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HomeMy WebLinkAboutCAG-20-065 - Duvall - A116 - Curb Paint, Temp Stop & Crosswalk Lines A Washing/km State TarDepartment of Transportation Request for_�Ap - royal of Material. Contract Number FA Number N/A SR Duvall Ave NE Date CAG 20-065 - . — . — 1/19/2023-- _ Section/Title of Project Duvall Ave NE County King Contractor Reed Trucking & Excavating, Inc. Subcontractor Stripe Rite This form shall be completed prior to submittal.If this form is not compete at time of submittal it may I, For WSDOT Use Only be returned for information that was omitted. RAM# 102 I PE Use Bid Item Material or ' Name and Location of Fabricator, Specification PEJQPL i Hdqtr./QPL HQ Use No. Product/Type Manufacturer or Pit Number Reference ' Code Code _ A116 ! Paint Ennis 9-34.2(6) 8/3101 A116 , Glass Beads` Potters 9-34.4 8/3101 1 Project Engineer/Representative Date State Materials Engineer/Representative Date � i 1/19/2023 Acceptance Action Codes for use by Project Engineer and State Materials Laboratory 1. :Acceptance Criteria: Acceptance based upon"Satisfactory"Test Report for samples of materials to be incorporated into project. 2. Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material. 3. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material.Catalog Cut Approved ❑Yes ❑No 4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material. ' 5. Acceptance Criteria: Only'Approved for Shipment','WSDOT Inspected'or'Fabrication Approved Decal'material shall be used. 6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 1 1 8O. Source Approved: Visual Inspection Required 1 9. Approval Withheld: Submit samples for preliminary evaluation. 10. Approval Withheld: _ 11. Miscellaneous Acceptance Criteria. Remarks (PE): Remarks (HQ): I. . DOT Form 350-071 Project Engineer Distribution Revised 03/2021 ®Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materials Lab-MS 47365 .r � Washington State' TI/ Department of 1tanspodtation Qualified Product List Product Information Manufacturer: Ennis-Flint; Inc. - Salem, OR Product Name : Morline: White I.D. No. 985691/HWVW1 and Yellow I.D. No. 985697/HWVY3 Standard Spec : 9-34.2(4), Pavement Marking - Low VOC Solvent Based Paint Product Description : Permanent pavement marking paint: Low VOC solvent based; Sprayed application. 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. Last Updated : Aug 1, 2019 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 Qualified Product List https://wsdot.wa.gov/biz/mats/QPL/QPLPrint.cfm?Product_no=19936... Engineer's addition Washington State January 19,2023 Qualified Product List Contractor Product Information Contractor: Contract No: Sub Contractor: Date: Bid Item: Manufacturer: Ennis-Flint, Inc. - Salem, OR Product Name: Morline: White I.D. No. 985691/HWVW1 and Yellow I.D. No. 985697/HWVY3 Standard Spec : 9-34.2(6), Pavement Marking - Temporary - Paint - Solvent Base Product Description : Temporary pavement marking paint: Low VOC solvent based; Sprayed application. 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. Last Updated : Aug 1, 2019 To be completed by the field inspector: Quantity: Verified By: Date: 1 of 1 1/19/2023,9:41 AM Date Printed: 2/16/2021 Product: 985691 Safety Data Sheet ENNIS-FLINT The Mart of TraR,c Sai•tr Section 1. Identification Product Code: 985691 Product Name: SB WHT 150 VOC ACRYLIC Product Type: SB Paint Recommended Use: Traffic Markings Supplied by: Ennis-Flint, Inc. 4161 Piedmont Parkway,Suite 370 Greensboro, NC 27410 T: 800.331.8118 Emergency Telephone: Chemtrec 1-800-424-9300 2. Hazards Identification EMERGENCY OVERVIEW: FLAMMABLE liquid and vapor. This product contains a component suspected of causing cancer. However, it is in a non-respirable form and inhalation is unlikely to occur from exposure. This classification is relevant when exposed to dust or powder form only(e.g.sanding,grinding). GHS Classification Carc. 1B, Eye Irrit.2, Flam.Liq.2, Muta. 1B, STOT SE 3 NE Symbol(s)of Product Signal Word Danger GHS HAZARD STATEMENTS Flammable Liquid,category 2 H225 Highly flammable liquid and vapour. Eye Irritation,category 2 H319 Causes serious eye irritation. STOT,single exposure,category 3, NE H336 May cause drowsiness or dizziness. Germ Cell Mutagenicity,category 1B H340 May cause genetic defects.Classification as mutagenic category 1 , if one of the ingredients is contained in an amount of at least 0.1 % .Applicable to liquids ,solids(in w/w)and gases(v/v).The fabric can also have their own exposure limit. Routes of exposure depend on the form of the ingredient. Carcinogenicity,category 1B H350 May cause cancer. GHS PRECAUTIONARY STATEMENTS P201 Obtain special instructions before use. P210 Keep away from heat/sparks/open flames/hot surfaces.-No smoking. P233 Keep container tightly closed. P240 Ground/bond container and receiving equipment. P241 Use explosion-proof electrical/ventilating/lighting/.../equipment. P242 Use only non-sparking tools. P243 Take precautionary measures against static discharge. P261 Avoid breathing dust/fume/gas/mist/vapours/spray. P281 Use personal protective equipment as required. P305+P351+P338 IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to do.Continue rinsing. Page 1 /8 Date Printed: 2/16/2021 Product: 985691 P308+P313 IF exposed or concerned:Get medical advice/attention. P312 Call a POISON CENTER or doctor/physician if you feel unwell. P337+P313 If eye irritation persists:Get medical advice/attention. P403+P233 Store in a well-ventilated place. Keep container tightly closed. 3. Composition/Information on Ingredients Chemical Name CAS-No. Wt.% GHS Symbols GHS Statements Calcium Carbonate 1317-65-3 25-50 No Information No Information Acetone 67-64-1 10-25 GHS02-GHS07 H225-319-336 Titanium Dioxide 13463-67-7 2.5-10 No Information No Information Solvent Naphtha(Petroleum), Light Aromatic 64742-95-6 2.5-10 GHS08 H304-340-350 Magnesium silicate(talc) 14807-96-6 2.5-10 No Information No Information Chloroalkanes 61788-76-9 2.5-10 No Information No Information Xylene 1330-20-7 1.0-2.5 GHS02-GHS07 H226-315 Ethylbenzene 100-41-4 0.1-1.0 GHS02-GHS08 H225-304-373 Crystalline Silica,Quartz 14808-60-7 0.1-1.0 GHS08 H351 4. First-aid Measures FIRST AID-GENERAL ADVICE:When symptoms persist or in all cases of doubt seek medical advice. FIRST AID-INHALATION: Move to fresh air. Give oxygen or artificial respiration if needed. Consult a physician if symptoms persist. FIRST AID-INGESTION: Do NOT induce vomiting. If conscious, rinse mouth and drink plenty of water. Never give anything by mouth to an unconscious person.Consult a physician. FIRST AID-SKIN CONTACT:Wash affected area immediately with soap and plenty of water. Remove contaminated clothing and launder before reuse. Consult a physician if symptoms persist. FIRST AID-EYE CONTACT: Rinse immediately with plenty of water,also under the eyelids,for at least 15 minutes. Consult a physician if symptoms persist. MOST IMPORTANT SYMPTOMS AND EFFECTS:Contact will cause irritation and redness to exposed areas.Causes painful stinging or burning of eyes and lids,watering of eyes. Prolonged contact may even cause severe skin irritation or mild burn. Overexposure by inhalation or ingestion may cause CNS depression,drowsiness,dizziness,confusion headache or loss of coordination. NOTES TO PHYSICIAN:Treat symptomatically.Contact poison treatment specialist immediately if large quantities have been ingested or inhaled. 5. Fire-fighting Measures UNUSUAL FIRE AND EXPLOSION HAZARDS: Flammable liquid. Vapors can form an ignitable mixture with air. Vapors can flow along surfaces to a distant ignition source and flash back. Vapors can spread along ground and collect in low or confined areas (sewers,basements,tanks). Water spray may reduce vapor, buy may not prevent ignition in closed spaces. SPECIAL FIREFIGHTING PROCEDURES:Flammable. Cool fire-exposed containers using water spray. As in any fire,wear self- contained breathing apparatus pressure-demand, MSHA/NIOSH(approved or equivalent)and full protective gear. EXTINGUISHING MEDIA: Alcohol Foam,Carbon Dioxide,Dry Chemical, Foam 6. Accidental Release Measures STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED:ELIMINATE all ignition sources(no smoking,flares, sparks or flames in immediate area). Take precautionary measures against static discharges. All equipment used when handling the product must be grounded. A vapor suppressing foam may be used to reduce vapors. Use personal protective equipment. Ensure adequate ventilation. Dike far ahead of liquid spill for later disposal. Use clean non-sparking tools to collect absorbed material. METHODS AND MATERIALS FOR CONTAINMENT AND CLEANUP:Soak up with inert absorbent material. Use non-sparking or explosion proof means to transfer material to a sealed,appropriate container for disposal.Clean contaminated surfaces thoroughly. ENVIRONMENTAL PRECAUTIONS: Prevent entry into waterways,sewers, basements or confined areas. Avoid release to the environment. For larger spills,cover drains and build dikes to prevent entry into sewer systems or bodies of water. EMERGENCY ADVICE: Evacuate surrounding areas. Keep unnecessary and unprotected personnel from entering. Do not touch or Page 2/8 Date Printed: 2/16/2021 Product:985691 walk through spilled material. Shut off all ignition sources. No flares,smoking or flames in hazard area.Avoid breathing vapor or mist. Provide adequate ventilation.Wear appropriate respirator when ventilation is inadequate. Put on appropriate personal protective equipment. PERSONAL PRECAUTIONS: Use personal protective equipment as required. Remove all sources of ignition. Prevent foot traffic. Only specially trained or qualified personnel should handle cleanup.Stop the leak if there is no risk involved.Avoid breathing vapors, mist or gas. Ensure adequate ventilation.Wear appropriate respirator when ventilation is inadequate. 7. Handling and Storage HANDLING: Flammable liquid. Avoid heat, sparks and open flames. Ensure adequate ventilation. Avoid breathing vapor, mists or dust. Avoid contact with eyes,skin,and clothing. Wear appropriate personal protective equipment. Wash contaminated clothing before reuse. Do not eat,drink or smoke when using this product. Wash thoroughly after handling. Observe good industrial hygiene practices. Prevent vapor buildup by providing adequate ventilation during and after use. Take precautionary measures against static discharges. All equipment used when handling the product must be grounded. STORAGE: Keep containers tightly closed in a cool,well-ventilated place. Store away from heat and sources of ignition. Use where airflow will keep vapors from building up in or near the work area and adjoining areas. Dissipate static electricity during transfer by grounding and bonding containers and equipment before transfering material. Use explosion proof electrical equipment for ventilation, lighting and material handling. Keep in properly labeled containers. 8. Exposure Controls/Personal Protection Ingredients with Occupational Exposure Limits Chemical Name ACGIH TLV-TWA ACGIH-TLV STEL OSHA PEL-TWA OSHA PEL-CEILING Calcium Carbonate N.E. N.E. 15 mg/m3 N.E. Acetone 250 ppm 500 ppm 750 PPM N.E. Titanium Dioxide 10 mg/m3 N.E. 15 mg/m3 N.E. Solvent Naphtha(Petroleum), Light N.E. N.E. N.E. N.E. Aromatic Magnesium silicate(talc) 2 mg/m3 N.E. 2 mg/m3 N.E. Chloroalkanes N.E. N.E. N.E. N.E. Xylene 100 ppm 150 ppm 100 ppm N.E. Ethylbenzene 100 PPM 125 ppm 100 PPM N.E. Crystalline Silica,Quartz 0.025 mg/m3 N.E. 0.05 mg/m3 N.E. Further Advice:MEL=Maximum Exposure Limit OES=Occupational Exposure Standard SUP=Supplier's Recommendation Sk=Skin Sensitizer N.E. =Not Established Personal Protection RESPIRATORY PROTECTION: If exposure limits are exceeded or irritation is experienced, NIOSH/MSHA approved respiratory protection should be worn. Positive-pressure supplied air respirators may be required for high airborne - contaminant concentrations. Respiratory protection must be provided in accordance with current local regulations. SKIN PROTECTION:Chemical resistant impervious gloves/clothing. 0 EYE PROTECTION: Use chemical safety goggles and/or full face shield where splashing is possible.Contact lenses a,r( % should not be worn when workingwith this material. Maintain eye wash fountain and quick-drench facilities in work Y -= areas. OTHER PROTECTIVE EQUIPMENT: Eyewash stations,safety showers,ventilation systems. Page 3/8 Date Printed: 2/16/2021 Product:985691 (L HYGIENIC PRACTICES:When using,do not eat,drink or smoke. Provide regular cleaning of equipment,work area and clothing.Wash hands before breaks and immediately after handling the product. Handle in accordance with good industrial hygiene and safety practice. ENGINEERING CONTROLS: Provide exhaust ventilation sufficient to keep the airborne concentration of this product below its exposure limits. Exhaust air may need to be cleaned by scrubbers or filters to reduce environmental contamination. 9. Physical and Chemical Properties Appearance: White Liquid Physical State: Liquid Odor: Aromatic Solvent Odor Threshold: Not Established Density,g/cm3: 1.401 pH: Not Applicable Freeze Point, °C: No Information Viscosity: No Information Solubility in Water: Insoluble Partition Coefficient, n-octanol/ No Information Decomposition temperature, °C No Information water: Boiling Range,°C: Not Determined Explosive Limits, %: Not Determined Combustibility: Supports Combustion Flash Point, °C: 0 Evaporation Rate: Slower than Diethyl Ether Auto-Ignition Temperature,°C No Information Vapor Density: Heavier than air Vapor Pressure,mmHg: No Information (See"Other information"Section for abbreviation legend) 10. Stability and Reactivity REACTIVITY:No reactivity hazards known under normal storage and use conditions. STABILITY:Stable under recommended storage conditions. CONDITIONS TO AVOID:Avoid all possible sources of ignition(heat,flames and sparks). Do not pressurize,cut weld,braze, solder,drill,grind or expose containers to heat or sources of ignition. INCOMPATIBILITY:Strong acids. Chlorinated compounds. Strong oxidizing agents. HAZARDOUS DECOMPOSITION PRODUCTS:Carbon oxides. Hydrocarbons. Carbon dioxide. 11. Toxicological Information + Practical Experiences MOST IMPORTANT SYMPTOMS AND EFFECTS:Contact will cause irritation and redness to exposed areas.Causes painful stinging or burning of eyes and lids,watering of eyes.Prolonged contact may even cause severe skin irritation or mild burn. Overexposure by inhalation or ingestion may cause CNS depression,drowsiness,dizziness,confusion headache or loss of coordination. EFFECT OF OVEREXPOSURE-INHALATION: Inhalation may cause irritation to the respiratory tract(nose, mouth, mucous membranes). May cause central nervous system depression with nausea, headache,dizziness,vomiting,and incoordination. Sanding and grinding dust may be harmful if inhaled. EFFECT OF OVEREXPOSURE-INGESTION: Ingestion may cause irritation to mucous membranes. May cause gastrointestinal irritation, nausea,vomiting, and diarrhea. EFFECT OF OVEREXPOSURE-SKIN CONTACT: Irritating to skin. Repeated exposure may cause skin dryness or cracking. EFFECT OF OVEREXPOSURE-EYE CONTACT: Irritating to eyes. EFFECT OF OVEREXPOSURE-CHRONIC HAZARDS: Ethylbenzene has been classified by the International Agency for Research on Cancer(IARC)as possibly carcinogenic to humans(Group 2B). Prolonged or repeated overexposure to ethylbenzene may result in adverse effects to the kidneys, liver,respiratory system,thyroid,testicles,and pituitary glands. This product contains titanium dioxide in a non-respirable form. Inhalation of titanium dioxide is unlikely to occur from exposure to this product. Inhalation exposure to respirable levels of crystalline silica may cause respiratory impairment and lung damage. This product contains crystalline silica (quartz)in a non-respirable form. Inhalation of crystalline silica is unlikely to occur from exposure to this product. Crystalline silica Page 4/8 Date Printed: 2/16/2021 Product: 985691 (quartz)has been classified by the International Agency for Research on Cancer(IARC)as a known human carcinogen. CARCINOGENICITY:This product contains one or more substances which are classified by IARC as carcinogenic to humans(Group I), probably carcinogenic to humans(Group 2A)or possibly carcinogenic to humans(Group 2B). PRIMARY ROUTE(S)OF ENTRY: Eye Contact, Inhalation,Skin Absorption, Skin Contact Acute Toxicity Values The acute effects of this product have not been tested. Data on individual components are tabulated below CAS-No. Chemical Name Oral LD50 Dermal LD50 Inhalation LC50 1317-65-3 Calcium Carbonate >2000 mg/kg >2000 mg/kg >20001 ppm(Gas/Mist) 67-64-1 Acetone 5800 mg/kg Rat >15700 mg/kg Rabbit N.I. 13463-67-7 Titanium Dioxide >10000 mg/kg Rat N.I. >20001 ppm(Gas/Mist) 64742-95-6 Solvent Naphtha (Petroleum), Light Aromatic 8400 mg/kg Rat >2000 mg/kg Rabbit >20001 ppm(Gas/Mist) 14807-96-6 Magnesium silicate(talc) >2000 mg/kg >2000 mg/kg >20001 ppm(Gas/Mist) 61788-76-9 Chloroalkanes >2000 mg/kg >2000 mg/kg >20001 ppm(Gas/Mist) 1330-20-7 Xylene >2000 mg/kg >2000 mg/kg >20001 ppm(Gas/Mist) 100-41-4 Ethylbenzene >2000 mg/kg 15400 mg/kg Rabbit >20001 ppm(Gas/Mist) 14808-60-7 Crystalline Silica,Quartz >2000 mg/kg >2000 mg/kg >20001 ppm(Gas/Mist) N.I.=No Information 12. Ecological Information ECOLOGICAL INFORMATION:The environmental impact of this product has not been fully investigated. Do not contaminate ponds, waterways or ditches with this material. PRESISTENCE AND DEGRADABILITY: No Information BIOACCUMULATIVE POTENTIAL: No Information MOBILITY: No Information OTHER ADVERSE ECOLOGICAL EFFECTS:No Information 13. Disposal Information ,711------- , tii, Product DISPOSAL METHOD:This material,as supplied, is a hazardous waste according to federal regulations(40 CFR 261). Dispose of contents/container in accordance with the local/regional/national/international regulations. Do not re-use empty containers. Empty containers pose a potential fire and explosion hazard. Do not cut, puncture of weld containers. STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED: ELIMINATE all ignition sources(no smoking,flares, sparks or flames in immediate area). Take precautionary measures against static discharges. All equipment used when handling the product must be grounded. A vapor suppressing foam may be used to reduce vapors. Use personal protective equipment. Ensure adequate ventilation. Dike far ahead of liquid spill for later disposal. Use clean non-sparking tools to collect absorbed material. CONTAMINATED PACKAGING: Empty containers retain product residue and can be dangerous. Do not pressurize,cut,weld, braze, solder,drill, grind,or expose such containers to heat,flame,sparks static electricity,or other sources of ignition. 14. Transport Information SPECIAL TRANSPORT PRECAUTIONS: No Information Page 5/8 A.. Date Printed: 2/16/2021 Product:985691 Road Transport UN Number: UN1263 Shipping Name: Paint Transport Hazard Class: 3 Packing Group: II ERG No: 128 Sea Transport UN Number: UN1263 Shipping Name: Paint IMDG Class: 3 Packing Group: II EmS-No: F-E,S-E Marine Pollutant: Not A Marine Pollutant Air Transport UN Number: UN1263 Shipping Name: Paint IATA Class: 3 Packing Group: II 15. Regulatory Information U.S. Federal Regulations: CERCLA-SARA Hazard.Category This product has been reviewed according to the EPA'Hazard Categories'promulgated under Sections 311 and 312 of the Superfund Amendment and Reauthorization Act of 1986(SARA Title Ill)and is considered,under applicable definitions,to meet the following categories: Flammable(gases,aerosols,liquids,or solids),Carcinogenicity,Serious eye damage or eye irritation,Specific target organ toxicity(single or repeated exposure),Germ cell mutagenicity [SARA,SECTION 313:. • This product contains the following substances subject to the reporting requirements of Section 313 of Title Ill of the Superfund Amendment and Reauthorization Act of 1986 and 40 CFR part 372: Chemical Name CAS-No. Xylene 1330-20-7 Ethylbenzene 100-41-4 Toluene 108-88-3 ITOXIC SUBSTANCES CONTROL ACT: .. _ This product contains the following chemical substances subject to the reporting requirements of TSCA 12(B)if exported from the United States: Chemical Name CAS-No. Chloroalkanes 61788-76-9 U.S. State Regulations: I NEW JERSEY RIGHT-TO-KNOW: The rY The following materials are hazardous or among the top five components in this product. Chemical Name CAS-No. Page 6/8 • Date Printed: 2/16/2021 Product:985691 Calcium Carbonate 1317-65-3 Acetone 67-64-1 Acrylic polymer Calcined Aluminum Silicate Powder 92704-41-1 Titanium Dioxide 13463-67-7 Solvent Naphtha(Petroleum),Light Aromatic 64742-95-6 Magnesium silicate(talc) 14807-96-6 Chloroalkanes 61788-76-9 Xylene 1330-20-7 Ethylbenzene 100-41-4 Crystalline Silica,Quartz 14808-60-7 [PENNSYLVANIA"RIGHT-TO-KNOW u r The following non-hazardous ingredients are present in the product at greater than 3%. Chemical Name CAS-No. Calcium Carbonate 1317-65-3 Acetone 67-64-1 Acrylic polymer Calcined Aluminum Silicate Powder 92704-41-1 Titanium Dioxide 13463-67-7 Petroleum Hydrocarbon Resin 64742-16-1 Solvent Naphtha(Petroleum), Light Aromatic 64742-95-6 Magnesium silicate(talc) 14807-96-6 Chloroalkanes 61788-76-9 Xylene 1330-20-7 Ethylbenzene 100-41-4 Crystalline Silica,Quartz 14808-60-7 FCALIFORNIA PROPOSITION 65 CARCINOGENS . WARNING Warning:The following ingredients present in the product are known to the state of California to cause Cancer: Chemical Name CAS-No. Titanium Dioxide 13463-67-7 Magnesium silicate(talc) 14807-96-6 Ethylbenzene 100-41-4 Crystalline Silica,Quartz 14808-60-7 [CALIFORNIA,PROPOSITION 65 REPRODUCTIVE TOXINS' WARNING Warning:The following ingredients present in the product are known to the state of California to cause birth defects,or other reproductive hazards. No Proposition 65 Reproductive Toxins exist in this product. International Regulations: As follows - { CANADIAN WHMIS•y® _ ~ u _._� �! This SDS has been prepared in compliance with Controlled Product Regulations. Page 7/8 Date Printed: 2/16/2021 Product:985691 16. Other Information Revision Date: 2/11/2021 Supersedes Date: 12/11/2020 Datasheet produced by: Regulatory Department HMIS Ratings: Health: 3 Flammability: 4 Reactivity: 1 Personal Protection: X NFPA Ratings: Health: 3 Flammability: 4 Reactivity: 1 Hazards: N.I. Legend: N.A.-Not Applicable,N.E.-Not Established, N.D.-Not Determined The information on this sheet corresponds to our present knowledge. It is not a specification and it does not guarantee specific properties. The information is intended to provide general guidance as to health and safety based upon our knowledge of the handling,storage,and use of the product. It is not applicable to unusual or non-standard uses of the product where ind'tructions and recommendations are not followed. Any use of the product not in conformance with this SDS or in combination with any other product or process is the responsibility of the user. Page 8/8 Waishkititan State Departnient'oi1 ansportafion Qualified Product List Product Information Manufacturer: Potters Industries, Inc. - Canby, OR Product Name : Glass Beads for Pavement Marking Standard Spec : 9-34.4, Pavement Marking - Glass Beads Product Description : Glass beads: Exterior coating(s) as required for the type of pavement marking being used (Reapproved 5-10-11) 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. Last Updated : Mar 19, 2013 Contractors with WSDOT Click here for Contractor Product Info Page Copyright WSDOT©2016 To be completed.by the field inspector: Quantity: Verified By: Date: