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HomeMy WebLinkAboutCAG-20-065 - Duvall - A79 - Raised Pavement Marker Type 2 Washington State �/ Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave NE Apr CAG 20-065 01/26/2022 Sector/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# 079 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQFL Hdgtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference Code Code AZ1,A22.A25, 1/2" HMA 1, 2, B6-B2, Icon Materials - Auburn 2535 A21,A22,A25, B6$21 L55-1 US Oil - Tacoma 2535 Project Engineer/Representative Date State Materials Engineer/Representative Date 1/26/2022 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory OAcceptance Criteria: Acceptance based upon"Satisfactory"Test Report for samples of materials to be incorporated into project. 0. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. See Remarks 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material. Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. 5 Acceptance Criteria: Only'Approved for Shipment', 'WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: 9 Approval Withheld: Submit samples for preliminary evaluation. 10 Approval Withheld: 11. Miscellaneous Acceptance Criteria. Remarks (PE): Prior to use, provide a letter certifying that the material and sources for the mix are the same as shown on the original mix design, per Special Provisions 5-04.2(2). For proposed Remarks RAP in HMA mix, provide Toxicity Test Reports and Certification per Std. Spec. 9-03.21(1) (HQ): dated no older than 90 days (not required if RAP is from City of Renton's roadways). Truck Ticket shall show Mix ID 200031. Provide Scale Cert. Provide Bill of Lading for Asphalt Binder and Tack Coat (QPL Code 2535). DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor EtRegion Operations Engineer 0 Fabncation Inspection 0 Region Materials 0 State Materals Lab-MS 47365 Washington State Department of Transportation-Materials Laboratory PO Box 47365 Olympia WA 98504/1655 S.2nd Ave.Tumwater WA 98512 BITUMINOUS MATERIALS SECTION MIX DESIGN REPORT MATERIAL: HMA Class 1/2"-9-03.8-2020 ✓ QPL NO: HMA 2020-044 DATE SAMPLED: 07/07/2020 SAMPLE ID: 0000012817f / DATE RECV'D: 07/13/2020 MIX ID NO: MD20003I ESAL RANGE: 3 to<30 J CONTRACTOR: ICON Materials NOTE:Verify approval status on WSDOT QPL list.Reference Mix Design required prior to WSDOT use. APPROVED FOR QPL ON�/06/2020 -------CONTRACTOR'S MIX DESIGN TEST ' ' TA--- Specification Pb 4.8 5.3 5.8 %Gmm @ Ninitial 8 84.7 86.4 87.8 <89.0 %Va @ Ndesiga 100 5.8 4.0 2.4 Approximate 4.0 %VMA @ Ndesign 100 14.5 14.0 13.6 _>14.0 %VFA @ Ndesign 100 60 72 82 65-75 %Gmm @ Nmax 160 97.1 <98.0 Dust to Asphalt Ratio(D/A) 1.4 1.2 1.1 0.6-1.6 Pbe 3.8 4.3 4.8 Gmm 2.505 2.486 2.469 Gmb 2.360 2.386 2.409 Gb 1.033 1.033 1.033 Gse 2.699 2.698 2.700 Hamburg Wheel-Test(mm) 2.9 _<10.0 Stripping Inflection Point Pass I one @ 15000 Passes Indirect Tensile Strength(psi) 110 175 STATE MATERIALS LABORATORY TEST DATA . cification Tolerance Pb 4.8 5.3 5.8 %Gmm @ Ninitial 8 84.2 85.8 86.7 <_ 9.0 %Va @ Ndesign 100 6.2 4.3 3.1 A.. .ximate 4.0 2.5-5.5 °%VMA @ Ndesign 100 14.8 14.3 14.2 >_1 .0 _> 13.0 %VFA®Ndcsign 100 58 71 7B 65-75 %Gmm @ Nmax 160 97.3 <9: 0 Dust to Asphalt Ratio(D/A) 1.4 1.2 1.1 0.6- .6 Pbe 3.8 4.4 4.8 Gmm 2.515 2.491 2.478 Gmb 2.359 2.385 2.401 Gb 1.033 1.033 1.033 Gse 2.711 2.704 2.712 Hamburg Wheel-Test(mm) 3.1 <_10.0 Stripping inflection Point Pass None @ 5000 Passes Indirect Tensile Strength(psi) 114 <_175 STATE MATERIALS LABORATORY RECOMMENDATIONS-- --- Asphalt Binder Supplier US OIL- / Asphalt Binder Grade PG58H-42 J Percent Binder(Pb)(By Wt Total Mix) 5.3 %Anti-Strip(By Wt.of Asphalt Binder)/Type 0.004 Sample Wt.(grams) 4750 (lnformatio :1 Only) Ignition Calibration Factor 0.87 (Information I Only) Optimum Mixing Temperature(°F) 312 Compaction Temperature(°F) 291 %RAP Binder %RAS Binder For verified mix designs older than 12 months, provide a letter certifying that the materials and sources are the same as shown on the original mix design, per Page 1 of 2 Special Provision 5-04.2(2). Washington State Department of Transportation-Materials Laboratory , PO Box 47365 Olympia WA 98504/1655 S.2nd Ave.Tumwater/WA 98512 BITUMINOUS MATERIALS SECTION MIX DESIGN REPORT MATERIAL: HMA Class 1/2"-9-03.8-2020 QPL NO: HMA 2020-044 SAMPLE ID: 0000012817f MIX ID NO: MD200031 CONTRACTOR'S DESIGN AGGREGATE STRUCTURE AND AGGREGATE TEST DATA Material: 5/8"-3 " D Chill 3/8"-0 1/4"-0 r Wash Fines Combined Spec Tolerance Source: A464I A464J A4644 A464.1 A4644 Ratio: 20.0% 7.0% 53.0% 15.0% 5.0% 3/4 in 100.0 100.0 100.0 100.0 100.0 100 99-100 99-100 1/2 in 77.0 100.0 100.0 100.0 100.0 95 90-100 90-100 3/8 in 27.0 94.0 98.0 100.0 100.0 84 90 Max 78-90 No.4 2.0 7.0 65.0 97.0 98.0 55 50-60 No.8 2.0 2.0 40.0 65.0 84.0 36 28-58 32-40 No.16 1.0 2.0 25.0 40.0 69.0 23 No.30 1.0 2.0 18.0 27.0 52.0 17 No.50 1.0 2.0 12.0 18.0 22.0 11 No.100 1.0 2.0 9.0 14.0 4.0 7 No.200 1.0 1.4 6.3 10.5 0.5 5.2 2.0-7.0 3.2-7.0 Gab Coarse 2.703 2.689 2.689 Gab Fine 2.591 2.541 2.553 Gsb Blend 2.703 2.689 2.625 2.541 2.553 2.628 Sand Equivalent(SE) 62 78 74 68. 45 Min %Uncompacted Voids 49 48 42 48 44 Min %Fracture 87 92 98 92 90 Min Double Face Fracture STATE MATERIALS LABORATORY AGGREGATE TEST DATA •- •- Gsb Coarse 2.726 2.660 2.681 Gsb Fine 2.590 2.575 2.570 2.584 Gsb Blend 2.726 2.660 2.621 2.575 2.570 2.634 Sand Equivalent(SE) 68 79 83 72 45 Min %Uncompacted Voids 47 44 Min %Fracture 96 97 97 97 90 Min Double Face Fracture _._._._ ._..�..-_ COMMENTS _..-. Remarks: Result Code: Kurt R.Williams,P.E. Billing Code Stale Materials Engineer T198-1 Steven J.Davis Bituminous Materials Engineer Date: 8/6/2020 Phone: (360)709-5424 Page2of2 WSDOT-Materials Laboratory Qualified Products List(QPL) https://wsdot.wa.gov/bizlmats/QPL/QPLMixDesighGrid.cfm Washington State VW Department of Wansportation Qualified Products List HMA Paving Contractor: ICON Materials Product Name : Hot Mix Asphalt Standard Spec : 5-04 Hot Mix Asphalt Description : The HMA Mix Designs listed have been evaluated and approved by the WSDOT State Materials Laboratory. Components of the Mix Design must be approved prior to submitting for the evaluation of the Mix Design. A`Contract Specific' Reference Mix Design is required for all Statistical HMA to be placed. The request is to be processed through the MATS Program. Contact the State Materials Laboratory Bituminous Materials Engineer— 360-709-5424 with further questions. Acceptance Criteria is still required for the HMA Mix, Asphalt Binder, Mineral Aggregate and Recycled Materials. Acceptance Code : 2521 Code Description : Receipt of a `Contract Specific' Reference Mix Design Evaluation Report from the State Materials Laboratory Bituminous Materials Engineer is required for all Statistical evaluations indicating the material meets the requirements of the specifications under which it is listed. The Qualified Products List Approved HMA Mix Design page and the`Contract Specific' Reference HMA Mix Design must be received prior to incorporating the material into the project. The Contractor is required to highlight the intended Approved Mix Design Number when submitting the QPL page for HMA to be incorporated. Hot Mix Asphalt, Asphalt Aggregate and Asphalt Binder shall meet the requirements of WSDOT Specifications Sections 5-04, 9-02 and 9-03. Refer to WSDOT Standard Specifications Section 9-03.21 and Contract documents to see if recycled materials are permitted and documentation requirements. The Project Engineer Office is required to verify material being delivered to the job site is from the sources listed on the'Contract Specific' Reference HMA Mix Design. Product Restrictions: Statistical Mix Designs need to be Referenced - Contact Bituminous Materials Engineer - 360-709-5424 Note 1 : The Project Engineer is required to retain Approval Documents. Note 2 : Aggregate Sources, Anti-Stripping quantity and Ant-Stripping brand are identified on Mix Design. Product Description :N IMA Spec Gyration Aggregate Mix Design PG Binder PGAB Expiration Class Year Level Source No I Remarks Grade Supplier , Date 1 I 11 I ][A464 [MDz00019 EG58V_22 [us i?A Class 100 OIL 05/29/2022 J 1 of 2 1/26/2022, 1:00 PM WSDOT-Materials Laboratory Qualified Products List(QPL) https://wsdot.wa.gov/bizlmats/QPL/QPLMixDesignGrid.cfm HMA Class 2020 100 A464 MD200031' PG58H-22 US OIL 08/06/2022 1/2" • HMA Class 2018 100 A464 MD210014 PG58H-22 US OIL 04/14/2023 3/8" HMA Class A464 3/8" 2018 100 -03/23/2021 JMD210015 PG58V-22 US OIL 04/15/2023 * High RAP Design Commercial: Hot Mix Asphalt 5-04.2(1)B Product Description: All HMA mix designs listed on the QPL may be used for Commercial HMA without a `Contract Specific' Reference Mix Design. Product Description : HMA Spec Gyration Aggregate Mix Design PG PGAB Expiration i Binder Class Year Level Source No Grade Supplier Date HMA . Class 75 A-464 HMA2020012 58PG H_22 US OIL 03/18/2022 1/2" Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 2 of 2 1/26/2022, 1:00 PM Alik Washington State vac Depsktment of Transportation HMA Mix Design Submittal Contract Information Contact Number State Route Section Date 7/1/20 Project Engineer Reske HMA Paving Contractor Submitted By ICON Materiels Tim Shearer HMACiass Gyration levels HMA EVakration Method ESALs(millions Da'e inch❑14 Inch N Initial: 8 N Design: 100 N Max: 160 CI Statistical❑Commercial 3.0<30 J l VT Inch El 1 Inch 1_U`ln0.S181IS11 J RAP to be used m production / RAP atockplletorer� RAS t0 be used in production RAS stockpile tonnage Yes n No 20A or less' Ekes Ig No 0% Asphalt Binder Information BrIMMAsptatt Binder Supplier Asphalt Binder Specific Gravity(Gb) Asphalt Binder Grade Proposed Pb US Oil&Refining 1.033 . PG5811.22 V 5.3. orcingTemperature Range Temperature Range Anti-Striptype 'Anti-Strip% 306-318F 286-29SF NONE N/A atingliVAsPhat Binder Supp er Asphalt Binder Specific Gravity(Gb) Asphalt Border Grade Proposed Pb Ming Temperature Range Compaction Temperature Range Anti-Ship Type 'Anti-Ship% •If Required by Contract Contractor Aggregate Structure and Aggregate Test Data In the table below provide the`Material°identification(3/4"-0,#4-0,etc.),`Source"(3-199,E-320,etc.),'Ratio" (45%,20%,etc.),and the percent passing each sieve for each stockpile used in the mix design as well as the combined gradation and the specification requirements for the class of HMA used.Report all stockpile gradations to the nearest tenth of a percent Report the combined gradation to the nearest whole percent except the U.S.No.200,which must be reported to the nearest tenth of a percent. Material SA".-3/8" 3/8"-0 1/4"-0 D chips WadFines Combined Specification Gradation Requirements Source A-464 A-464 A-464 A-464 A-464 Ratio 20 53 15 7 5 1 36'Square �_ - --- - 1°Square 44°Square 100.0 100.0 100.0 100.0 100.0 100 100 4'Square 77.0 100.0 100.0 100.0 100.0 95 90-100 W Square 27.0 98.0 100.0 94.0 100.0 84 90 MAX. U.S.No.4 2.0 65.0 97.0 7.0 98.0 55 U.S.No.8 2.0 40.0 65.0 2.0 84.0 36 28-58 U.S.No. 16 1.0 25.0 40.0 2.0 69.0 23 U.S.No.30 i.0 18.0 27.0 2.0 52.0 17 U.S.No.50 1.0 12.0 18:0 2.0 22.0 11 U.S.No.100 1.0 9.0 14.0 2.0 4A 7 y U.S.No.200 1.0 6.3 10.5 IA0.5 5.2 ,2-7 DOT Form 350-042 Per 1 04 Revised 10/2016 Contractor's Aggregate Test Data i In the table below provide all of the aggregate specific gravity and aggregate quality property test data determined for each stockpile and the selected design aggregate structure(Combined Gradation)as required. The specification requirements only apply to the design aggregate structure (Combined Gradation). Material S18"-3/8" 13/8"-0 1/4"-0 D chips I wash fines Combined Gradation , Source A-464 A-464 A-464 A-464 A-464 Ratio 20 53 15 7 5 Gsb Coarse 2,703 2.689 N/A 2.689 N/A _ Gsb Fine N/A 2.591 2.541 N/A 2.553 Gab Blend 2.703 2.625 2.541 2.689 12.553 12.628 Sand Equiv. N/A 62 78 N/A 74 68 45 Min. Utt t;ompac ed N/A 48.7 48.3 N/A 42.1 48.0 Void Content ESAU, 44 itfini mum Coarse Fracture 87 98 jN/A 192 N/A --'92 j 90%Minimum *Fractured Faces,0 Single ®Double(Must Check One) Contractor's Hamburg Wheel-Track Device(HWTD)and Indirect Tensile Strength(IDT)Test Data(if Required by Contract) In the table below provide the rut depth(mm)and Stripping Inflection Point(Pass/Fait)in accordance with WSDOT FOP forAASHTOT 324,and Indirect Tensile Strength(psi)by performing WSDOT FOP forASTM D 6931. Primary Asphalt Binder Secondary Asphalt Specification Proposal Binder Proposal Requirements Hamburg Wheel-Track Testing(mm) 2.94 10 mom or less Stripping Inflection Point Pass Pass Indirect Tensile Strength Test(psi) no Remarks DOT form 350.042 Page 2 of 4 Revised 1012016 Additional Information for High RAP and/or RAS HMA Mix Designs (If Applicable) In the tables below,provide the required information for HMA mix designs containing a 20%Recycled Asphalt Pavement(RAP)and/or any amount of Recycled Asphalt Shingles(RAS).Testing shall be performed in accordance with AASHTO R 29 to establish a true grade for each asphalt component and the final blend.HMA mix designs that contain higher levels of RAP and/or any amount of RAS will not be accepted for verification testing at the State Materials Laboratory without the information completed below. Warm Mix Asphalt(WMA)mix designs will not be accepted with>%20 RAP and/or any amount of RAS. _.�._..-_ Primary Asphalt Supplier Grade of Virgin Asphalt Binder(PGAB) Pb Virgin Asphalt Binder(PGAB)by Wt of Mix Pb of RAP Recycling Agent %Recycling Agent by Wt.of Binder Pb of RAS %Asphalt Binder Contributed from RAP by Wt. %Asphalt Binder Contributed from RAS by Wt. %Total QuantityAsphalt Binder of Mix of Mx Contributed from RAP&RAS by Wt.of Mix (40%)max Pba RAP Gb RAP Gmm RAP Pba RAS Gb RAS Gmn RAS Property Test PGAB Virgin PGAB RAP RAS Lab Blend Lab Blend Test Temp Test data Tc Tc Test Data Specification Original High Temp,DSR, kPA rain 1.00 Rolling Thin Film Oven High Temp,DSR,KPA min 2.20 Pressure Aging Vessel @ 100°C Int.Temp, max 5000 DSR,kPA Pressure Aging Vessel©100°C Low Temp, BBR Stiffness,MPa max 300 Pressure Aging Vessel at 100°C Low Temp, min 0.300 BBR,m-value MPa Seconds As•halt Su •her Grade of Virgin Asphalt Binder(PGAB) Pb Virgin Asphalt Binder(PGAB)by Wt of Mix Pb of RAP Recyding Agent %Recycling Agent by Wt.of Binder Pb of RAS %Asphalt Binder Contributed from RAP by Wt. %Asphalt Binder Contributed from RAS by Wt %Total Quantity Asphalt Binder of Mix of Mx Contributed from RAP&RAS by Wt.of Mix (40%)max Pba RAP Gb RAP Gmm RAP Pba RAS Gb RAS Gmm RAS Property — — - Virgin PGAB Virgina PGAB RAP RAS Lab Blend Lab Blend - Test Temp _ Test data Tc Tc Test Data S ecification Original High Temp,DSR,kPA min 1.00 Rolling Thin Film Oven High Temp, DSR,KPA min 2.20 Pressure Aging Vessel @ 100°C Int.Temp, mart 5000 DSR,kPA ! Pressure Aging Vessel©100°C Low Temp, max 300 BBR,Stiffness,MPa -- Pressure Aging Vessel©100°C Low Temp, _ BBR,rn.value,MPa f min 0.300 DOT Form 350-042 Page 9 of 4 Revised 10/2016 Contractor's HMA Mix Design Data In the table below provide the HMA volumetric mix design data determined by performing WSDOT SOP 732.The Va,VMA,VFA,and Gmb values must be determined from replicate mixtures compacted to the appropriate Ndesign gyration level In accordance to section 8.2 of SOP 732,back calculated values from replicate mixtures compacted to Nmax are got acc@ptable. Primary Asphalt Binder Secondary Asphalt Binder ^' HMA Properties -0.5% Pb Design +0.59b -0.5% Pb Design +0.5% Pb Design Pb Design Pb Design Pb Design Pb 4.8 53 5.8 %Gmm @ Nini 84.7 86A 87.8 %Gmm @ Ndes(Va) 94.2 96.0 97.6 %VMA @ Ndes 14.5 14.0 13.6 %VFA(Ndes 60.0 71.5 82.4 Dust/Asppalt Ratio 1.364 1.201 .1.DB1 Pbe 3.813 4.331 4.810 Gmrn 2.505 2.486 2.469 Gmb 2.360 2386 2.409 Gse 2.699 2.698 2.700 Height @ Nini 130.2 127.5 125.9 Height @ Ndes 117.1 114.7 113.3 Contractor's HMA Mix Design Proposals) In the table below provide the HMA volumetric mix design data that comes closest to,or intersects,4.0%Va, from the testing performed via WSDOT SOP 732.This may be the same as the Pb design data from the table above.Also provide the%Gmm data developed from the replicate mixtures compacted to appropriate Nmax gyration level. HMA Properties Primary Asphalt Secondary Asphalt Specification Binder Proposal Binder Proposal Requirements Pb 5.3 %Gmm i Nini 86.4 % Gmm @ Ndes 96.0 98.0 __ %VMA @ Ndes 14.0 %VFA IS Ndes 71.5 Dust/Asphalt Ratio 1.201 0.6-1.6 pbe 4.331 Gmm 2.486 Gmb 2.386 Gse 2.698 % (83 Gmm @ Nmax 97.1 898.0 I certify this HMA job-mix formula(JMF)has been developed in accordance to WSDOT Standard Operating Procedure (SOP)732'Volumetric Design for Hot-Mix Asphalt(HMA)".The HMA JMF has been verified in accordance to section 10 of SOP 732 which consist of preparing replicate mixtures containing the selected design aggregate structure at each of the following binder contents:(f)the estimated design binder content,Pb(design);(2)0.5 percent below Pb(design); (3)0.5 percent above Pb(design). I am aware,In accordance to WSDOT Standard Practice QC 8,Approval of Hot Mix Asphalt Mix Designs for the Qualified Products List,that a response will be provided within 25 calendar days for WSDOT mix designs,and 40 calendar days for cents cts outside f WSDOT. Chris Pedersen-CTl. (--____ e.____. 253-383-8778 7/1/20 Printed Name Signature Phone Date DOT Form 350 442 Page 4 014 Revised 1012016 0.45 Power Chart Icon 2020 0.5 Inch HMA 100 gyr US Oil 58H-22.xlsx 100.0 , 1 I 1 , ,t11- '--- - 90.0 i ,"- i I I A,i I /-' 80.0 1 1 ; 1 . / 1 14 4 4 / . i 70.0 I i i / / • i ______Max Density Line 60.0 I j I 1 I 50.0 i 1 i I .- I i 1 I —c, —JMF , 1 j I 40.0 1 ./ I..... f--- - i I I 1 I 30.0 ! i V I I I . /1 1 i 1 „II i 20.0 1 I ,fr i i i i Le I I I -1 loo, i 1 1 10.0 1 .Z1' ' j C?i 1....0' 0.0 . _ _. _._±.I I __ _ __t i 8 8 8 I . N 8 4 to ,.. Lk, i C Til° U.S.OIL&REFINING January 23, 2020 e Temperature - Viscosity Chart ... y p yJ. 0 .. 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I g E oi Yd oaw, na -. a 11 T '11 11 T MI T m T T T •n T 11 T 11 11 11 T 11 11 T 11 a 11 11 11 11 T 11 11 -n T 11 T Ti T T 7t Ti 11 •n T Log of Absolute Temperature, Shown in F r Specific Gravity= 1.033 at 60 F Washington Department of nsportation Qualified Product List Product Information Manufacturer : U.S. Oil & Refining Co., Tacoma - WA Product Name : PG: 52S-28, 58S-28(8H-22 58V-22, 64S-28, 64H- 28 Standard Spec : 9-02.1(4), Asphalt - Performance Graded (PG) Asphalt Binder Product Description : Performance graded asphalt binders (APPROVAL WILL EXPIRE 11/1/2023) Product Restriction : Acceptance Code : 2535 Code Description : Bituminous materials may be accepted by the Engineer based on the asphalt binder supplier's Certification of Compliance incorporated in their Bill of Lading. The Certification will include a statement certifying specification compliance for the product shipped. Additionally, verification samples are required to be taken in accordance with table 9-3.7 of the Construction Manual. Verification samples are not required for bituminous materials used for fog seal. Note 1 : Check Approved Mix Design for Anti-stripping requirements. Last Updated : Oct 19, 2020 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 ©❑ WSDOT MATERIALS LAB 08/25/2021. Aggregate Source Approval Report Owner: La Pianta Limited Partnership Aggregate Source: 'PS-A-464 Lessee: Icon Materials, Inc. -Known as: Auburn Pit Located•in: SW1/4 SW1/4 SEC 28&29 Section 28,29,T21N RSE County: King Remarks: Mineral Agg.and Surfacing: Test Date: 10/17/2018 Expiration Date: 10/17/2023 Absorption:1.26 Apparent Sp:G.:2.744 Bulk Sp.G.(SSD):2.686 Bulk Sp.G.:2.652 Deg:57 LA:14 Remarks: • Currently approved.as a-source of aggregate for: ATB - Ballast BST Crushed Cover Stone BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing Key Stone Crushed Surfacing Top Course Gravel Backfill for Foundation Class A HMA Other Courses • HMA Wearing Course Maintenance Rock Permeable Ballast Acceptance tests need to:be performed as necessary. Aggregates for Concrete: Test Date: 10/24/2018 Expiration Date: 10/24/20.23 ASR-14 Day: ASR-One Year:0.037 CCA Absorption:1.24 CCA Sp.G:2.68 Deg:72 FCA Absorption:2.18 FCA Organics:3 FCA Sp.G:2.624 LA:11 Remarks: .Current 1 Year ASR(ASTM C1293)results:0.037%. Results-expire on 12/9/202S 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 Spails,Rock for Rock-Wall,Erosion'and Scour Protection: Test Date: Eicplratlon Date: Absorption: Apparent Sp.G.: Bulk Sp.G.(SSD): Bulk Sp.G.: Deg: LA Remarks: NOT Approved for: Quarry Spells Riprap Rock for Erosion and Scour Protection Rock for Rock Walls Stone 9-27.3(6) Streambed Aggregates: Test Date: 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 may be required. Contact the Regional Materials Engineer'or the State Geotechnical Engineer for direction. Currently Approved for: Gravel Borrow for Str Earth Walls ALL OTHER PIT RUN MATERIALS: Project Engineer may request preliminary samples but Aggregate Source Approval is not required. AGGREGATE MATERIALS NOT REQUIRING ASA APPROVAL: Aggregate for Gravel Base 9-03.10 Gravel Backfill for Foundation Class B 9-03.12(1)B Gravel Backfill for Walls 9-03.12(2) Gravel Backfill for Pipe Zone Bedding 9-03.12(3) Gravel Backfill for Drains 9-03.12(4) Gravel Backfill for Drywells 9-03.12(5) Backfill for Sand Drains 9-03.13 Sand Drainage Blanket 9-03.13(1) Gravel Borrow 9-03.14(1) Select Borrow 9-03.14(2) Common Borrow 9-03.14(3) Native Material for Trench Backfill 9-03.15 Foundation Material Class A and B 9-03.17 Foundation Material Class C 9-03.18 Bank Run Gravel for Trench Backfill 9-03.19 Commercial Concrete Aggregate 6-02.3(2)B ��a,lank U. S. OIL &REFINING CO. =° * * ems„ 3001 Marshall Ave. Tacoma, WA.98421 R 44z wgsO' CERTIFICATE OF COMPLIANCE Type of Emulsion:CSS-1 Specific Gravity: 1.014 Date: 12/9/2020 Specification Test on Original MIN. MAX. TK2003 Blend Number 20-E-22 Viscosity, SSF,@25°C (77°F), D-244 20 100 22.0 Storage Stability,day%,D-6930 1 0.7 Particle Charge,D-244 Positive Positive Sieve Test,%,D-6933 0.1 0.03 Distillation Residue,%,D-6997 57 62.6 Cement Mixing test,%,D-6935 2.0 0.1 Tests on Residue Penetration, @25°C(77°F),D-5 100 250 147 Ductility,@25°C(77°F),D-113 40 >120 Solubility in Trichloroethylene,%,D-2042. 97.5 99.8 Ash,Weight% 1.0 0.06 The shipment of asphaltic material identified above and covered by this Bill of Lading complies with American Association of State Highway Transportation Officials (AASHTO)Specifications for CSS-1 as modified by special provisions applicable to this project. This meets or exceeds Washington State Department of Transportation Specifications for this product listed under Cationic Emulsified Asphalt. Paulina Kome U. S. Oil&Refining Co. LABORATORY Date: 12/9/2020 Washington State Department of Transportation Qualified Product List Product Information Manufacturer : U.S. Oil & Refining Co., Tacoma - WA Product Name : Grade CMS-2, CMS-2h, CRS-1, CRS-2 CSS-1 CSS-1h Standard Spec : 9-02.1(6), Asphalt - Cationic Emulsified Asphalt Product Description : Cationic emulsified asphalt. (APPROVAL WILL EXPIRE 11/1/2023) Product Restriction : Acceptance Code : 2535 Code Description : Bituminous materials may be accepted by the Engineer based on the asphalt binder supplier's Certification of Compliance incorporated in their Bill of Lading. The Certification will include a statement certifying specification compliance for the product shipped. Additionally, verification samples are required to be taken in accordance with table 9-3.7 of the Construction Manual. Verification samples are not required for bituminous materials used for fog seal. Samples will be appropriately marked and forwarded promptly to the State Materials Laboratory. Last Updated : Oct 19, 2020 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 WWashington State Department of Transportation Request for Approval of Material Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 8/20/21 Section/Title of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor Stripe Rite, Inc This form shall be completed prior to submittal. If this form Is not compete at time of submittal it may For wenn,.Ilse Only be returned for information that was omitted. RAM 1 004 PE Use Bid Item Material or Name and Location of Fabricator, Specification PEIQPL Hdqtr/QPl HQ Use No. , ProducUfype Manufacturer or Pit Number Reference Code Code A79 RPM Type II Ennis Flint 9-21.2 3101 Thomasville, NC A79 RPM Crafco Inc 9-02.1(8) 11 adhesive Chandler, AZ Lot#A6426 A79 RPM epoxy Forrest Technical Coatings 9_26 2 2210 adhesive Eugene, OR Project E gineer/R=.,:-entative Daatte � State Materials Engineer/Representative Date Pi"' rli •• p , , tion Codes for us* by Project Engineer and State Materials Laboratory 1. ccepta ce Criteria: cceptance based upon"Satisfactory'Test Report for samples of materials to be incorporated into project. 2. Acceptanc- riteria: 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 . Acceptance Criteria: Submit Shop Drawings for'Approver 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: CMiscellaneous Acceptance Criteria. emarks (PE):Visual Acceptance. Verify flexible adhesive delivered to site is from approved lot listed on the QPL Remarks (HQ): DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor 0 Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materials Lab-MS 47365 STIMSONITE MODEL C80 Raised Pavement Markers PRODUCT DATA Product Type: C8OFH Design: 4.55" x 3.20"x 0.66" (11.6 cm x 8.1 cm x 1.8 cm) Weight: 2.50 oz. (71 grams) Material: ABS plastic body with coated acrylic lens Specification: Meets ASTM D 4280 and Caltrans 81-3.02C Effective Date: 2016 t Product Description: Physical Characteristics: Raised pavement markers are a safety device used on roads to improve delineation and increase preview time, particularly under wet conditions,and have been shown to decrease crash rates on highways with raised pavement marker center lines by approximately 0.5 crashed per million vehicle miles. Slope Of Lens: 35 degrees to base Raised pavement markers play an important safety function on roads, communicating both the travel path for short and long Lens Face: 2.60sq.in.(16.8sq.cm.) range vehicle operation. Longitudinal Flexural Strength Requirement: >2,000 lbs.(907 kg) Raised pavement markers may be applied using epoxy, bitumen, or preformed thermoplastic.The marker is normally applied to the (ASTM D 4280) road surface, but may be recessed into a saw cut as well. Compressive Strength ASTM D4280:: >6,000 lbs.(2,722 kg) Compressive Strength CA 669: >2000 lbs. Product Advantages: • Abrasion resistant coating provides enhanced retained Specific Intensity(cd/fc): reflectivity (ASTM D 4280 and Caltrans 669) 0 Degrees 20 Degrees • Advanced optics deliver high reflectivity and durability white 3.0 1.2 Yellow 1.8 0.72 • Specially engineered bottom ensures aggressive grip to the Red 0.75 0.30 roadway Green 1.0 0.4 Blue 0.28 0.11 • Recommended for high ADT and high intensity conditions Specific Intensity After Abrasion Resistance Testing(cd/fc): (ASTM D 4280) 0 Degrees 20 Degrees White 1.5 0.60 Packaging: Yellow 0.90 0.36 Available in 100 piece boxes per color combination.One pallet Red 0.38 0.15 (36"x 40"x 50") = 48 boxes or 4,800 markers. One truckload = 26 Green 0.14 0.06 Blue 0.14 0.06 pallets. Other: The following lens colors are available:white,yellow, red, blue, green, and fluorescent orange. Markers are available as a one-way marker with one lens and one plug, a two-way marker with two lenses of the same color, or a two-way marker with two different colored lenses. The product data offered herein is,to the best of our knowledge,true and accurate,but all recommendations are made without warranty,expressed or implied.Because the conditions of use are beyond our control,neither Ennis-Flint nor its agents shall be liable for any injury,loss or damage,direct or consequential,arising from the use or the inability to use the product described herein.As Ennis-Flint has neither control over the installation of product described herein nor control of the environmental factors the installed markings are subjected to,there is no guarantee as to the durability or the retroreflective properties of any marking system applied.No person is authorized to make any statement or recommendation not contained in the Product Data,and any such statement or recommendation,if made,shall not bind the Corporation.Further,nothing contained herein shall be . construed as a recommendation to use any product in conflict with existing patents,and no license under the Dens—FLINT claimsof any patent is either implied or granted A Traffic Safety Solutions Company 800.331.8118 sales@ennisflint.com www.ennisflint.com ©Ennis-Flint All Rights Reserved =,;,` Washington State Va. Department of Transportation Qualified Product List Product Information Manufacturer : Ennis-Flint, Inc., Thomasville - NC Product Name : Stimsonite Model C80 Standard Spec : 9-21.2, Pavement Marking - RPM - Type 2 (Abrasion Resistant Coating) Product Description : Type 2 raised pavement marker; Abrasion resistant coating Product Restriction : Acceptance Code : 3101 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. Note 'Restrictions' when present. Note 5 : This type of Raised Pavement Marker may be used as Recessed Pavement Markers. See Std. Plan M20.30 Last Updated : Oct 10, 2018 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT© 2016 FORREST PRODUCT DATA SHEET FTC Traffic Marker Adhesive Technical Coatings EAS-06A/ 18M000 DESCRIPTION MIX AND CURE FTC Traffic Marker Adhesive is a two part epoxy Mix Ratio: standard set adhesive system specially designed for EAS-06A/18M000 to 1: 1 the bonding of traffic buttons and other lane EAS-06B/12K002 Hardener markers. This product meets the requirements of Cure Firm set @ 70°F=2 hrs Washington State Department of Highways Characteristics: Firm set @ 50°F=4 hrs specification, section 9-26.2, the Arizona Based on 40 mm Hard set @ 70°F=4 hrs Department of Transportation section 706.04, the film Full Cure Time @ 70°F=24 hours State of Oregon Highway specification 762.06 and the American Public Works Association specification Recommended 44-2.02 B 4. 18M000 EAS-06 is also excellent for Application 32°F-105°F bonding wood to concrete and concrete to concrete Temperature: and asphalt. Recommended -20°F-160°F Bond Temperature: PRODUCT BENEFITS CLEANUP • Excellent Bonding Uncured epoxy may be cleaned off of tools with • Dry Bond Test Methyl Ethyl Ketone (MEK), Toluene, or solvent Arizona 706.05 blends. 7 days—passed • Wet Bond Test Caution: These solvents may damage plastics. Arizona 706.05 24 hours—passed SAFETY • Wet Bond Test This product contains no Volatile Organic Arizona 706.05 Compounds (VOC). See Material Safety Data Sheet 74 hours—passed (MSDS)for more safety information PHYSICAL PROPERTIES Volume Solids: 100% READ MATERIAL SAFETY DATA SHEETS Weight Solids: 100% BEFORE USING THIS PRODUCT. Weight/Gallon: 11.97 lbs/gal Viscosity(cP)Helipath Part A and B LIMITATIONS TV @ 77°F: 100,000-300,000 The technical data and suggestions for use in this product Color: Part A White data sheet are currently correct to the best of our Color:Part B Black knowledge, but are subject to change without notice. Coverage:4" Round 200 buttons/gallon Because application and conditions vary, and are beyond Coverage:4"Square 100 buttons/gallon our control, we are not responsible for results obtained in Pot Life: 7-10 minutes using this product, even when used as suggested. The 1 lb Batch @ 70F user should conduct tests to determine the suitability of the product for the intended use under then existing conditions. Our liability for breach of warranty, strict TEST RESULTS liability in tort, negligence or otherwise is limited exclusively to replacement of the product or refund of its Compressive price. Under no circumstances are we liable for incidental Strength(psi):2 in >300 and consequential damages. cubes,3 day cure 02/03/2014 BJW Forrest Technical Coatings www.forrestpaint.com Ph: (800)537-7201 1011 McKinley infoforrestpaint.com (541)342-1821 Eugene, OR 97405 rWashington State lr Department of Transportation Qualified Product List Product Information Manufacturer : Forrest Technical Coatings, Eugene - OR Product Name : EAS-06A (18M100) and EAS-06B (212K200) Standard Spec : 9-26.2, Pavement Marking - Adhesive for Lane Markers Product Description : Two component epoxy resin adhesive for raised pavement markers Product Restriction : Acceptance Code : 2210 Code Description : Acceptance is by field verification of an acceptable Manufacturer's Certificate of Compliance per WSDOT Standard Specification 1-06.3 and the lot(s) or batch(es) of material being certified, where applicable, shall be identified. This documentation is required with each delivery of material to the project. Supporting mill test reports indicating that the product meets the applicable specifications may also be required. Last Updated : May 18, 2015 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 • Washington State �� Department at Wansportation Qualified Product List Product Information Manufacturer : Crafco, Inc., Chandler - AZ Product Name : Hot Applied Flexible Marker Adhesive Standard Spec : 9-02.1(8), Pavement Marking - Flexible Bituminous Pavement Marker Adhesive Product Description : Flexible bituminous pavement marker adhesive: Approved lot number (approved lot numbers will be purged from the QPL Database at the end of the calendar year, unless noted otherwise) - A5641, A6426, A3275, A5913, A6916, A6883, A2400. Product Restriction : Approved lots do not require samples to be submitted. eptance Code : 1155 Code cription : Receipt of isfactory Test Report from WSDOT Materials Laboratory is uired indi g the lot(s) of material meets the requirements of the specifications unde it is listed. The Test Report must be received prior to incorporating t ateria the project. Each sample shall consist of one unopened box or of component of ma ' to be delivered to the State Materials Labo ory a minimum of 10 days prior se. Last Updated : Aug 5, 2021 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016