statements which in any way atter Euclid's installation information or instructions in its product literature or on its packaging labels.Arty installation of Euclid products which!ads to contarm with such installation information or instructions shall void this warranty.P'oduct demonstrations,if any are done for illustrative purposes only and do not constitute a warranty or warranty alteration of any turd,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 Pennsylvania SUBMITTAL REVIEW 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. �3rray'SL Osborne,k CONSULTING ENGINEERS By: DRS Date: 1/20/22 CHICAGO • ATLANTA • DALLAS • LOS ANGELES • MINNEAPOLIS • NYC/PHILA • RENO SEATTLE MEXICO • CANADA , n • Washington State W/ Department of Transportation Request for Ap roval of Material Contract Number FA Number NIA SR Duvall Ave NE Date • CAG 20-065 12/16/2021 Section/Tine 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 Y For W8DOT Use Only be returned for information that was omitted. RAM# 059&061 PE Use Bid item • Material or Name and Location of Fabricator, - Specification PEIQPL HdgtrJQPL HQ Use No. Product/t'ype Manufacturer or Pit Number Reference Code Code A4 CSTC Black River Quarry 4-04 ' 10 P44-52, B6-B9 . . . . . Project Engineer/Representative ;--- (-----,e- Date .State Materials Engineer/Representative Date • 4 \-}#4b .- 12116/2021 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. 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 Withheld: Per ASA.Report, source not approved for CSTC Miscellaneous Acceptance Criteria. • Remarks (PE); • Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ❑X Contractor 0 Region Operations Engineer 0 Fabrication Inspection 0 Region Materials 0 Slate Materials Lab•MS 47365 • • WSDOT MATERIALS LAB 12/16/2021 Aggregate Source Approval Report Owner: Kangley Rock&Recycling,Black River Aggregate Source.-A-51) 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: T ast 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: r 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 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 1 PROJECT: Internal Testing DATE: 12/9/2021 LOCATION:Black River-Quarry SAMPLE SOURCE:A-51.6 SAMPLE DESCRIPTION: RCA 5/8" Crushed Surfacing Top Course (Type 1G) AGGREGATE SIZE: 5/8" TESTER: Sean SIEVE WEIGHT PERCENT PERCENT SPECIFICATION SIZE RETAINED RETAINED PASSING COS 9-03.9 3/4" 0.0 0 100 100 1/2" 0.3 3 98 80 - 100 3/8" 1.1 11 89 #4 3.5 35 65 46 - 66 #40 8.5 85 15 8 - 24 #200 9.9 99 2 0 - 10 PAN 10.0 100 0 WET SAMPLE: 10.4 TOTAL MOISTURE: 3.8% DRY SAMPLE: 10.0 S.E.: 62% FM: 1.20 FRACTURE % 95% DUST RATIO: 10% 'The minimum percent passing the No.60 and No.100 sieves may be reduced to 6 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 nonairentrained concrete containing more than 500 lb of cement per cubic yard(C 33 6.2) K: Washington State �''/ Department of Transportation Request for.Ap[ roval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 Section/Title of Project Duvall Ave NE County King i 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# 060 FE Use Bid Item Material or . Name and Location of Fabricator, Specification PEIQPL Hdgtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference- Code Code A35 CSTC Kangley Rock & Recycling 4-04 1, 2, A44-52., 1175, B6-B9 ASA Project Engineer/Representative Date State Materials Engineer/Representative Date . �-2 _~'�—' 12120f2021 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. Acceptance Criteria: Mfg.Cert'of Compliance for�" g p 'Acceptance'prior to use of material. See Remarks. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved 0 Yes El No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Onl y fy'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). (HC Remarks Provide Scale Cert. and Daily Scalefnan's Reports. Delivery Ticket shall show bid item number and description. DOT Form 350-071 Project Engineer Distribution Revised 03/2021 0:1 Contractor 0 Region Operations Engineer El Fabrication Inspection El Region Materials El Stale Materials Lab-MS 47366 PROJECT: Internal Testing DATE: 12/9/2021 LOCATION: Black River Quarry SAMPLE SOURCE: A-516. SAMPLE DESCRIPTION: RCA 5/8" Crushed Surfacing Top Course (Type 1G) AGGREGATE SIZE: 5/8" TESTER: Sean SIEVE WEIGHT PERCENT PERCENT SPECIFICATION SIZE RETAINED RETAINED PASSING COS 9-03.9 3/4" 0.0 0 100 J 100 1/2" 0.3 3 98 80 - 100 3/8 1.1 . 11 89 #4 3.5 35 65 .46 - 66 #40 8.5 85 15 4. 8 - 24 #200 9.9. . 99 2 J 0 - 10 PAN 10.0 100 . 0 WET SAMPLE:. 10.4-- --TOTAL MOISTURE: 3:8°fo DRY SAMPLE: 10.0 S.E:: : 62% 4 FM:. 1.20 FRACTURE %- 95% 'J DUST RATIO: 10% . • "The minimum percent passing the No.50 and No.700 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 par cubic yard or in nonair-entrained concrete containing more than 500 ib of cement per cubic yard(C 33 6.2) • ® 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(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 Drywelis 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 llU'T -Materials Laboratory https://www.wsdot.wa.gov/biz/mats/l1YLA,??LYrodmto.ctmYYroduct n... VW hingtan State Dopnrtmcnt at 1�anepartattan 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 � Washington State -11 Department of Transportation Request for Approval of Material Contract Number. FA Number N/A SR Duvall Ave NE Date CAG 20-065 Section/Title of Project Duvall Ave NE County 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# 065 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 Cade Code ass,a4a Tier 2 9-03.21(1)C 10 A35,A CSTC Squak Mountain A43.03.02 Bank Run Gravel for Trench.Backfill 9-03.19 -A52.03.02 Tier 1 Squak-Mountain-Issaquah -9=03.21(1)C 1,2 B6-B9 Tier 1 Gravel Backfill for Pipe Zone Bedding 9-03.12(3) . 1 2 S-quak Mountain-Issaquah 9-03.21(1)C • • • • • 1 . Project Engineer/Representative - Date State Materials Engineer/Representative Date 1/3/2022 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. OAcceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. 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 fabricationof 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 pproval Withheld: Reclamation facility must be on the QPL as a Tier 2 facility, per WSDOT 9-03.21(1)C. 11. Miscellaneous Acceptance Criteria. See below QPL pages,Squak Mnt out of Issaquah is not' Remarks currently an approved facility. (PE): Remarks Remarks: . (HQ): Prior to use, provide toxicity testing and certification of toxicity characteristics in accordance with Section 9-03.21(1). 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 O Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materials Lab-MS 47365 WSDOT-Materials Laboratory Qualified Products List(QPL) https://wsdot.wa.gov/biz/mats/QPL/QPLProduct;Grid:cfih ell State �I/ Department of itanaportatton Qualified Products List Standard Specification: 9-03.21(1)C Product Name I Spec Title I Manufacturer __ i Tier 1 and Tier 2 - Recycled I Recycled Concrete I Central Pre-Mix (An Oldcastle Infrastructure Concrete Aggregate (RS-C-343) I Aggregate !Company), Spokane Valley-WA Tier 1 and Tier 3 - Recycled i Recycled Concrete Tucci and Sons, Lakewood-WA Concrete Aggregate (RS-B-352) j Aggregate Tier 1 and Tier 2 - Recycled Recycled Concrete Kangley Rock & Recycling, Black River, Concrete Aggregate (RS-A-516) I Aggregate {Renton-WA Tier 1 - Recycled Concrete I Recycled Concrete Aggregate (RS-F-211) Aggregate ;Cowden Gravel & Ready Mix, Bellingham-WA1 Tier 1 - Recycled Concrete I Recycled Concrete Aggregate (RS-R-189) ;Aggregate American Rock Products, Richland-WA Tier 1 - Recycled Concrete Recycled Concrete ;American Rock Products, Pasco-WA I Aggregate (RS-FN-121) I Aggregate Tier 1 - Recycled Concrete I Recycled Concrete IAmerican Rock Products, Walla Walla-WA Aggregate (RS-O-146) ;Aggregate _ Tier 1 and Tier 3 - Recycled Recycled Concrete I I Concrete Aggregate (RS-C-345) Aggregate I Pro-Recycle, LLC, Spokane Valley-WA Tier 1 - Recycled Concrete 1 Recycled Concrete Holroyd Green Products Plant, Tacoma-WA Aggregate (RS-B-351) I Aggregate Tier 1 - Recycled Concrete I Recycled Concrete 1 re re I Renton Concrete Recyclers, Renton-WA ,Aggregate 99 9 (RS ----A-519) I A._99 9ate _ I 'Tier 1 - Recycled Concrete Recycled Concrete] Blake Sand & Gravel, Sequim-WA Aggregate (RS-Q-241) _ Aggregate 1 Tier 1 - Recycled Concrete I Recycled Concrete jDs0nComPanYTacomaWA A re ate S-B-350 I A re ate Tier 1 - Recycled Concrete I Recycled Concrete Aggregate (RS-D-359) I Aggregate Lenz Enterprises, Inc., Stanwood-WA I Tier 1 - Recycled Concrete Recycled Concrete Corliss Resources, Inc., Puyallup-WA .Aggregate (RS-B-349) Aggregate • Tier 1 - Recycled Concrete Recycled Concrete Corliss Resources, Inc. Enumclaw-WA 1Aggregate (RS-A-518) Aggregate !Tier 1 - Recycled Concrete ; Recycled Concrete 1Action Materials, Inc., Spokane-WA Aggregate (RS-C-344) I Aggregate __ _ , Tier 1 and Tier 3 - Recycled Recycled Concrete . Concrete Aggregate (RS-D-360)_;Aggregate I Fruhling Sand &Topsoil, Bothell-WA , Tier 1 - Recycled Concrete j Recycled Concrete I I Aggregate (RS-OR-90) I Aggregate I.V. Riley, Bingden-WA • Tier 1 and Tier 2 - Recycled Recycled Concrete • Stampede Sand &Gravel LLC, Easton-WA • . i Concrete Aggregate (RS-S-312)__ Aggregate _ �— Tier 1 and Tier 3 - Recycled Recycled Concrete Miles Resources - Lakeview, Lakewood-WA I Concrete Aggregate (RS-B-353) i Aggregate I Tier 1 and Tier 3 - Recycled I Recycled Concrete Reece Construction Company, Arlington-WA Concrete Aggregate (RS-D-361) Aggregate 1 of 2 12/29/2021,8:45 AN. WSDO'Pt-Materials Laboratory Qualified Products List(QPL) https://wsdotwa.gov/biz/mats/QPL/QPLProductsCind.ctm Tier 1 and Tier 3 - Recycled Recycled Concrete Girard Resources & Recycling LLC, Concrete Aggregate (RS-A-517) Aggregate Covington-WA Tier 1 and Tier 3 - Recycled Recycled Concrete Girard Resources & Recycling LLC, Concrete Aggregate (RS-D-358) Aggregate Snohomish-WA Tier 1 and Tier 2 - Recycled Recycled Concrete Interstate Concrete & Asphalt, Elk-WA Concrete Aggregate (RS-C-346) Aggregate Tier 1 - Recycled Concrete Recycled Concrete Black Lake Resources, Littlerock-WA Aggregate (RS-J-217) l Aggregate Tier 1 - Recycled Concrete i Recycled Concrete Black Lake Resources, Grand Mound-WA Aggregate (RS-J-216) (Aggregate - Tier 1 - Recycled Concrete Recycled Concrete Kitsap Reclamation & Materials, Bremerton- Aggregate (RS-I-118) Aggregate WA Copyright WSDOT© 2016 2 of 2 12/29/2021,8:45 AM ALLIANCE PO Box 2377 Alliance Testing Services (,,t1'1 TESTING Renton,WA 98056 425-757-0762 ,....� SERVICES Plant 1-Alliance Testing Services Product 68-Squak Mountain CSTC Name/Title Mike Costello/Manager Period: 01/01/2019-04/09/2019 Report Date 04/09/2019 Procedure Sieve/Test Result Unit 9-03.9.3 Crushed Surfacing TC AASHTO Ti 1/27 3/4"(19mm) 100.0 % 100-100 1/2"(12.5mm) 89.4 % 80-100 #4(4.75mm) 49.7 % 46-66 #40(0.425mm) 13.3 °k 8-24 #200(75um) 7.60 % 0-10 AASHTO T176 SE 53 >40 AASHTO T335 Fractured Faces(>1) 86 >75 9-03.12(3)Gravel Backfill for Pipe Zone Bedding 9-03.19 Bank Run Gravel for Trench Backfill Sieve Size Percent Passing 1.5i" j 99-100 i/ Sieve Sire Percent _._ 1" 1 75-100 I , ' 50-100 it No.4 22-100 No.4 20 80 i No.200 _ 0-10 No.40 3-24 i Dust Ratio: %max., No.200 10.0 max.i Sand Equivalent i 30 min. i Sand Equivalent J 35 min_ StonemontQC Washington State •/ Department of Transportation Request for Approval of Material Contract Number FANurnber N/A SR Duvall Ave NE Date CAG 20-065 8/31/21 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# 027 PE Use L Bid Item Material or Name and Location of Fabricator, Specification PEJQPL Hdgtr./QPL HQ Use No. ProductfType Manufacturer or Pit Number Reference Code Code 20x24 Locking Olympic 3 A51 Frame FoundryInc 7-05 roject need-,. : ,,tive Date State Materials Engineer/Representative Date • 0 eptance yction Codes for use y roject Engineer and State Materials Laboratory 1. Acce•to e Criterla:•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 0 Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material. Catalog Cut Approved ®Yes ❑No Remarks 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): Frame and Grate shall have rust protective coating per Special Provisions 7-05.2 Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 In Contractor El Region Operations Engineer 12 Fabrication Inspection 0 Region Materiels El State Materials Lab-MS 47365 A., ' f BID ITEM A49, A50, A51 Frame and Grate shall have rust protection coating per Special Provision 7-05.2 7/5• ,5/5• 1/1/2• 4 11/2" ..I..1/5+ 1 5/8• 20,/4 3 3/4' r 3/4• 25 i/4' L -- _t 22• I _J II L 2 1/2' 1 5/5' 3/_—r 4. SLOE OVAL --- 3/4. 22+/2• •I 1 1L'4•_ _t. 24 I µ- —T 24',29 21 1/4'- - .. -I I-yr 5/5• FRAME 5L0T miaow AND RECESSED FOR S/$-11 NC x Y SOCKET HEAD(ALLEN MEAD)CAP SCREW 15/5•(TO CRANCC-.d.-1/H) rALTERNATE +I F1 3/5' ,� _��_... ___ ii �� 5 SUBMITTAL REVIEW _ j I No Exceptions Taken 20' ; X Make Corrections Noted = -_ ' Amend &Resubmit Rejected-See Remarks IMPORTANT NOTICE: This review 1 5/5' 24. f 5/e'(Tp.ERANLE=a0•,-Il+e7 does not relieve the Contractor from r,,/. `1a•R. / responsibility to comply&conform + I ,a/s• with the Plans, Specifications, and I Contract Documents. ,/b' I 'I 5/+5 R 5. Z I/4' liftPARTING UK 3/r VANE DETAIL C715Efy tiL O9bo1TIC, inc. CONSULTING ENGINEERS By:MB Date: 9/15/21 NOTES: WSDOT STD B2B OLYMPIC FOUNDRY INC. 20"X 24"REVERSIBLE LOCKING FRAME&VANED GRATE MATL:Frame;Cast Iron ASTM A48 CL30.Grate;Ductile Iron ASTM A536 CL80-55- RATING: H-20 PART NO. SM6OV DTI 06 APPROX WT:Frame 160 Lbs,Grate 104 Lbs REV:A DATE:7/3/2003 New border REV TOLERANCE A DOCUMENT APPROVED DWN:CL DATE:7/3/2003 REV: DATE: Kx.., - BY: DATE: .-.06 CHKD:CL DATE:7/3/2003 x y.o� DWG#:SM60 VANED DT SCALE:N/A SHEET:1 OF 1 A+-20Ea , Engineer Addition Washington State �w Department of Transportation Qualified Product List Product Information Manufacturer : Olympic Foundry, Inc., Seattle - WA Product Name : Metal Castings for Catch Basins and Inlets Standard Spec : 9-05.15(2), Drainage Structures - Metal Frame, Grate and Solid Metal Cover for Catch Basins or Inlets Product Description : Manufacturer of frame, grate and solid metal cover for catch basins or inlets; See Std Plan B-25.20, B-30.10; B-30.20, B-30.30, B-30.40 and B- 30.50 for further details Product Restriction :, Accepta a Code : 5140 Code Descri ion : Accept e is based on field verification of the 'WSDOT- A' impressed into t casti (A is an alpha fabrication inspectors' identification). Document, in the in ctors'IDR, the fabrication stamp information identifying the inspectors' letter d q tity and either'F' or'D'for foreign or domestic steel and/or iron or not m ed. If the tract contains a Buy America clause and the material is marked F not at all, the PE ' responsible for acquiring a Certificate of Material Origin m the Contractor. Note 7 : The Pro t Offic I need to forward a copy of the completed QPL page to the Fabrication Inspec. ' Office for notification as soon as this material is approved for use. Last Updated : Sep 13, 2010 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 4 i . � Washington State I/ Department at Transportation Request for Approval of Material, Contract Number ---. FA Number NSA Duvall Ave NE Date CAG 20-065 _ _ ___ 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#016 PE Use Bid Item ' Material or Name and Location of Fabricator, Specification PEIQPL - Hdgtr.IQPL HQ Use No. ,' Product/Type Manufacturer or Pit Number Reference - Code Code A51 'Type 1-L Shope 7-05 3. A 51 Type 1 Riser Shope 7-05 13 ---- A-51 ' Curb inlet Shope -- — -- - 1-05- , See RAM 14 , 'Project Engineer/Rep ,, live ;Date State Materials EnglneeilRepresentative Date f, As, =' Cti ..i?. v Ac eptance lion CodeB for useby Project Engineer and State Materials Laboratory 1. cceptance -r(teri, . Acceptance based upon"Satisfactory"Test Report for samples of materials to be incorporated into rOject. 2. Acceptance ' stria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. 0 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): Provide Frame & Grate Submittal Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ❑Contractor 0 Region Operations Engineer 0 Fabrication Inspection 0 Region Materials 0 Stale Materials Lab-MS 47366 411116 1,71 Washington State �I/ Department of Transportation Request for.Ap royal of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 _ 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 9016 PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL Hdgtr.IQPL HQ Use No. Product/Noe Manufacturer or Pit Number Reference Code Code A51 Type 1-L Shope 7-05 3 A-51 Type 1 Riser Shope 7-05 3 A-51 Curb Inlet Shope 7-05 See RAM. 14 • Project Engineer/Representative Date State Materials Engineer/Representative Date 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. 0 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): Provide Frame & Grate Submittal Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ❑Contractor El Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materials Lab-MS 47365 SUBMITTAL REVIEW 48 X No Exceptions Taken Make Corrections Noted Catch Basins Amend & Resubmit shope Rejected-See Remarks IMPORTANT NOTICE:This review Catch Basin Type 1-L Concrete Proc't:c+s does not relieve the Contractor from WSDOT B-5.40-02 responsibility to comply&conform with the Plans, Specifications, and Contract Documents. Reinforcing Gray&Osborne, Lao. • ASTM/WSDOT requirements CONSULTING ENGINEERS • All components By: TLS Date: 9/7/21 • #3 grade 60 reinforcing Riser Sections • 36 " 24' 20' • Available in 2",4",6"&12" 6" • Lift holes provided in all risers and must be grouted up from both inside and outside to assure watertight structure Reducing Top Slab • Standard unit is designed for frame and 32"20• ‘4"36• grate to be placed on top. 0 12" Precast Base • The unit is provided with 25 inch diameter knockouts on all four sides leaving minimum wall thickness of 2 inches • Lift holes provided in all risers and must be grouted 36"20• ♦ g" up from both inside and outside to assure watertight 24" structure Weights • Base Unit 2,480 lbs , • 6 inch Reducing Top 430 lbs 6"REDUCING SLAB • 12 inch Riser Section 537 lbs • 6 inch Riser 280 lbs 36" * 40• Conformity Standards 2" • Washington State APWA/WSDOT Standard Specifications / t • WSDOT B-la 44" 25" 12' 4" Note:drawings not to scale Shope Concrete,LLC (253)848-1551 sh^pe 1618 East Main Avenue Fax Line 1 (253)845-0292 1-800-422-7560[TOLL FREE] Puyallup,WA 98372-3142 Fax Line 2(253)864-6172 www.shopeconcrete.com Y catch basin products mo = WSDOT Catch Basin Risers Type 1 3 30" 4" 24" 20" 1 34" 30" 24 20" 6" \� . --- �\ -.i -- 34" 30" / 2, 24" 20" I -.4. T SUBMITTA ♦ 30" X No Exceptions Ta 34' 24" 20" Make Corrections No Amend & Resubmit ��'� 0 ioe Rejected-See Remarks 12" IMPORTANT NOTICE: T . vi 30" Jr does not relieve the Ca "r 20" 0 responsibility to 29rrpf I 4„ St \,Y�' with the Plans, ecifi o ,an S 1 Contract Documents. .. , - Gray 4tir Osborne, I . .Y CONSULTING ENGINEERS ``. I '54 By: TLS Dec 9/7/21 34" ♦ 30" 24" 20" 34" 44110 30" 24" 20" lo 0/ � I 44.0e 24" 11111111 0 4001124 �� Y Pi Imo,.... 17"KNOCKOUT ALL FOUR SIDES ,, I i i ..yi Note::drawings not to scale SI Shope Enterprises,Inc. (253)848-1551 1-800-422-7560[FREE CALL—North America] 1618 East Main Avenue Fax Line 1(253)845 0292 www.shopeconcrete.com concrete products Puyallup,WA 98372-3142 Fax Line 2(253)864-6172 60 Catch Basin she De Products Concrete Products Curb Inlet Typ- 6 Reinforce WSDOT B-25.03-02 • ASTM 15 • All compo -nts • #3 grade 60 r 'r-Iforcing bar _‹CIEION 6 Inch Riser - • 300 lbs 12 Inch Riser • 600 lbs *4't " 34" 30 24" 10-.4r$2o" Precast Base • Base unit has four-way knock outs pro ided for 6" RISER pipe entry • 1100 lbs 41411111‘ 4401.°11 • 11/2 inch hole on each side for handling Conformity Standards • Washington State APWA/WSDOT Standard Specifications 30" • WSDOT B-25.60-02 2;001b2o" ,k\ k 0 12" RISER 1114W,, „ !•• 34:400004 3°" 26 4" Si 0 1111140, „ 0 17" -• 25" 4" S • ,---" ate:drawings not to scale Shope Concrete,LLC (253)848-1551 shope 1618 East Main Avenue Fax Line 1(253)845-0292 1-800-422-7560[TOLL FREE] Convoha Puyallup,WA 98372-3142 Fax Line 2(253)864-6172 www.shopeconcrete.com Engineer Addition Washington State f/r Department of ltnnsportation Qualified Product List Product Information Manufacturer : Shope Concrete Products, Puyallup - WA Product Name : Precast Concrete Catch Basins Standard Spec : 9-05.50(3), Precast Concrete Catch Basins Product Description : Manufacturers of precast concrete catch basins and risers; for assistance, see Std Plan B-5.20, B-5.40, B-5.60, B-10.20, B-10.40, B-10.60 and B- 30.90 for further details. Product Restriction : �► eptance Code : 5120 Code cription : Acceptance is based on field verification of`W.S.D.O.T. INSPECTED' s . Document, in the fiel ' spectors' IDR, the fabrication inspectors' initial, quantity and e `F' or`D' oreign or domestic steel and/or iron or not marked. Concrete Adjustme ctions less than 12 inches - Acceptance shall be Visually in accordance ' Section C. If the Contract contains a Buy America clause and the erial is marked F or not the PEO is responsible for acquiring a Certific of Material Origin from the Contractor. • The Project Offi ' need to forward a copy of the completed QPL page to the Fabrication fice for notification as soon as this material is approved for us st Updated : Sep 9, 2017 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016