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HomeMy WebLinkAboutCAG-20-065 - Duvall - A52-Catch Basin Type 2 48 IN. Diam. • • ' :j k_. _ 4' - " - 6 - 4 . J . _ - - , . 4 J ! J 4 J_4' `.! 4-J 4' J 4 J 4 J.4 - . . - . . - - ' . J 4 o y .gig'i�=ii2i�`ti��i�ci��iv•vat'i•tii�iv��i�:ii`=i�.-.r��iw�i��i���iinii`�ii"'i� i“`�i��i��iv,ei(y i ;p' _ r u n rru u rrirruutrrttru.tinrurrtritrl,uuIiIIIIrrr n.turrtiu uuuuu itriitttILI .. ItiuLl�truuuuuuuunnu uunnu nuuu uf irtrrrliriiirirtttr = Cam.,_ �� _ 1e� Cu=UNITEC Corporation 4_ E .off = 358 Upland Drive ve • Seattle Washington 98188 C' _ • • �� = Catthatr 13inniirftnn =• :• ; -„, ,...-_-- . = ... • . o� _ This is to certify that r7�r i.vc." scale(s) _• • '`� = Located at: $o WAA,- /� ,,, rrn a is `/i'S�j ,/a4 w IA was (were) serviced on this 244' day of 71¢m t,Edn.( 20 2-7, by an authorized representative of C�:, i o = R Cam: • the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. , -ip = A record of said inspection is on file at the above address and in the offices of UNITEC CORPORATION. = Co • • C�., " _ (206) 575-1100 Cam• `" :0 a' ttrnrrnttrnnttnnnnirnrrtrn r[rnnrinnrritrrr.rrrrnirutturnntntitninanurtirinknrtnnrturrrtitnattrirnrnruturirtrltnrrntruutrtnunlE C ode /1,A\/\Aril f\�\�\!�'/\!\I\/^\/`��4 ir\�iri\/'7•/� /!• /\�\dce,•�\/\/\/\/\/\/\'i\/\!\ ti1+0 O O. .p p, p. O• G, ? ; O. O; 9`' . Gr ira" CaO: i _ ; Gr yG- O- 0.9- OO. O. G- p. �0 ANIFEST Am Test Inc. LABOR AT ORIES 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 Suite C AMTEST Services Kirkland, WA 98034 (425) 885-1664 LABOR A TO R IES vvw.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 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 RESULT UNITS Q , D.L. METHOD ANALYST DATE Acid Digestion Y SW-846 3050E KF 02/27/22 Lead 8.70 ug/g 0.84 EPA 6010D KF 03/01/22 • • P.3. L• ) SQUAK MOUNTAIN MATERIALS Project Name: SQUAK AmTest ID: 22-A002570 AMTEST 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 3050B KF 02/27/22 Lead 8.89 ug/g 0.80 EPA 6010D KF 03/01/22 AMTEST Identification Number 22-A002571 Client Identification (5)5/8 Sampling Date Total Metals PARAMETER r 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 AMT EST Identification Number 22-A002573 Client Identification (2) 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 13.9 ug/g 0.85 EPA 6010D KF 03/01/22 P.5 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 3050B 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 3050E 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 3050B 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 NE 126th PL Analytical Suite C AINTEST Services Kirkland, WA, 98034 (425) 885-1664 LABORATORIES www.amtestlab.corn QC Summary for sample numbers: 22-A002567 to 22-A002576 DUPLICATES SAMPLE# LANALYTE 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 • ...q,: • .ES kir AmTest Chain of Custody Record 13600 NE 126th PI,Suite C, Kirkland,WA 98034 L .kaanAroalea Ph(425)885-1664 Fx(425)820-0245 • www.amtestiab.com • •( • - Chain of Custody No. i— — • _ , .,•'." Client Name &Address: 1 ,',..- Invoice To: <...,•i .,.. ", ,..z.i.,),,1 ,;7.1 bvq.K.42•',,t_..-..2 !' -, - • ./7 ..2..7 1,',V./7 ';(:,..;' i'i-:;:l..'i.l'ik,. . 7 •:*•t4"." i' I/ CA. Y,C?'/12'2 '4 r•,' ,6'1 4J'r,:l./.) I ele-W.'t le_vt.1 4- / r L ' /- r L,t•' r c.-e,.7 t....„...-t‘t..ti,fpf:f) .,6 I) • - ''' Contact Person: n . .:. ,---, , „-- Invoice Contact: f.-) _,,,„...,„,t.. .,, , i . ,1,..,; , \ ,p r 0 -f:I It. .,,r.et y ,, i. . 1,,,, ,h1„4,.,.:,." .,,t i y: !/1.,;,;kr?: , ,-1 , , . L., - t : Phone No: '•-•-?,i /JO i;f, e7/.(,,,,...1 PO Number: i:1 {. :i •'-:? 7/--/ ,/:-(p- , i.e,/,' - Z'e b(-_„.,/ ',3"/T 1 4'/,,•& Fax No: Invoice Ph/Fax: , . E-mail: 1•".„.. ._.. ,,_...?,.. •:.• ni 1-‘ 1 ,.1,t=4:7-tvf..L. rIe./i:f A Ls.-.l0•:l'•if.-:.[L/:t/7 Invoice E-mail: Pl')vre t'l)it kihI.._k lo„. .4,1, 7,47.0.., . Report Delivery: (Choose aunat apply) Data posted to online accotint: YES / NO • re- -. Mail / Fax /(. Ernaji..-1 / Posted Online Web Login ID: ... Special Instructions: . . ' . Ikequeste.d..TAT-:.,(Rush must be pre-approved by lab) 14.5 Tern upon Receipt: e'Standard-; RUSH ( 5 Day / 3 Day / 48 HR / 24 HR• ) j Projeallahe: .. .7.:(//fc,: • to Analysis Requested ... Project Number: 13..cu a .c —C1- Fa' E E x 4..r 33 33 :a g (J) u) m u cu a.3 X 4._ • Client ID .4-1 ra E o U AmTest ID (35 characters max) Z3 -se :ist • • . CY . 7-- (07 i ..— 51S - ' -70 LI . . • . . :71 _ 5 --7z, 7g Z • 15 4. . 762 4 2.' collectediRelinquished By: Date Time Received By: Date Time 2 -L.7- ?-2 ,iVT.,,,v , , . zizqi?2, los _ Relinquished By: Date Time Received By: • • Date Time Relinquished By: Date Time Received By: • Date . Time • COMMENTS: • ' . P.9 • Truck Scale Report & Certification Date Tested: January 14,2022 CO -1 ► . NO: Company Icon Materials E-mail. Name and Asphalt Scale raysscalederek@yahoo.com 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 12 Sections: #: 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 J-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 , CO NB Company Icon Materials E-mailu Name and Inbound 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 10' Arrival: Platform: Capacity: 60 ton _ CLC: 50 ton Scale: Murphy Make: Rice Lake Serial#: 834429 County: King Number of 6 Scale Serial N/A Reg IQ 710 Sections: #: Element: 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 16705 Truck Scale Report & Certification /A 1 A Date Tested: January 14,2022 CO -1,L V 4 NC Company Icon Materials E-mail.- rayssca lederek@ya hoo.com Name and Outbound Scale 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 5 Scale Serial 8QEH Reg IQ 710 Sections: #: Element: 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 o < < < < 0 VVVVilari►a%V\%V liar\Q%“11,4,��/VVVVVVVVVVO/4eir4j%ije/OarV\�%Arab,\�/ o p. =l1t111111111.LIIIIIILL1i1I1111L11IIIIJU1lIlIII1JIlllllli_i1111111IL1111L1.1tIII,u 1111 IIIIII1111111111III1111lIIIIf11l1IIIitiLLt1111I1 11111111IIIRiIlt1111111111II p` :4 __ _ UNITEC Corporation = �o. 1 = �111�eC 358 Upland Drive • Seattle,Washington 98188 Co _- ,) = (1Irrtifirati of ,Jxt i rtiott _ <:, = 45- ,<-,>) E _ 1 lV 9O �O7/ ( ) = C4 o' This is to certify that scale s /� • �1 � � `o I = Located at: d� � �''= 20 2- byan authorized representative of Co 1 was (were) serviced on this 1 day of ` ' _ the UNITEC CORPORATION. Certified Test Weights traceable to U.S. Government Standards were used. _ o 0 E A record of said inspection is on file at the above address and in the offices of UNITEC CORPORATION. _ C';, :o.) ri — = C— (206) 575-1100 tz (. , o _ ( -ImIallllll(TT1TT1IT1111111l1 LTi lTfl la11111-11!!1_l i-II1T11I1111I11'lI 11111miLlllll tCaLlsIrIT�Ilrwl-li IIIIIIl 111111 t.1.11111111... 1it11111-T1Tlw_nTlnl 1111 11f 111ii .. „ 0 /0\/\/0�/\/\/0\/\/elo,/."►/r\/\/9\/e�►I0\/��/\I0\/0\/e\/p\/r\/a\/�\/8\/0\ie.\/ep►/��/r\/�\I0\(> Washington State Ir/ Department of Transportation Request for Approval of Material Contract Number FA Number NSA SR Duvall Ave NE Date CAG 20-065 01128;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# 80 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 A44-A52 CSTC 513'Natural Sumner Pe B-231 7414 2 , B6-89 A44-A52 I CR(`1 1,1" a,,,w N 7-04 ,$b-By Bank Run A43-A52 Trench Backfill to. Sumner Pit B-231 9-03.19 1, 2 A43-A52 Bank 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 Zen.Bedding Sumner Pit B-231 9-03.12(3) 1, 2 Project Engineer/Representative Date State Materials Engineer/Representative Date 1/31/2022 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. 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. 1t1 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 0 Contractor Region Operations Engineer ❑Fabrication Inspection El Region Materials El State Materals 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 J 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 mmmum percent passing the No.50 and No 100 sieves may be-educed to 5 end 0.respectively,if the aggregate is to be used in en-entrained concrete containing more than 400 lb of cement per cubic yard or in nonarr-entrained concrete cortamng more than 500 lb of cement per cubic yard(C 33 6.2) 9-03.12(3) Gravel Backfill for Pipe Zone Bedding Sieve Size Percent Passing 114" 99-1001 1" 75-100 %" 50-100 4 9-03.9(3) Crushed Surfacing No.4 20.80 1 Base Course q Top C0uj )llnd Keystone No.40 3-24 Sim She Percent Passu No.200 10.0 max. 1'h" 99-100 Sand Equivalent 35 min. S 1" 80-100 %" 99-100 d %" 50-80 - 9-03.19 Bank Run Gravel for %" 80-100 J Trench Backfill No.4 25-45 46-66 4 Sieve Size Percent No.40 3-18 8-24 221/r 75-f00 I No.200 7.5 max. 10.0 max.i No.4 22.100 %Fracture 75 min. 75 min. i No.200 0-10 Sand Equivalent 40 min. 40 min. i 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 t 80 - 100 3/4" 1 .8 18 82 5/8" 2.7 27 73 `.1 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 relnnnr,rr'pen out cass.ng the No DO and NC '110 sieves may oe reduced(a S and 0 'esneohrely it the aggregate is to be used m arr-enlralred Concrete rininir'q 1 i:xe Iran 41C b of error 1 pee tuba,yard re in rntr a rerntr,66,61 r'.ryir I ete(..)11,111,rug eir.re:t,n"CO It,or"relent per cubic yard(r:33 6 2) 9-03.12(3) Gravel Backfill for Pipe Zone Bedding gm Size Percent Passing 1%" 99-100 4 1" 75-100 J 9-03.9(3) Crushed Surfacing %- so-loo 4 �se Cour, Top Course and Keystone j No.40 3-24 No.4 20-80 Y Sieve Size Percent Passing — No.200 10.0 max. —_-____ 1- y'> l U0 _� Sand Equivalent 35 min.4 1" 80-100 J Y.." 99-100 %" 50-80 4 Si" 80-100 No.a 25-45 ab 66 9-03.19 Bank Run Gravel for No.40 3-18 B-24 Trench Backfill No.200 7.5 max.'', 10.0 max. Sie e i 8 Perce sing %Fracture 75 min.1 75 min. 75.100 4 Sand Equivalent 40 min. 4 40 min. __ No 22.100 4 No.200 0-10 4 Dust Ratio: %max.J Sand Equivalent 30 min.4 Y'YYYY'�-'f l"YYYYYY'Y"YYYY, Page added by engineer WSDOT MATERIALS LAB o1/28/2022 Aggregate Source Approval Report Owner: Cava Materials Aggregate Source: PS-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 Weanng 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 Wail, 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 Spalis 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):2.681 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: For geosynthetic reinforcement,the gravel borrow shall be tested for pH priorto placement.For metallic reinforcement,the gravel borrow"shall be tested for pH, resistivity,chlorldes,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 Approval of Material Contract Number FA Number NSA Duvall Ave NE Date CAG 20-065 ISR 101/28/2022 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 0 081 PE Use Bid item Material or Name and Location of Fabricator, Specification PE/QFL Hdgtr./QPL HQ Use Nc. Product/Type Manufacturer or Pit Number Reference Code Code A27 A44-A52 Gravel Borrow Icon Materials-Auburn A-464 7-04 1, 2 B6-B9 A44-A52. B6-B9 CSTC Icon Materials-Auburn A-464 7-04 1, 2 A44 A52 CSBC Icon Materials-Auburn A-464 7-04 1, 2 B6-89 Project Engineer/Representative -�(--- Date State Materials Engineer/Representative Date L_ r: -, I 1/31/2022 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 21. Acceptance Criteria: Acceptance based upon"Satisfactory"Test Report for samples of materials to be incorporated into project. 2. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment', 'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 10. Approval 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 0 Region Operations Engineer 0 Fabrication Inspection ❑Region Materials 0 Slate Materials Lab-MS 47365 ICON Summary Report Sample Information Sample No 1264637438 i0o- . . Product Id 2380 Product Name Gravel Borrow BD" Specification WSDOT 9-03.14.1 Gravel Borrow Date Sampled 01/07/2022 09:00 m- Sampled By Skye Southward „- Sample Type Investigative so- Sample Method Surge Pile ' ' 60- Notes 3o- 2022 Submittal (B) 20- 10- o.,.. t . . v..... t . ,r...T I r I. . t ..r.l `$�i; I.. • N. a. -• &Ifl09.n000tmml 010(03;0 16 070 066 060 1 42 001)210 010065 002 Cu 1091 C<0 S 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 #40(.425mm) 25 0-30 sieve She PermtPunkt. 115" 99-100 #100(.15mm) 9 %Passing No.200 1" 75-100 #200(75pm) 6.7 0-7 Dust Ra60' %Passing No.40 $i" Q0-100.) 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 Pauli 9-03.19 Bank Run Gravel for 4" 99-100 Trench Backfill 2" 75-100 *rag No.4 50-80 If 2" 75-100 No.40 30 max./ No.4 221.001 No.200 0-10 No.200 7.0 max. Dust Ratio: %max. 4 Sand Equivalent 50 min. tl Sand Equivalent 30 min. 1 StonemontQC 01/10/2022 CRH Americas Materials(AMAT) ICON Summary Report Sample Information Sample No 303028092 a.- • • Product Id 2350 Product Name 5/8"CS TC 9D; Specification 9-03.9(3)Crushed Surfacing TC B". Date Sampled 01/08/2022 10:00 is- Sampled By Randy Mattson a- / Sample Type Investigative s,. Sample Method Surge Pile " - / Notes 2022 to- Submittal 00- 10 YYr�^^ II// 0 • I .I . t.... I - I • • r 9•'T I iv 1.. 1.. &.-.Dom'"a,mwi DMIESi on 0X 106 D50 312 DEC 413 0,5055 004 Cu 2123 C4'00 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 7176 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) so 46-66 9-03.12(3) Gravel Backfill for #8(2.36mm) 44 Pipe Zone Bedding Sine Size #16(1.18mm) 32 Percent Pa rte 1 99-100 VI #30(.6mm) 21 %Passing No.200 1" 75-100 #40(.425mm) 17 8-24 Dust Ratio: %Passing No.40 %" 50-100 #50(.3mm) 12 No.4 20-80/ #100(.15mm) 6 No.40 3-24 #200(75pm) 4.2 0-10 200 lO.Omax.� 9-03.9(3) Crushed Surfacing Sand Equlvalerk 35 min. Base Course Top ..›Course Keystone Sieve size Peres* 1i" 99-100 1' 80-100 9-03.19 Bank Run Gravel for Trench Backfill it" 99-100 i S4" 50-80 a 11111 SS" 80-100 II 7 No.4 25-45 46-66 No.4 22.100 No.40 3-18 8-24 �f No.200 0-10 t / 5-100 No.200 7.5 max. 10.0 max.1 Dust Ratio. 3%max Sand Equivalent 0 min. if %Fracture 75 min. 75 min. Sand Equivalent 40 min. 40 min. J ,,..,,,,._.,__ _...............—.,Materials(AMAT) ICON Summary Report Sample Information Sample No 655576787 Product Id 2379 00, `--,..-,. Product Name 1 1/4"CS BC 90' Specification 9-03.9(3)Crushed Surfacing BC 10' Date Sampled 01/04/2022 11:05 Sampled By James Begley 60_ Sample Type Process Control 50- Sample Method Surge Pile " i. w- Notes x,- 2022 Submittal 20. 16:� 0 ... i . . ,t...... i . . i....Tiirii . i1 9«r00a.m0 mm 715E51 00 030 204 050 7 50 050 1063 054356 004 Cu 21 54 Cc 1 A 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 Sieves Size vPercPercentot Pampa #10(2mm) 25 13.1" 99-100 Ti #40(.425mm) 9 3-18 96 Passing No.200 1" 75-100• / #100(.15mm) 3 Dust Ratio: %Passing No.40 %" 50-100i #200(75pm) 2.0 0-7.5 No.4 20.8011 No.40 3-24 t� No.200 10.0 max. 9-03.9(3) Crushed Surfacin Sand Equivalent 35 min. Course Top Course and Keystone Sieve Sine Passing 1%" 99-100 1" 80-100 1 9-03.19 Bank Run Gravel for %" 99-100 Trench Backfill %" 50-80 r SI�S� %" 80-100 Z 7� No.4 25-45 46-66 No.4 22-100 2" 75-100 f No.40 3-18 �/ 8-24 No.200 0-10� No.200 7.5 max. 1// 10.0 max. Dust Ratio: %max. /1 %Fracture 75 min.1/ 75 min. Sand Equivalent 30 min. Ir 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.cfm?prefix=A&pi... WSDOT MATERIALS LAB 01/31/2022 Aggregate Source Approval Report Owner: La Pianta Limited Partnership Aggregate Source: PS-A-4641 Lessee: Icon Materials,Inc. Known as: Auburn Pit Located in: SW1/4 SW1/4 SEC 28&29 Section 28,29,T2111 R5E County: King Remarks: Mineral Agg.and Surfadng: Test Date: 10/17/2018 Expiration Date: 10/17/2023 Absorption:1.26 Apparent Sp.G.:2.744 Bulk Sp.G.(SSD):2.686 Bulk Sp.G.:2.652 Deg:57 LA:14 Remarks: Currently approved as a source of aggregate for: ATB 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 CCAAbsorption:1.24 CCASp.G:2.68 Deg:72 FCAAbsorption:2.18 FCAOrganics:3 FCASp.G:2.624 LA:11 Remarks: Current,'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,Rode 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/bizJmats/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.'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 maybe required.Contact the.Regional Materials Engineer or the State Geotechnial 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 Washington State ♦/ Department of Transportation Request for Apiproval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 1/26/2022 Section I Titie 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 0 029C PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL lidgtr./QPL I HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code .ir Mortar Speedcrete 3 A49-A53 Project Engineer/Representative Date State Materials Engineer/Representative Date 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. 3O. 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 0 Contractor Region Operations Engineer ❑Fabncation Inspection El Region Materials State Materals Lab-MS 47365 ►- s The Euclid Chemical Company [IL 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. PRIMARY APPLICATIONS o • Repair of numerous interioriexterior,above/below grade,vertical/overhead structural surfaces without forming m FEATURES/BENEFITS D_ • 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 -13 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) Volumetric Resistivity 7,980 ohm-cm Freeze Thaw Resistance ASTM C666 r^ 320 cycles 99.0%RDF PACKAGING SPEED CRETE PM is packaged in 50 lb (22.7 kg) poly-lined bags. SHELF LIFE 1 year in unopened package COVERAG E/YI ELD 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 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. o o � Priming & Bonding (Saw Cut&Chipped Out Repairs): Thoroughly clean any exposed reinforcing steel, and a 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 Coats/Toppings): 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 www.euclidchemical.com 800-321-7628 t • 216-531-9596 f • 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 aroducs shall be free from defects in malends and workrnarship for one(1)year from the date of purchase.Unless authorized m writing by ar officer of Euclid no other representations or statements made by Euclid or its representatives.in writing or orally.shall alter this warranty.EUCLID MAKES NO WARRANTIES IMPLIED OR OTHERWISE. AS TO THE MERCHANTABILITY OR FITNESS FOR ORDINARY OR PARTICULAR PURPOSES OF ITS PRODUCTS AND EXCLUDES THE SAME.II any Euclid product tads to conform wan this warranty.Eucld will replace the product at 10 cost to Buyer.Replacement of any product shall be the sole and exclusive remedy available and buyer shall have no clarn for ncidental or consequential damages.Any warranty claim must oe made within one(1}year'tom the date of the clamed breach.Euclid does not authorize anyone on its behalf to make airy written or oral statements which in any way after Euclid s mstailation information or instructions in its product derature or on its packaging labels.Any installation of Euclid products which tads to conform w'th such nstallation information or instructions shall void this warranty Product demonstrations,if any,are done for illustrative ourposes only ans do not constitute a warranty or warranty alteration of any kind,Buyer shall be solely responsible for determining the suitability of Euclid s products for the Buyer s intended purposes Qualified Product List https:/iwsdot.wa.gov/biz/mats/QPL/QPLPrint.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: 1 of 1 1;26/2022,2:24 PM • ANL WOWashington State Department of Transportation Request for Approval of Material Contract Number FA Number SR Date CAG 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./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code B17 ALL THRD ROD STS INDUSTRIAL Std. Plan - 10 106 A49-A53 SPEEDCRETE/REDLINE 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 t_ 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. 2. Acceptance Criteria: Mfg. Cert.of Compliance for'Acceptance'prior to use of material. (7Acceptance 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. 0.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 0000 A307 All Thread Rod,Galvanized BID ITEM 817 FOR HYDRANT RUNS The ASTM A307 specification covers carbon steel bolts and studs ranging from 114'through 1 diameter A307 is an economical low carbon nlatenal often manufactured using A36 round bar.Dimensional specifications are governed by ASME 818.31.3.A307 all thread rod is available in hot dip galvanized finish,which provides a corosron resistant zinc coating.The all thread rod noted on this page is domestic,melted and manufactured in the USA B. EL .. PRODUCTS GO/ERRINC STANDARDS MECHANICAL PROPERTIES CHEMICAL PROPERTIES GOVERNING STANDARDS SUBMITTAL REVIEW NO Girolorw LOAn ktrAv Cs•ucuww sr lve amend A Rnwnne ArT111 A707 Covers'he mechanical and material requirements for net series cheerers in diameters horn )( 4eiecsrd-See rk- Rens Ira tnrougn a'mace Of ramin steer navng a mnanune rensae snengm 0160 coo psi ,MP'1NrANT NOTICE rhsrmx« :Jons r,c;rexawr 1!>•a Goolla for firm roapmabnty to comply d wive, ASME E10.at-a Covers me genera and dnreesonal data'a,mmn Series Treaded lads v COR'TEM SWA Tr.Rod.Far era Plan,speoacarera and COR fad.Plan-3111.1 .lrnuarl ooaarv.rls A JIY!Y1 1 UMC .vPec A �.w� V s•• ✓ C i.r h.,rie$Me neat form sexes class Amyx,tolerance and descrnNnn sa undyed screw UNF Clan 7A threads Rl ORR [tale 1/114072 Diameter + These PIMA + 7> A307 AO Thread Rod,Galvanized or The Euclid Chemical Company SPEED CRETE RED LINE ED RAPID SETTING REPAIR MATERIAL EUCLID CHEMICAL 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 • Interior and exterior xi • 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 L^ m The following are typical values obtained under laboratory conditions. Expect reasonable variation under field conditions. Compressive Strength, psi (MPa)ASTM C109 Freeze Thaw Durability Factor ASTM C666 24 Hour 2,550(17.6) 300 Cycles 96.75% 7 Day 4,000(27.6) 28 Day 5,700(39.3) Shrinkage 50%RH ASTM C157(3"x3"x11"specimens r Set Time, ASTM C266 were removed from molds @ 24 hours) Z Initial 8 20 Min 28 Day -0.069% m Final 15-30 Min Expansion 100% RH ASTM C157(3"x3"x11"specimens Split Tensile Strength,psi (MPa) ASTM C496 were removed from molds @ 24 hours) 7 Day 240 (1.7) 28 Day 0.142% 28 Day 290 (2.0) Flexural Strength, psi (MPa) ASTM C348 Scaling Resistance ASTM C672 7 Day 700 (4.8) 50 Cycles 0%loss 28 Day 918 (6.3) Volumetric Resistivity 5,250 ohm-cm Appearance: Available in 6 shades of gray of PACKAGING oxl SPEED CRETE RED LINE is packaged in 50 lb (22.7 kg) poly-lined bags, and 50 lb(22.7 kg) pails wo V 3 a SHELF LIFE 18 months in original, unopened packaging COVERAGE One 50 lb (22.7 kg) bag yields approximately 0.47 ft3(0.013 m3)when mixed with 5.5 qt(5.2 L) water 19215 Redwood Road • Cleveland, OH 44110 www.euclidchemical.com 800-321-7628 t • 216-531-9596 f DIRECTIONS FOR USE Surface Preparation:Concrete surfaces must be structurally sound,free of loose or deteriorated concrete and free of dust,dirt,paint,efflorescence,oil and all other contaminants. Mechanically abrade the surface to achieve a surface profile equal to CSP 6-8 in accordance with ICRI Guideline 310.2. Properly clean profiled area. Priming&Bonding (Saw Cut&Chipped Out Repairs): Thoroughly clean any exposed reinforcing steel,and apply DURALPREP A.C.to the concrete and the reinforcing steel within the repair area.Refer to the DURALPREP A.C. technical data sheet for full instructions. Alternatively, application of a scrub coat of SPEED CRETE RED LINE to the saturated surface dry(SSD)concrete surface may be used for bonding.The repair material must be placed on the scrub coat before the scrub coat dries out. Mixing: SPEED CRETE RED LINE will require approximately 5 to 5.5 qt(4.7 to 5.2 L) of potable water per 50 lb (22.7 kg) bag to achieve the proper mix consistency. Pour the measured amount of water into a clean mixing container, then add the SPEED CRETE RED LINE, and thoroughly mix for no more than 60 seconds to a stiff, no slump, putty-like consistency. Mix small quantities of SPEED CRETE RED LINE in a clean pail with a hand trowel. Use a rotary mixer with rubber tip blades for mixing quantities up to 100 lbs. (45.4 kg). To fill patches 2" (5.1 cm) deep or greater, add clean, pre-dampened,3/8" (0.96 cm) size pea gravel. DO NOT USE LIMESTONE AGGREGATE.The mix ratio must not exceed 40 lbs. (18 kg) of pea gravel to each 50 lb (22.7 kg) bag or pail of SPEED CRETE RED LINE. Mixing procedure:Start mixer,load water,load pea gravel,and then load the SPEED CRETE RED LINE. MIX FOR NO MORE THAN 60 SECONDS. Application: For vertical repairs,place SPEED CRETE RED LINE in 1/8"-2" (3.2mm-50.0 mm) lifts.To ensure a complete bond with the entire surface,force the SPEED CRETE RED LINE firmly into the SSD area by hand or with a trowel. Slightly overfill the repair, and following initial set, shave the material to conform to the contour of the surrounding surface. Always shave SPEED CRETE RED LINE toward the common bonding edge between the repair mortar and the existing surface. Cure material using standard curing practices. Cold Weather Installation: Application at temperatures below 40'F (4'C) extends the set time. Heating the repair area until warm, using warm water for mixing, and tenting/insulating the repair area after application will increase strength development. Do not use direct heat on the repair after it is installed. CLEAN-UP Clean application tools and mixing equipment with water immediately following use. PRECAUTIONS/LIMITATIONS • Keep in covered storage away from all moisture. • Mix no more than 60 seconds. • Use only potable water with SPEED CRETE RED LINE. • Mix to a stiff, putty-like, no slump consistency. Do not add more water than recommended. • Do not apply SPEED CRETE RED LINE as a horizontal topping or as a tile setting mortar. • When necessary,follow the recommendations in ACI 305R "Guide tQ o r ACI 306R "Guide to Cold Weather Concreting". �V �A • 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 T— 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. Wink Gray&lire orne•Inc. CONSULTING ENGINEERS Rev.03.19 By DRS Date 1/11/2022 WARRANTY:The Euc'.d Chemical Company('Euclid'I solely and expressly warrants that is aroducts shall be free from defects m materials and workmanship for one f11 year'rorr the dirt,11 purchase.Unless authorized in writing by an officer of Euclid no other representations or statements made by Euclid or its representatives,in writing or orally.shall alter this warranty.EUCUD MAKES NO WARRANTIES IMPLIED OR OTHERWISE. AS TO THE MERCHANTABILITY OR FITNESS FOR ORDINARY OR PARTICULAR PURPOSES OF ITS PRODUCTS AND EXCLUDES THE SAME.If any Euclid product tads to conform with this warranty.Euclid will 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 be made within one(I)year from the dale of the c awmed breach.Euclid 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 literature or on its packaging labels.Any installation of Euclid products whicn tails to conform with such installation information or instructions shall void this warranty.Product demonstrations, any.are done for illustrative purposes only and do not constitute a warranty or warranty alteration of any kind.Buyer shall he solely responsible for detemxrnng the sr.tabdity of Euclids products for the Buyer s,mended 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. Gray 8L Osborne,Inc. CONSULTING ENGINEERS By: DRS Date: 1/20/22 CHICAGO ATLANTA • DALLAS • LOS ANGELES • MINNEAPOLIS • NYC/PHILA • RENO SEATTLE • MEXICO • CANADA • 4. Washington State �, Department of Transportation Request for A r p.. oval of Material Contract Number FA Number NSA SR Duvall Ave N E Date CAG 20-065 12/16/2021 _ Section 1 Tide 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.# 059&061 • . . PE Use Bid item Material or Name and Location of Fabricator, Specification PEIQPL . .Hdgtr1QPL• HQ Use No. Product/1'ype Manufacturer or Pit Number Reference Code Code 44 CSTC Black River Quarry 4-04. 10 B6-B9 ' • . • j • Project Engineer/Representative ::--1 Date ' ,State Materials Engineer/Representative Date L-G 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. . i 2. Acceptance Criteria: Mfg.Cert of Compliance for'Acceptance'prior to use of material. 3. Acceptance tance Criteria: CatalogCuts for'Acce'Acceptance'prior to use of material.Catalog Cut Approved P P o9 PP El Yes [3-No . 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of'material. . . 5. Acceptance.Criteria: Onl y ty'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. . c10. Approval Withheld: Rer ASA Report, source not approved for CSTC. Miscellaneous Acceptance Criteria. • Remarks (PE): Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 a Contractor 0 Region Operations Engineer 0 Fabrication Inspection ❑Region Materials 0 State Materials Lab-MS 47365 0 WSDOT (MATERIALS LAB 12/16/2021 Aggregate Source Approval Report Owner: Kangley Rock&Recycling, Black River Aggregate Source:`RS-A-51 1 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: 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 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 0 100 100 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.50 and No.100 sieves may be reduced to 6 and 0.respectively,if tho 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) 1,71 Washington:State Department of Transportation Request for.ApF - roval.of Material Contract Number FA Number NSA 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# 060 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL Hdgtr1QPL -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 L� Date State Materials Engineer/Representative Date 12/20/2021 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 0 Acceptance Criteria: Acceptance based upon"Satisfactory'Test Report for samples of materials to be incorporated into project. 2. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5. Acceptance Criteria: Only'Approved for Shipment'.'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9. Approval Withheld: Submit samples for preliminary evaluation. 10, Approval Withheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Prior to use, provide toxicity testing and certification of toxicity characteristics in accordance with Section 9-03.21(1). Remarks rks Provide.Scale Cert..and Daily Scalernan's Reports.. Delivery Ticket shall show bid item number and description. DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor 0 Region Operations Engineer 0 Fabrication Inspection ❑Region Materials 0 State Materials Lab-MS 47365 .a 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 1 G) 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 4 100 1/2" 0.3 3 98 4 80 - 100 3/8" 1.1 11 89 #4 3.5 35 65 J 46 - 66 #40 8.5 85 15 J 8 - 24 #200 9.9 99 2 J 0 - 10 PAN 10.0 100 0 WET SAMPLE: 10.4- TOTAL MOISTURE: 3.8% 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.100 sieves may be reduced to 5 and 0.respectively,if the aggregate is to be used in air-entrained concrete containing more than 400 lb of cement per cubic yard or in 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:CS-A-5176) • 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 Spalls,Rock for Rock Wall, Erosion and Scour Protection: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA: Remarks: NOT Approved for: Quarry Spalis Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(6) Streambed Aggregates: Test Date: Expiration Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA: Remarks: NOT Approved for: Streambed Aggregate Streambed Aggregate Gravel Borrow for Structural Earth Walls: Test Date: Expiration Date: Bulk Sp.G.(SSD): Deg: LA: NOT Approved for: Gravel Borrow for Str Earth Walls ALL OTHER PIT RUN MATERIALS: Project.Engineer may request preliminary samples but Aggregate Source Approval is not required. AGGREGATE MATERIALS NOT REQUIRING ASA APPROVAL: Aggregate for Gravel Base 9-03.10 Gravel Backfill for Foundation Class B 9-03.12(1)B Gravel Backfill for Walls 9-03.12(2) Gravel Backfill for Pipe Zone Bedding 9-03.12(3) Gravel Backfill for Drains 9-03.12(4) Gravel Backfill for Drywalls 9-03.12(5) Backfill for Sand Drains 9-03.13 Sand Drainage Blanket 9-03.13(1) Gravel Borrow 9-03.14(1) Select Borrow 9-03.14(2) Common Borrow 9-03.14(3) Native Material for Trench Backfill 9-03.15 Foundation Material Class A and B 9-03.17 Foundation Material Class C 9-03.18 Bank Run Gravel for Trench Backfill 9-03.19 Commercial Concrete Aggregate 6-02.3(2)B sl �a i WSDOT-Materials Laboratory https://www.wsdot.wa.gov/bizlmats/QPL/QPLProdinfo.cfm?Product n... Washington State VAI IF Department of 7tansportatioa 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 Ssarfacinq; 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 .111I► WI" Washington State Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave N E 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# 070 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL Hdqtr./QPL HQ Use No. ProducvType Manufacturer or Pit Number Reference Code Code A52 Pipe Adpt Trelleborg 3 Proje Engine . .- •tive Date State Materials Engineer/Representative Date (� 1/10/2022 ccepta ce 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 QX 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 (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor DRegion Operations Engineer ❑Fabrication Inspection Region Materials ❑Stale Materials Lab-MS 47365 TRELLEBORG PIPE SEALS TRELLEBORG CIVI Irbil piter Data Sheet ,� 111111 . Lir Provides a good sealing surface on corrugated HDPE pipe Easy to install-Simply stretch it over the pipe to the desired location Certified to ASTM C923 when used with a Kor-N-Seal® Connector Specifically designed for use with most sizes of ADS, Hancor, Lane, N-Flow,Quality Culvert,JM Eagle and Contech A2000 �..•�■ The unique design of our Pipe Adapter distributes the force from the pipe clamp on our Kor-N-Seal connector directly against the inside walls of the pipe corrugations, creating a watertight seal up to 24 inches*. SUBMITTAL REVIEW X No Exceptions Taken Make Corrections Noted Amend& Resubmit Rejected-See Remarks IMPORTANT NOTICE:This review does not relieve contractor from his responsibility to comply&conform with the Plans, Specification, and Contract Documents. 410100 Gray 8E Osborne, Inc. CONSULTING ENGINEERS By. DRS Date: /6/2022 CORRUGATED PIPE ADAPTER Pipe Pipe Pipe O.D. Adapter Sealing Pipe Pipe Pipe 0. Adapter Sealing Kor-N-Seal Connector Kor-N-Seal Connector Size Mfg. Ref,+I/. Pan No. Capabdi� �...,Size Mfg. Ret.+ ?Part No. Capability ADS 9 1/8 CGA-8A WT 1 Contech S206-28L, 25 1/2 CGA-24C WT 8 Hancor 9 1/8 CGA-8H S106-12 or S406-12 WT uuu 24 A2000 S306-28L Lane 9 7/16 CGA-8L wT JM Eagle 27 1/2 CGA-24JM S206-30L ST ADS 113/8 CGA-10A WT S206-38L, ADS 35 CGA-30A ST 10 Hancor 11 3/8 CGA-10H 5106-16A WT S306-38L-STORM Lane 113/4 CGA-10L WT S206-40, Hancor 36 CGA-30H ST ADS 14 3/8 CGA-12A 5106-16T or W7 S306-40-STORM Hancor 14 3/8 CGA-12H 5106-20BWS WT S206-381, N-Flow 35 CGA-30N ST Lane 14 9/16 CGA-12L WT 5306-381-STORM JM Eagle 14 1/4 CGA-12JM ST S206-40, Baughman 35 13/20 CGA-30B ST 12 Quality 30 S306-40-STORM 14 1/2 CGA-12Q S106-20BWS ST Culvert 1 Quality 34 7/8 CGA•30Q S206-38, ST Baughman 14 1/2 CGA-128 ST f 1 Culvert N-Flow 15 CGA-12N ST i 5306-38L-STORM Lane 34 3/4 CGA-30L ST Contech 12 3/4 CGA-12C 5108-16A WT I Contech 5206-36, 32 3/16 CGA-30C ST A2000 ei : A2000 S306-36-STORM ADS 17 1/2 CGA-15A WI !�' S206-38, Hancor 17 1/2 CGA-15H 5306-20W5. WT JM Eagle 34 5/8 CGA-30JM S-306-38-STORM ST S206-20L Lane 17 7/16 CGA-15L WT ADS 41 7/8 CGA-36A 3206-44L-46, ST Baughman 18 1/4 CGA-15B ST Hancor 41 3/8 CGA-36H S306-44L-46 ST 5206-22 or S206-24A N-Flow 18 CGA-15N ST Lane 40 7/8 CGA-36L ST 15 Quality P 17 1/2 CGA-15Q 106-20W5, ST Baughman 41 1/2 CGA-366 5206-44L, Culvert N-Flow 41 1/8 CGA-36N ST JM Eagle 17 1/2 CGA-15JM 5206.20E ST • 36 Quality S306-44L-STORM Contech Culvert S 41 3/8 CGA-36Q ST 15 5/8 CGA-15C 106-20AWS WT A2000 Contech 5206-42L, ST ADS 21 3/16 CGA-18A WT A2000 38 3/4 CGA-36C S306-42L-STORM y Hancor 21 3/16 CGA-18H WT JM Eagle 41 1/2 CGA-36JM S206-441 ST Lane 21 3/16 CGA-181_ WT ADS 47 11/16 CGA-42A ST Baughman 21 4/19 CGA•18B 5206-24L,S306-24L ST Hancor 47 15/16 CGA-42H ST N-Flow 21 CGA-18N ST Baughman 48 1/5 CGA-428 ST 18 Quality 215/16 CGA-18Q ST 42 N-Flow 48 CGA-42N S206-52L ST Culvert Quality Contech S206-221,S306-22L Culvert 48 1/4 CGA-42Q ST 19 1/4 CGA-18C WT A2000 or S206-24A Lane 47 3/8 CGA-42L ST S206-52 JM Eagle 20 7/8 CGA-18JM S206-24 WT JM Eagle 47 3/8 CGA-42JM ST 21 Contech ADS 53 7/16 CGA-48A ST 22 9/16 CGA-21C S206-26,S306-26 WT A2000 Hancor 53 11/16 CGA-48H ST ADS 27 3/4 CGA-24A S206-30L-32, W7 Lane 54 CGA-48L ST Hancor 27 3/4 CGA-24H S306-30L-32 WT Baughman 54 3/10 CGA-48B 5206-58L Si Lane 28 CGA-24L WT 48 N-Flow 54 CGA-48N ST 24 Baughman 28 1/2 CGA-24B S206-32,S306-32 ST Quality N-Flow 28 CGA-24N ST Culvert 54 3/4 CGA-48Q ST Quality 2715/16 CGA-24Q S206-30L-32, ST JM Eagle 53 13/16 CGA-48JM S206-58 ST Culvert S306-30L-32 5206-64L 54 Hancor 60 15/16 CGA-54H ST S206-66 60 ADS 66 1/4 CGA-60A S206-70L ST Hancor 67 3/16 CGA-60H S206-72 ST WT= Watertight ST=Soiltight Covered under U.S.Patent No.6,364,373 \r/aV TRELLEBORG W W W.TRELLEBORG.COM/PIPE-SEALS TRELLEBORG PIPE SEALS TRELLEBORG CIIIV . i lirli a pter , ._ gem , rill\ Data Sheet Ili Provides a good sealing surface on corrugated HDPE pipe Easy to install-Simply stretch it over the pipe to the desired location Certified to ASTM C923 when used with a Kor-N-Seal® Connector Specifically designed for use with most sizes of ADS, Ill Hancor, Lane, N-Flow,Quality Culvert,JM Eagle and Contech A2000 The unique design of our Pipe Adapter distributes the force aipai from the pipe clamp on our Kor-N-Seal connector directly against the inside walls of the pipe corrugations, creating a watertight seal up to 24 inches*. CORRUGATED PIPE ADAPTER Pipe Pipe Pipe O.D. Adapter Sealing Pipe Pipe Pipe0.D. Adapter Sealing Kor-N-Seal Connector Kor-N-Seal Connector Size Mfg. Ref.+t/4 Part No. Capability Size Mfg. Ref.+,/. Part No. Capability ADS 9 1/8 CGA-8A WT Contech S206-28L, 251/2 CGA-24C WT 8 Hancor 9 1/8 CGA-8H S106-12 or S406-12 WT 24 A2000 S306.281 Lane 9 7/16 CGA-8L WT JM Eagle 27 1/2 CGA-24JM S206-30L ST ADS 11 3/8 CGA-10A WT 5206-38L, ADS 35 CGA-30A ST 10 Hancor 11 3/8 CGA-10H S106-16A WT S306-38L-STORM Lane 11 3/4 CGA-10L WT S206-40, Hancor 36 CGA-30H ST ADS 14 3/8 CGA-12A S106.161 or WT S306-40-STORM Hancor 14 3/8 CGA-12H S106-20BWS WT S206-38L, Lane 14 9/16 CGA-12L WT N-Flow 35 CGA-30N 5306-38L-STORM ST JM Eagle 14 1/4 CGA-12JM ST S206-40, Baughman 35 13/20 CGA-30B ST 12 Quality 30 S306-40-STORM 14 1/2 .CGA-12Q S106-208WS ST Culvert Quality Baughman 14 1/2 CGA-12B ST Culvert 34 7/8 CGA-30Q 5206-38, ST N-Flow 15 CGA-12N ST Lane 34 3/4 CGA-30L S306-38L-STORM ST Contech S206-36, 12 3/4 CGA-12C S106-16A WT Contech 32 3/16 CGA-30C ST A2000 A2000 5306-36-STORM ADS 17 1/2 CGA-15A WT S206-38, 5106-20WS. JM Eagle 34 5/8 CGA-30JM ST Hancor 17 1/2 CGA-15H WT S-306-38-STORM S206-20L Lane 17 7/16 CGA-15L WT ADS 41 7/8 CGA-38A S206-44L-46, ST ,y Baughman 18 1/4 CGA-156 S206-22 or S206-24A ST Hancor 41 3/8 CGA-36H S306-44L-46 N-Flow 18 CGA-15N ST Lane 40 7/8 CGA-36L 15 Quality Baughman 41 1/2 CGA368 NMI 17 1/2 CGA-15Q 5106-20WS, ST S206-44L, Culvert N-Flow 41 1/8 CGA-36N 5206-201 36 5306-44L-STORM JM Eagle 17 1/2 CGA-15JM ST Quality 41 3/8 CGA-36Qg Contech Culvert kid 15 5/8 CGA-15C 510640AWS WI A2000 Contech S206-421, <. ADS 21 3/16 CGA-18A WT A2000 38 3/4 CGA-36C 5306-421-STORM Hancor 21 3/16 CGA-18H WT JM Eagle 41 1/2 CGA-361M S206-441 ST Lane 21 3/16 CGA-18L WT ADS 47 11/16 CGA-42A ST Baughman 21 4/19 CGA-18B 5206-24L,S306-24L ST Rancor 47 15/16 CGA-42H ST 18 N-Flow 21 CGA-18N ST Baughman 48 1/5 CGA-426 ST 5206-52 L Quality 215/16 CGA-18Q ST 42 N-Flow 48 CGA-42N ST Culvert Quality 48 1/4 CGA-42Q ST Contech S206-22L,S306-22L Culvert 19 1/4 CGA-18C WT A2000 or S206-24A Lane 47 3/8 CGA-42L ST JM Eagle 20 7/8 CGA-181M S206-24 WT JM Eagle 47 3/8 CGA-42JM S206-52 ST Contech ADS 53 7/16 CGA-48A ST 21 A2000 22 9/16 CGA-21C S206-26,5306-26 WT Rancor 5311/16 CGA-48H ST ADS 27 3/4 CGA-24A S206-301-32, WT Lane 54 CGA-481 ST Hancor 27 3/4 CGA-24H S306-30L-32 WT Baughman 54 3/10 CGA-48B 8206-581 ST Lane 28 CGA-241. WT 48 N-Flow 54 CGA-48N ST 24 Baughman 28 1/2 CGA-24B S206-32,5306-32 ST Quality 54 3/4 CGA-48Q ST N-Flow 28 CGA-24N ST Culvert Quality 2715116 CGA-24Q 5206-30L-32, ST JM Eagle 53 13/16 CGA-48JM S206-58 ST Culvert S306-30L-32 S206-641 54 Hancor 60 15/16 CGA-54H ST S206-66 60 ADS 66 1/4 CGA-60A S206-70L ST Hancor 67 3/16 CGA-60H S206-72 ST WT=Watertight ST=Soiltight Covered under U.S.Patent No.6,364,373 /i TRELLEBORG WWW.TRELLEBORG.COM/PIPE-SEALS r► Washington State ♦/ Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 01/02/2022 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# 068 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEJQPL Hdgtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code A52 Kor-n-seal NPC 3 Project Engi er/Representative Date State Materials Engineer/Representative Date A'L 1/10/2022 Acc ance 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): Remarks (HO): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 El Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials State Materials Lab-MS 47365 J KOR-N-SEAL® I & II AP nC FLEXIBLE PIPE-TO-MANHOLE CONNECTORS ,40 SPECIFICATION SHEET Stainless Steel Korband Stainless Steel (lb Pipe Clamp I i Reinforced Nylon Wedge ,.�`v or Stainless Wedge EPDM OR SUBMITTAL REVIEW POLYISOPRENE X No Exceptions Taken _ Make Corrections Noted Amend&Resubmit Rejected-See Remarks KOR-N-SEAL I - WEDGE KORBAND CONNECTOR ASSEMBLY IMPORTANT NOTICE:This review does not relieve contractor from his responsibility to comply&conform with the Plans,Specification,and Contract Documents. Gray 8z Osborn,,LIc. CONSULTING ENGINEERS y>t _ ', By: DRS ��� . \ifs , , , . /if ' t I iriInstall Kor-N-Seal I-Wedge Korband Install Kor-N-Seal II-Wedge Korband Install Pipe Clamps) with Socket Wrench& Torque Limiter with Standard Torque Wrench with T-Handle Torque Wrench www.npc.com KO NSEAL 250 Elm Street • P.O. Box 301 I Milford, NH 03055, U.S.A. Tel: 603-673-8680 • 800-626-2180 • Fax: 603-673-7271 02/06 KOR-N-SEAL° I & II `l� Flexible Pipe-to-Manhole Connectors /7QC SPECIFICATION SHEET PERFORMANCE Test ASTM Method Test Requirements Kór-N-Seal®I&II Head Pressure C923-7.1 0°-13 psi(30 ft)for 10 min. +13 psi for 10 min. 7°-10 psi(23 ft)for 10 min. +10 psi for 10 min. - Deflection Test C923-7.2.2 7°in any direction Over 7° in any direction Load Test C923-7.2.3 150 Ibs/in.pipe dia. Over 150 Ibs/in.pipe dia. Performed on all standard sizes of Kor-N-Seal Connectors. RESILIENT EPDM OR POLYISOPRENE RUBBER Conforms to ASTM C923 Test ASTM Method Test Requirements TEST RES®LTS Kor-N-Seal 1&11 Chemical Resistance D543,at 22°C for 48 h 1 N Sulfuric Acid No weight loss No weight loss 1 N Hydrochloric Acid No weight loss No weight loss Tensile Strength D412 1200 psi 1580 psi Elongation at Break 350%min. 500% Hardness D2240 (shore A durometer) t 5 from the manufacturer's 48±5 specified hardness • Accelerated Oven-Aging D573 70±1°C for 7 days Decrease of 15%, max. of original 10.1% tensile decrease tensile strength, decrease of 14.0% elongation decrease 20%max.of elongation Compression Set D395,method B;at 70°C Decrease of 25%, max. 13% decrease for 22 h of original deflection Water Absorption D471,immerse 0.75 by 2-in. Increase of 10%, max. .8% increase specimen in distilled of original by weight water at 70°C for 48 h Ozone Resistance D1171 Rating 0 Rating 0 Low-temperature Brittle Point D746 No fracture at-40°C No fracture at-40°C Tear Resistance D624,method B 200 lbf/in. No tear at 210 lbf/in. INTERNAL KORBAND Conforms to ASTM C923,ASTM A666,and A240 —Korband Assembly is manufactured of 300 series stainless steel. —Toggle Expander is made of 300 series stainless steel. —The 106/406 series Wedge Expander is made from reinforced nylon or 300 series stainless steel. —The 206/306 series Wedge Expander is made from 300 series stainless steel. EXTERNAL PIPE CLAMP Conforms to ASTM C923,ASTM A666,and A240 External take-up clamps are manufactured of 300 series stainless steel. www.npc.com 250 Elm Street • P.O. Box 301 Milford, NH 03055, U.S.A. 05/06 Tel: 603-673-8680 • 800-626-2180 • Fax: 603-673-7271 Washington State �/ 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 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# 028B PE Use Bid Item Material or Name and Location of Fabricator, Specification PEJQPL Hdqtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code A52.02 Aar Locking Manhole Ring East Jordan 7-05 3 P ct .it•j' • Representative Date State Materials Engineer/Representative Date 1/10/2022 A c eptance 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 ❑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. 10. Approval Withheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor El Region Operations Engineer 0 Fabrication Inspection 0 Region Materials El State Materials Lab-MS 47365 d BID ITEM 45-7'SPEC /,::�tk • 3715ZPT 3717C1PT Assembly REF- 7-05 A52-CBTYPE2 u:;i eJ mired/ (3) BOLTS :OLTHOLES — 3 PLCS EQUALLY SPACED 120' (SEE DETAIL) APART ON 23 1/16" Product Number 4 . DIA B.C. 00371573 \---, Design Features i;.y:. a.w I"� , "' t �\— Materials �� • � Frame o� Gray Iron(CL358) R EN T ON /�/ \\== Cover Gray Iron(CL35B) •" o CV9VE \\�_ j °� SUBMITTAL REVIEW • C• \0 No Exceptions Taken / \� Make Corrections Noted Amend&Resubmx -Design Load • • Rgeded-See Remarks � — Heavy Duty MPOT : view -Open Area (1) 1" PICKHOLE BOTTOM VIEW does atRTAN relieve NOTICE cordradorThisfhomre Ns n/a 1 1/4" SHARP FACE responsibiiy to campy 8 conform -Coating GOTHIC with the Plans.Spedlfbaeon,and 3 BLT SOC. (ALLEN HEAD) Contract Documents. Dipped (3) 1112 -.'Designates Machined Surface 25" DIA. 5/8"-11 X 1.5 SS___ Ciwyc tic Ion 1" W/ SS & RUBBER WASHERS 3/4" [ �t �,` By: DRS Date:1/5/22 Certification ASTM A48 _,l -Country of Origin.USA 8( 4"� 2 1/2" ��� Major Components COVER SECTION EON BOLTING DETAIL 00371512 00371781 - 26 1/2" 01A 1/4" 25 1/4" DIA—1 1/16" N/4" DIA Drawing Revision NEOPRENE GASKET 1 1/16" 12/24/201407 Designer- SMH ir- r 1/8„ 1/8.. 12/24/2014 RevisedBy:DVD �, j L I r 6" Disclaimer �` 1/$" Weights(Os/kg)dimensions(Inches/min) r ' • r / and d rig provided.or your guidance We 5/$" J i�� Y reserve the• :he right to moody specifications without ,�,e GASKET GROOVE DETAIL - 27 5/16" DIA r� CONFIDENTIAL:This drawing is Me pmpery �, of El GROUP.Inc..and embodies confidential information. 2" STACKregistered marks,patents,trade secret onto matron. 34 1/8" DIA andlor know how that is the property of EJ GROUP.Inc Copyright m 2012 EJ GROUP,Inc. ✓ STACKING DETAIL Contact• i cct reserved. FRAME SECTION 800 626 4653 ejco.com 70— Washington State Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave N E 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# 065 PE Use Bid Item Material or Name and Location of Fabricator,. Specification PEIQPL Hdqtr./QPL HQ Use No. ProductlType Manufacturer or Pit Number Reference Cade Code A35,A.43 AG2, CSTC Squak Mountain Tier 2 9-03.21(1)C- 10 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 Squak Mountain-Issaquah 9-03.21(1)C • 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 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 far preliminary evaluation. 10. Approval 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/QPLProduc4sGrid.c!:n � Washington State VI/ Department et Transportation Qualified Products List Standard Specification: 9-03.21(1)C Product Name I Spec Title i Manufacturer _ Tier 1 and Tier 2 - Recycled Recycled Concrete 1 Central Pre-Mix (An Oldcastle Infrastructure Concrete Aggregate (RS-C-343) 'Aggregate !Company), Spokane Valley-WA J Tier 1 and Tier 3 - Recycled I Recycled Concrete iTucci and Sons, Lakewood-WA Concrete Aggregate (RS-B-352) I Aggregate Tier 1 and Tier 2 - Recycled Recycled Concrete `Kangley Rock & Recycling, Black River, Concrete Aggregate (RS-A-516) j Aggregate I Renton-WA i Tier 1 - Recycled Concrete Recycled Concrete I I Aggregate (RS-F-211) Aggregate !Cowden Gravel & Ready Mix, Bellingham-WA. Tier 1 - Recycled Concrete j Recycled Concrete I 1 Ai Rock Products, Richland-WA Aggregate (RS-R-189) ;Aggregate jmercan _____J Tier 1 - Recycled Concrete Recycled Concrete ;American Rock Products, Pasco-WA 1 Aggregate (RS-FN-121) 1 Aggregate_ __ Tier 1 - Recycled Concrete Recycled Concrete American Rock Products, Walla Walla-WA !Aggregate (RS-O-146) _ Aggregate I _ _ _ Tier 1 and Tier 3 - Recycled I Recycled Concrete ;pro-Recycle, LLC, Spokane Valley-WA I Concrete Aggregate (RS-C-345) Aggregate ; _ I Tier 1 - Recycled Concrete I Recycled Concrete i Holroyd Green Products Plant, Tacoma-WA ; Aggregate (RS-B-351) j Aggregate , _ 'Tier 1 - Recycled Concrete Recycled Concrete 1Renton Concrete Recyclers, Renton-WA Aggregate_(RS-A-519) _ _..Aggregate I i 'Tier 1 - Recycled Concrete Recycled Concrete IBlake Sand &Grave l, Sequim-WA l' !Aggregate (RS-Q-241) _J Aggregate 1 ,Tier 1 - Recycled Concrete i Recycled Concrete j Aggregate Dickson Company, Tacoma-WA i Aggregate CRS-B-350)) Tier 1 - Recycled Concrete Recycled Concrete Aggregate (RS-D-359) I Aggregate i Lenz Enterprises, Inc., Stanwood-WA 'Tier 1 - Recycled Concrete I Recycled Concrete Corliss Resources, Inc., Puyallup-WA Aggregate (RS-B-349) I Aggregate Tier 1 - Recycled Concrete , Recycled Concrete Corliss Resources, Inc., Enumclaw-WA ;Aggregate (RS-A-518) .Aggregate I ,Tier 1 - Recycled Concrete ; Recycled Concrete , j 1 I Action Materials, Inc., Aggregate (RS-C-344) i Aggregate Inc Spokane-WA _ , Tier 1 and Tier 3 - Recycled i Recycled Concrete ° j Fruhling Sand &Topsoil, Bothell-WA , Concrete Aggregate (RS-D-360) Aggregate ___ _ Tier 1 - Recycled Concrete I Recycled Concrete 1 Aggregate (RS-OR-90) Aggregate I.V. Riley, Bingden-WA ,Tier 1 and Tier 2 - Recycled Recycled Concrete Stampede Sand & Gravel LLC, Easton-WA Concrete Aggregate (RS-S-312) ___j Aggregate i Tier 1 and Tier 3 - Recycled Recycled Concrete Miles Resources - Lakeview, Lakewood-WA 1 Concrete Aggregate (RS-B-353) J Aggregate ______ Tier 1 and Tier 3 - Recycled i Recycled Concrete Reece Construction Company, Arlington-WA 1 Concrete Aggregate(RS-D-361) I Aggregate '. 1 of 2 12/29/2021,8:45 AIV. WSDOT.Materials Laboratory Qualified Products List(QPL) https://wsdotwa.gov/biz/mats/QPL/QPLProductscind.ctm Tier 1 and Tier 3 - Recycled Recycled Concrete 1Girard Resources & Recycling LLC, Concrete Aggregate (RS-A-517) I Aggregate Covington-WA Tier 1 and Tier 3 - Recycled Recycled Concrete Girard Resources & Recycling LLC, Concrete Aggregate (RS-D-358) Aggregate 1Snohomish-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 1Black Lake Resources, Littlerock WA Aggregate (RS-J-217) Aggregate Tier 1 - Recycled Concrete 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) j Aggregate WA I Copyright WSDOT© 2016 2 of 2 12/29/2021,8:45 AM ALLIANCE Alliance Testing Services (,f0_ $\ PO Box 2377 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 °5 46-66 #40(0.425mm) 13.3 % 8-24 #200(75um) 7.60 °k 0-10 AASHTO T1 76 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 Sf " 99-100 Sie eSizo Percent• : --- I" 75100j MINN= 7 -'•• _ %4 50-1001 No.4 22-100 No.4 20 80 / No.200 0-10 No.40 3-24 I Dust Ratio: %max.I No.200 • 10.0 max_ Sand Equivalent 30 min. Sand Equivalent I 35 min- 1 j StonemontQC r- Washington'State ♦/ Department of Transportation Request for Approval of Material 'Contract Number FA Number N/A SR Duvall Ave NE Data 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 MOOT Use Only be returned for Information that was omitted. _ _ RAM#017 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 A-52 Type 1 Riser Shope , 7-05 3 A-52 Poly Ladder Lane 7-05 3 Poly;Srp and rythoid - A-52 '=P'14 O : : Lane 7-05 3 A-52 Manhole Products Lane/Shope 7-05 3,4 • !Project Ineer/Rp'eSentative Date State Materials Engineer/Representative Date -A. `- tance ction,.Codes for use by Project Engineer and State Materials Laboratory ;1. cceptan a:Acceptance based.upon"Satisfactory"Test Report foe samples of Friaterials.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 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):Adjustment sections shall be 4" minimum. Provide Kor-N-Seal boot submittal. Provide Frame &Grate submittal. Remarks • (HQ): • • DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ❑Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materiels ❑Stale Materials Lab-MS 47365 i.. - 411111. Washington State �� 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 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#017 PE Use Bid Item Material or Name and Location of Fabricator, Specification PE/QPL Hdqtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code A-52 Type 1 Riser Shope 7-05 3 A-52 Poly Ladder Lane 7-05 3 Poly Fteli and hand hold 3 A-52 r' 1463U Lane 7-05 A-52 Manhole Products Lane/Shope 7-05 3,4 • 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. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved 0 Yes ❑No CD 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):Adjustment sections shall be 4" minimum. Provide Kor-N-Seal boot submittal. Provide Frame & Grate submittal. Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ❑Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materials Lab-MS 47365 catch basin products ®m= WSDOT Catch Basin Risers Type 1 34" 30" 24" 20„ 1r 34" 30" 24 20" 6" 'N -- `N N ii' NN �i N i 34„ 30" N\ / 24" 20" 2,r N I �'/ Nyi T SUBMITTAL R 34' 30" `N .' 24" 20° X No Exceptions Taken •••• . i�ilib- Make Corrections Noted z.' 0 Amend &Resubmit lz Rejected-See Remarks 1 30. 4,..., .... IMPORTANT NOTICE:Th. v'.. za" 0 0 does not relieve the C. 'a., •r ' •m 4„ NYI ' responsibility to corm k & ....I fore with the Plans,Specifica i ••s, • • . N, I , Contract Documents. ] y N N i Gray&Osborne, Inc. Tom.' CONSULTING ENGINEERS 30„ By: TLS Date: 9/7/21 "24" 1114b.0 20" * 34" 30" 24" 20" Noo, I 0 24" 0 4.0110: l000 24" 44 �� T - N 17"KNOCKOUT ALL FOUR SIDES Nyi N i Nyi Note:drawings not to scale Sh^ 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 Washington State -, Department of Transportation 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 b d on field verification of'W.S.D.O.T. INSPECTED mp. Document, i e field inspectors' IDR, the fabrication inspectors' initial, quantity a either'F' r'D'for foreign or domestic steel and/or iron or not marked. Concrete Adj ent Sections less than 12 inches - Acceptance shall be Visually in accorda with tion 9-1.4C. If the Contract contains a Buy America clause and the aterial is marke or not at all, the PEO is responsible for acquiring a Certifica of Material Origin from th ntractor. e 10 : The Pro' Office will need to forward a copy of the completed QPL page to the Fa • nspection Office for notification as soon as this material is approved for us Updated : Sep 9, 20 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT Cc,• 2016 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 ii- _ with the Plans, Specifications, and v a a Contract Documents. p� . .a Gray Osborn Inc. , _ a - CONSULTING ENGINEERS • 4 By: TLS te:9/7 '021 • 0 ow . o 0 0 0 0 0 talarvdo RADIUS WALL APPLICATION 12' ::::_. .________Ar...._r--, 1.1.. 111/2" 1 � •0000o0000000c - • :e FLAT WALL APPLICATION WALL FASTENING •.1 11 V 0 RAIL RUNG 4 STEP POLY LADDER 9/16" Grade 60 Round Bar '/2" Grade 60 Rebar I ,ffECORPO ATION L All Lane Poly Ladders meet the requirements of ASTM C-478, A-615, P.O.Box 925 503-692-9860 1)=1101, and AASHTO M-199 10758 SW Manhasset Dr. 800-666-0076 Tualatin,OR 97062 Fax 503-692-9863 www.laneinternational.com euve ORPORA /ON14L CERTIFICATE OF COMPLIANCE All LANE POLYPROPYLENE LADDERS are made of polypropylene that conforms to ASTM D4101-82. (The previous standard of ASTM 2146-82 was replaced by D4101-82.) The 1/2"reinforcing rod conforms to ASTM A-615 requirements. The 9/16"smooth round bar conforms to ASTM-36 requirements. The ladder meets all ASTM C-497,C- 478, AASHTO M-199 and WISHA requirements. All of the components are of domestic origin and all manufacturing is done in our plant in Tualatin, Oregon. These Lane Polypropylene Ladders are of U.S. origin and comply with the ARRA Act of 2009. Lane International Corp. ell Robertson,Vice President J 8, 2020 �:�•, OFFNQALSTAMP SHERI LEE DUYAO • is NOTARY PUaLIC-OREGON IT/ COMIVSSION NO.954359 MY COMMISSION EXPIRES SEPTEMBER 11,2020 L 1 Mailing Address: P.O. Box 925 •Tualatin, OR 97062 Street Address: 10758 S.W. Manhasset Dr. Tualatin, OR 97062 Phone: 503-692-9860 •800-666-0076• Fax: 503-692-9863 • www.laneinternational.com p_ 14938 r. 13" 330 mm ►1 III 1111 9% 2381 mm t i 100 00 6" 152.4 mm O O al 0o Bright Red Reflectors o0 • • • - 00 00 Isi�i:..a O O III/�1/1' 00 0i -r 1%$i'd i i it O O O • f00 0 0 0 0 0 0 O 0 O 0 0 0 0 0 O 0 O 0 0 0 O 0 O 0 0 0 O 0 O 0 0 0 00 00 0 0 O 0 0 0 0 0 0 0 0 0 r1 h 1514" 3674 mm 14" 3556 mm MITTAL REVIEW x No Exceptions Taken Make Corrections Noted SPECIFICATIONS Amend &Resubmit All Lane Poly Steps meet the requirements Rejected See Remarks of ASTM C-478 and AASHTO M-199. IMPORTANT NOTICE:This review The polypropylene conforms to ASTM D- does not relieve the Contractor from 4101. The '/" Grade 60 reinforcing bar responsibility to comply&conform meets ASTM A-615. with the Plans, Specifications, and Contract Documents. RUNG dray&Osborne, Inc. CONSULTING ENGINEERS By: TLS Date: 9/7/2021 LANE/COL YPROPYLENEMANHOLESTEPS ffe...OZON RTPORATION L P.O. Box 925. 10758 S.W. Manhasset Dr.•Tualatin,OR 97062.503-692-9860.800-666-0076 Fax 503-692-9863•www.laneinternational.com ILECORPORA7/ONAL CERTIFICATE OF COMPLIANCE All of the LANE PLASTIC MANHOLE STEPS made of polypropylene conform to ASTM D4101-82. (The previous standard of ASTM 2146-82 was replaced by D4101-82.) The 1/2"reinforcing rod conforms to ASTM A-615 Grade 60 requirements and is of domestic origin. They meet and/or exceed ASTM C478-88 paragraph 13.4,AASHTO M- 199, C497, SSPWC Standard Plan 636 and California Code of Regulations Title 8, General Industrial Safety Orders. The LANE PLASTIC MANHOLE STEPS meet and/or exceed the 1,500 lbs. pullout force and the vertical deflection of 800 lbs. when properly installed. All of the components are of domestic origin and all manufacturing is done in our plant in Tualatin, Oregon. These manhole steps are of U.S. origin and comply with the ARRA Act of 2009. We also certify that the reinforcing steel provided in our LANE PLASTIC MANHOLE STEPS is in full compliance with the American Iron and Steel requirements as mandated in the EPA's State Revolving Fund Programs, specifically the Consolidated Appropriations Act of 2014, Section 436. Lane International Corp. elly o rtson,Vice President Jan 8, 2020 OFFICIAL STAMP -•� r SHERI LEE DUYAO `` ,/ NOTARY PUBLiC.OREQON ;,,/ COMMISSION NO.954359 MY COMMISSION EXPIRES SEPTEMBER 11.2020 114.317- "4"-e-C Mailing Address: P.O. Box 925•Tualatin, OR 97062 Street Address: 10758 S.W. Manhasset Dr. Tualatin, OR 97062 Phone: 503-692-9860 •800-666-0076• Fax: 503-692-9863 • www.laneinternational.com HAND HOLD 13" Sao mm ant T 177 8 mm-- — Bright Red Reflectors • 3''" �9mm,—fIII 0 0 0 0o �� I!ilaif:},}i .o o 1, •. °0 °° lil��is�.�n U 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0°0 0 0000000000000000000 0 0 0 02 la 151" 38i a mm 14" 355.6 mm Hand Hold Step SUBMITTAL REVIEW "- No Exceptions Taken Make Corrections Noted Amend & Resubmit Rejected-See Remarks IMPORTANT NOTICE:This review does not relieve the Contractor from SPECIFICATIONS responsibility to comply&conform All Lane Poly Steps meet the requirements of with the Plans, Specifications, and ASTM C-478 and AASHTO M-199. The Contract Documents. polypropylene conforms to ASTM D-4101. The %z"Grade 60 reinforcing bar meets ASTM A-61 �irsy&Osborne, Inc. RUNG CONSULTING E=NGINEERS 1/2" Grade 60 Rebar By: TLS Date:9/7/2021 LANE POLYPROPYLENE MANHOLE STEPS ALKEZON RTPORAT/ONAL P.O.Box 925. 10758 S.W.Manhasset Dr.•Tualatin,OR 97062.503-692-9860.800-666-0076 Fax 503-692-9863• www.laneinternational.com ADLE/ CORPORATIONNTERNATIONAL CERTIFICATE OF COMPLIANCE All of the LANE PLASTIC HAND HOLD STEPS made of polypropylene conform to ASTM D4101-82. (The previous standard of ASTM 2146-82 was replaced by D4101-82.) The 1/2"reinforcing rod conforms to ASTM A-615 Grade 60 requirements and is of domestic origin. They meet and/or exceed ASTM C478-88 paragraph 13.4, AASHTO M- 199,C497, SSPWC Standard Plan 636 and California Code of Regulations Title 8, General Industrial Safety Orders. The LANE PLASTIC MANHOLE STEPS meet and/or exceed the 1,500 lbs. pullout force and the vertical deflection of 800 lbs. when properly installed. All of the components are of domestic origin and all manufacturing is done in our plant in Tualatin, Oregon. These manhole steps are of U.S. origin and comply with the ARRA Act of 2009. We also certify that the reinforcing steel provided in our LANE PLASTIC HAND HOLD STEPS is in full compliance with the American Iron and Steel requirements as mandated in the EPA's State Revolving Fund Programs, specifically the Consolidated Appropriations Act of 2014. Section 436. Lane International Corp. elly o rtson, ice President Jan 8, 2020 t�1.! OFFICIAL STAMP R'� NOTARYI LEE DUYAO E000N �,... `, ,� COMMISSION NO.95f359 My COMMISSION WIRES SEPTEMBER 11,2020 31—C ITH-1- 0-14/t6A1C:r Mailing Address: P.O. Box 925 •Tualatin, OR 97062 Street Address: 10758 S.W. Manhasset Dr. Tualatin, OR 97062 Phone: 503-692-9860 • 800-666-0076 • Fax: 503-692-9863 • www.laneinternational.com I Type 2 Catch Basins shall have Kor-N-Seal boots 14 Manhole Products Sti An 48"Type 2 Precast Catch Basin WSDOT B-10.20-02 Grade Adjustment Rings Available • 2" 3" 4" 6" Hole or Knock Out Dimensions • Maximum hole size is 36 inches • 8 inches of minimum distance between holes 4�� .�'f Mln • 2 inch diameter lifting holes provided 16"Max • Cored,cast-in and custom block-out/knock-outs available 4 101/2" 24„ 8" Conformity Standards t t • ASTM C478 manhole _ • ASTM C443 rubber gasket joint • ASTM D4101 polypropylene steps and ladders • Washington State APWA/WSDOT Standard 7 1'to6' Options Available SUBMITTAL REVIEW 12" • 2'Minimum sump • Specialized coatings X No Exceptions Taken • Cus ches Make Corrections Noted -> Z . Kor-N-Seal boots Amend & Resubmit 11 • 1'thru 10'Polypropylene lads 9ected-See Remarks • Round offset&center s FTiAtit N i NOTICE:This review I • Mastic does not relieve the Contractor from ■ responsibility to comply&confor ,to 6' Section Specificationswiith the Plans, Specifications, and Height Section Contract Documents. Base 2' - Base Slab 6" 410LBS 'IWO 7 I 12" 859 LBS 6" - - - - - ■ . 8" 24" 1,735 LBS Gray&Osborne, Lac. 36" 2,612 LBS CONSULTING ENGINEERS t 5" ' 48„ ..1 5„ t 48" 3,489 LBS By: T L S Date: 9/7/2 0 21, 58" 60" 4,365 LBS 72" 5,069 LBS Top Slab Plan View Gasket Shown Uncompressed Base Slab Flat Top 1,698 LBS 1,667 LBS 1 PC 20' GASKET PROFILE '�' 24" s 24" Note:drawings not to scale Shope Concrete,LLC (253)848-1551 Shpe1-800-422-7560[TOLL FREE] I � 1618 East Main Avenue Fax Line 1(253)845-0292 Puyallup,WA 98372-3142 Fax Line 2(253)864-6172 www.shopeconcrete.com 1 • es <2 1 SUBMITTAL REVIEW Specialized Products for Precasters x No Exceptions Taken Make Corrections Noted Amend &Resubmit Rejected-See Remarks Shope Concrete IMPORTANT NOTICE:This review does not relieve the Contractor from 1618 E. Main Ave responsibility to comply&conform with the Plans, Specifications, and Puyallup, WA 98372 Contract Documents. Gray&Osborne, Inc. CONSULTING ENGINEERS January 1, 2021 By: TLS Date: 9/7/2021 CERTIFICATE OF COMPLIANCE This is to certify that the HCC GASKETS manufactured by BestFitt Products LLC., Puyallup, Washington, Tett or exceed the Specification requiremelpts of ASTM C 361 and ASTM C 443 o`Y r standard rubber gaskets, ASTM C 1619/Class A and C for rubber gaskets, CSA A257.3-03, and AASHTO M-198, Type A for rubber gaskets. Gasket Specifications: 48"MH Gaskets,138.5" mcl, 997 cc 54"MH Gaskets,176" mcl 1267 cc 60"MH Gaskets, 193.0" mcl 1389 cc 72"MH Gaskets, 211" mcl 1579 cc 84"MH Gaskets,1.0625 Dia, 218.0" mcl, 3167 cc 96"MH Gaskets, 275.1" mcl, 2338 cc This certification does not guarantee any field application or testing performance criteria. These criteria are controlled by product dimensions and tolerances, as well as field installation conditions and techniques,which are outside of the control of the manufacturer. Sincerely, BestFitt Products LLC ??""4-- Jack Curry General Manager Engineer Addition Washington State V/ Department of Transportation Qualified Product List Product Information Manufacturer : Shope Concrete Products, Puyallup - WA Product Name : Precast Concrete Manholes Standard Spec : 9-05.50(2), Precast Concrete Manholes Product Description : Manufacturers of precast concrete manholes and risers; for assistance see Std Plan B-15.20, B-15.40, B-15.60 and B-30.90 for further details. Product Restriction : A tance Code : 5120 Code ription : Acceptance is b ed on field verification of`W.S.D.O.T. INSPECTED' p. Document, ' e field inspectors' IDR, the fabrication inspectors' initial, quantity an ' her' ' or`D'for foreign or domestic steel and/or iron or not marked. Concrete Adj nt Sections less than 12 inches - Acceptance shall be Visually in accord e with Se n 9-1.4C. If the Contract contains a Buy America clause and t aterial is marked not at all, the PEO is responsible for acquiring a Certifi e of Material Origin from the ractor. Not : The Project 0 'ce will need to forward a copy of the completed QPL page to the Fabrics i s ion Office for notification as soon as this material is approved for use. LastUpd d : Sep9, 20 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT© 2016