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Washington State
•/ Department of Transportation Request for Approval of Material
Contract Number FA Number N/A SR Duvall Ave NE Date
CAG 20-065 2/15/2022
Section 1 Title of Project Duvall Ave NE County King
Contractor Reed Trucking & Excavating, Inc. Subcontractor
This form shall be completed prior to submittal. If this form is not compete at time of submittal it may For WSDOT Use Only
be returned for information that was omitted. RAM#
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
SP 8-31.2 1, 2,
C3,C4 Sand Stoneway 9-03.1(2) ASA
+
Project Engineer/Representative Date State Materials Engineer/Representative Date
�— 2/17/2022
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.
11
2 Acceptance Criteria: Mfg.Cert.of Compliance for'Acceptance'prior to use of material.
. Acceptance Criteria: Catalog Cuts for'Acceptance'prior to use of material. Catalog Cut Approved ❑Yes ❑No
4. Acceptance Criteria: Submit Shop Drawings for'Approval'prior to fabrication of material.
5. Acceptance Criteria: Only'Approved for Shipment','WSDOT Inspected'or'Fabrication Approved Decal'material shall be used.
6. Acceptance Criteria: Submit Certificate of Materials Origin to Project Engineer Office.
7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action.
8. Source Approved:
9. Approval Withheld: Submit samples for preliminary evaluation.
10. Approval Withheld:
11. Miscellaneous Acceptance Criteria.
Remarks
(PE):
Remarks Remarks:
(Ho): Provide Scale Cert.
Delivery Ticket shall show bid item number and description.
DOT Form 350-071 Project Engineer Distribution
Revised 03/2021 ®Contractor ❑Region Operations Engineer ❑Fabrication Inspection ❑Region Materials ❑State Materals Lab-MS 47365
Stoneway Concrete Technical Services
Aggregate Sieve Analysis
PROJECT: Internal Testing DATE: 2/14/2022
LOCATION: Sumner Sand and Gravel
SAMPLE SOURCE: B-231
SAMPLE DESCRIPTION: Contractor Sand
AGGREGATE SIZE: Sand TESTER: Sean
SIEVE WEIGHT PERCENT PERCENT SPECIFICATION
SIZE RETAINED RETAINED PASSIN9 N/A
3/8" 0.0 0 100
#4 3.2 0 100 ✓
#8 113.3 17 83
#16__ 327.3 48 52 ✓
#30 530.1 78 22
#50 612.4 90 10
#100 643.7 95 5 I
#200 655.9 97 3 ✓
PAN 678.1 100 0
WET SAMPLE: 739.8 TOTAL MOISTURE: 8.3%
DRY SAMPLE: 678.1 FM (SAND): 3.28
SE: 62%
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 lb of cement per cubic yard(C 33 6.2)
SUBMITTAL REVIEW 9-03.1(2)B
Class 1 Class 2
X No Exceptions Taken Percent Passing Percent Passing
Make Corrections Noted
Amend & Resubmit Sieve Size Min. Max. Min. Max.
Rejected-See Remarks 99 100 99 100
IMPORTANT NOTICE: This review No.4 95 100 95 J 100
does not relieve contractor from his No.8 68 86
responsibility to comply&conform No. 16 47 65 45 80
with the Plans, Specification, and
Contract Documents. No. 30 27 42
No. 50 9 20 10 30
Gray&Osborne, Ir1bc:. No. 100 0 7 2 10
CONSULTING ENGINEERS No. 200 0 2.5 0 2.5
By: DRS Date:2/15/2022
ASTM C 136
ASTM C 33
WSDOT MATERIALS LAB 02/15/2022
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 Bacldill for Foundation Class A HMA Other Courses
HMA Wearing Course Maintenance Rock Permeable Ballast
Acceptance tests need to be performed as necessary.
•
Aggregates for Concrete: Test Date: 02/01/2018 Expiration Date: 02/01/2023
ASR-14 Day:0.56 ASR-One Year:0.04 CCA Absorption:1.18 CCA Sp.G:2.681
Deg:70 FCA Absorption:2.04 FCA Organics:1 FCA Sp.G:2.627
LA:12
Remarks: 1-Year ASR Results expire 12/19/2023
Currently approved for:
Coarse Concrete Aggregates
Fine Concrete Aggregates
Acceptance tests need to be performed as necessary Acceptance tests need to be performed as necessary
Riprap,Quarry Spa1Ls,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: