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HomeMy WebLinkAboutCOR_TSI #6 CL 3000 Concrete RAM ONLYPE Appr'l Code Date Project Engineer Distribution State Materials Engineer Distrubution Contractor General File Signing Inpsection Region Operations Engineer Other ___________________________________ Fabrication Inspection M/S 47365 Revised 03/2018 TSI #6 Request for Approval of Material Contract Number FA Number SR Date Hazen High School Pedestrian Signals KINGContractorSubcontractor Sare Electric Transportation Systems Inc TSI #6 2/19/2026 Section / Title of Project County This shall be completed prior to submittal. If this form is not complete at time of submittal it may be returned for information that was omitted. For WSDOT Use Only RAM # Bid Item No. Material or Manufacturer's Product/Type Name and Location of Fabricator, Manufacturer or Pit Number Specification Reference Hdqtr. Appr'l Code 1 CEMENT CONC. CL 3000 ( PED. POLE FOUNDATIONS ) MD# 04C4A Miles Sand & Gravel - PLT. 202,203 8-20.3(4) CEMENT ASH GROVE, SEATTLE, WA. 8-20.3(4) AIR ENTRAINMENT AE 90 MASTER BUILDERS, BEACHWOOD , OHIO 5-05 CONCRETE CURE 1100 WR MEADOWS, 6-04 FIBRE EXPANSION JOINT WR MEADOWS , HAMPSHIRE , IL. 6-04 Project Engineer/Representative Date State Materials Engineer 5. Acceptance Criteria: Only 'Approved for Shipment' or 'WSDOT Inspected' or 'Fabrication Approved Decal' material shall be used. 6. Acceptance Criteria: Submit Materials Certificate of Origin to Project Engineer. 7. Acceptance Criteria: Request Transmitted to State Materials Laboratory for Approval Action. 8. Source Approved: ______________________________________________________________________________________ 9. Approval Withheld: Submit samples for preliminary evaluation. Approval 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: Submit 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 mateiral. Region Materials State Materials Lab DOT Form 350-071 10. Approval Withheld: 11. Miscellaneous Acceptance Criteria. Remarks: Washington State Department of Transportation Washington State Department of Transportation I I I I Concrete Mix Design Contractor Submitted By Date Concrete Supplier Plant Location Contract Number Contract Name This mix is to be used in the following Bid Item No(s): Concrete Class: Remarks Mix Design No. Plant No. Cementitious Materials Cement Source Plant Type, Class or Grade Sp. Gr. Lbs/cy Fly Ash a F C Alkali % GGBFS (Slag) a 100 120 Concrete Admixtures Air Entrainment Manufacturer Product Est. Range (oz/cy) Water (Maximum) lbs/cy Is any of the water Recycled or Reclaimed? Yesd No Water Cementitious Ratio (Maximum) Mix Design Density (pcf) Design Performance (Attach Test Data) Average 28-day compressive strength (psi) Average 14-day flexural strength (psi) (Concrete Pavement Only) Concrete Chloride Ion Content (% by mass of cement) Water Soluble Acid Soluble Agency Use Only (Check appropriate Box) This Mix Design MEETS CONTRACT SPECIFICATIONS and may be used on the bid items noted above This Mix Design DOES NOT MEET CONTRACT SPECIFICATIONS and is being returned for corrections Reviewed By: PE Signature Date DOT Form 350-040 Revised 02/2024 Distribution: Original - ContractorCopies To - State Materials Lab - Structural Materials Eng. ; Regional Materials Lab; Project Inspector Page 1 of 2 Mix Design No. Plant No. Aggregate Gradation AASHTO Combined Nominal Maximum Size (In) Aggregates WSDOT Source No. b 1 2 3 4 5 Total Source Expiration Date b ASR Expansion (%) b 14 Day 1 Year Is ASR Mitigation Required? Stock Pile Grading c Percent of Total Aggregate Specific Gravity (SSD) Lbs/cy (ssd) Include Percent Passing for each aggregate component. Include Total only for Combined Gradations. 2 inch Percent Passing Total 1-1/2 inch 1 inch 3/4 inch 1/2 inch 3/8 inch No. 4 No. 8 No. 16 No. 30 No. 50 No. 100 No. 200 Fineness Modulus: (Required for Class 2 Sand) Proposed ASR Mitigation Method: Notes: a Fly ash or GGBFS is required for Class 4000P mix. b Enter data from WSDOT ASA Database. ASR Mitigation is required for sources with 14-day expansions greater than 0.20%. No mitigation is required if the 1-year expansion is less than 0.04%. Proposed mitigation methods for 14-day expansions greater than 0.45% require ASTM C 1567 tests proving that the method is effective. See WSDOT Standard Specification 9-03.1. c Stockpile gradation: AASHTO No. 467, 57, 67, 7, 8; WSDOT Class 1, Class 2; or combined gradation stockpile sizes. See WSDOT Standard Specification 9-03.1. d Attach test results indicating conformance to Standard Specification 9-25.1. DOT Form 350-040 Revised 02/2024 Distribution: Original - ContractorCopies To - State Materials Lab - Structural Materials Eng. ; Regional Materials Lab; Project Inspector Page 2 of 2 Concrete Mix ID:04C4A Spec'd Strength:3,000 Modification Factor:1.000 Number of Tests:30 Standard Deviation:488 Average Range(PSI):376 Fcr= Fc + 1.34(s):3,654 Standard Deviation:488 Fcr= Fc + 2.33(s) - 500:3,637 Coefficient of Variation, V:8.1% Within-Test Std Dev(PSI):334 Within-Test Coeff. of Var.5.5%Average 4.73 5.0%64 52 4,190 5,230 Batch-to-Batch Std Dev (PSI):356 Max:7.25 7.5%71 66 5,430 6,040 Batch-to-Batch Coeff. of Var.5.9%Min:3.00 3.0%55 33 3,410 4,100 Date Slump Air CT AT 7 Day 28 Day 1 05/21/25 4.00 6.9%62 48 5,430 5,990 2 05/19/25 4.50 4.8%63 56 4,380 5,100 3 05/15/25 4.00 6.2%60 47 5,320 5,820 4 05/12/25 3.75 3.0%66 62 4,360 5,360 5 05/05/25 5.50 5.8%70 59 3,680 4,540 6 05/01/25 4.50 3.0%64 62 5,580 7 04/22/25 4.00 6.5%63 57 3,850 4,570 8 04/17/25 3.00 4.0%66 45 5,750 9 04/15/25 4.00 7.0%62 45 4,100 4,970 10 04/10/25 3.25 6.0%58 48 3,930 4,670 11 04/07/25 6.00 4.8%67 51 3,700 5,140 12 04/03/25 4.25 5.3%59 48 4,230 5,340 13 01/28/25 5.75 5.0%63 42 3,410 4,410 14 12/31/24 3.50 3.8%56 37 4,450 5,640 15 10/28/24 5.50 3.5%63 51 4,170 5,450 16 10/08/24 4.00 5.0%71 62 4,740 5,580 17 08/27/24 5.00 5.2%71 55 4,290 4,990 18 07/15/24 5.00 4.5%65 59 4,170 5,540 19 06/18/24 6.25 4.2%66 52 4,360 5,620 20 06/12/24 6.00 4.2%71 60 4,210 4,960 21 06/12/24 3.50 4.6%62 50 4,400 5,200 22 06/11/24 4.50 4.1%69 50 3,550 4,830 23 05/14/24 5.00 5.3%68 59 4,050 4,970 24 05/14/24 7.25 5.9%66 61 4,010 4,800 25 05/09/24 5.50 7.5%67 66 3,490 4,100 26 04/22/24 4.50 3.9%62 48 4,240 5,490 27 04/18/24 4.50 5.4%56 38 4,970 6,040 28 04/17/24 5.50 4.4%55 33 3,430 5,340 29 04/16/24 5.50 6.5%56 48 4,430 5,240 30 04/16/24 4.25 4.0%62 46 4,060 5,880 ACI 318 Performance Approval Concrete Cylinder Report page 1 of 3 Features „Ready-to-use in the proper concentration for rapid, accurate dispensing Benefits „Improved resistance to damage from cyclic freezing and thawing „Improved resistance to scaling from deicing salts „Improved plasticity and workability „Reduced permeability – increased watertightness „Reduced segregation and bleeding Performance Characteristics Concrete durability research has established that the best protection for concrete from the adverse effects of freezing and thawing cycles and deicing salts results from: proper air content in the hardened concrete, a suitable air-void system in terms of bubble size and spacing, and adequate concrete strength, assuming the use of sound aggregates and proper mixing, transporting, placing, consolidation, finishing and curing techniques. MasterAir AE 90 admixture can be used to obtain adequate freeze-thaw durability in a properly proportioned concrete mixture, if standard industry practices are followed. Air Content Determination: The total air content of normal weight concrete should be measured in strict accordance with ASTM C 231, “Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method” or ASTM C 173/C 173M, “Standard Test Method for Air Content of Freshly Mixed Concrete by the Volumetric Method.” The air content of lightweight concrete should only be determined using the Volumetric Method. The air content should be verified by calculating the gravimetric air content in accordance with ASTM C 138/C 138M, “Standard Test Method for Density (Unit Weight), Yield, and Air Content (Gravimetric) of Concrete.” If the total air content, as measured by the Pressure Method or Volumetric Method and as verified by the Gravimetric Method, deviates by more than 1.5%, the cause should be determined and corrected through equipment calibration or by whatever process is deemed necessary. Description MasterAir AE 90 air-entraining admixture is for use in concrete mixtures. It meets the requirements of ASTM C 260, AASHTO M 154 and CRD-C 13. Applications Recommended for use in: „Concrete exposed to cyclic freezing and thawing „Production of high-quality normal or lightweight concrete (heavyweight concrete normally does not contain entrained air) MasterAir® AE 90 Air-Entraining Admixture 3 03 30 00 Cast-in-Place Concrete 03 40 00 Precast Concrete 03 70 00 Mass Concrete www.master-builders-solutions.com/en-us page 2 of 3 MasterAir AE 90 Technical Data Sheet Guidelines for Use Dosage: There is no standard dosage for MasterAir AE 90 admixture. The exact quantity of air-entraining admixture needed for a given air content of concrete varies because of differences in concrete-making materials and ambient conditions. Typical factors that might influence the amount of air entrained include: temperature, cementitious materials, sand gradation, sand-aggregate ratio, mixture proportions, slump, means of conveying and placement, consolidation and finishing technique. The amount of MasterAir AE 90 admixture used will depend upon the amount of entrained air required under actual job conditions. In a trial mixture, use 0.25 to 4 fl oz/cwt (16-260 mL/100 kg) of cementitious material. Measure the air content of the trial mixture, and, if needed, either increase or decrease the quantity of MasterAir AE 90 admixture to obtain the desired air content. In mixtures containing water-reducing or set-control admixtures, the amount of MasterAir AE 90 admixture needed may be somewhat less than the amount required in plain concrete. Due to possible changes in the factors that can affect the dosage of MasterAir AE 90 admixture, frequent air content checks should be made during the course of the work. Adjustments to the dosage should be based on the amount of entrained air required in the mixture at the point of placement. If an unusually high or low dosage of MasterAir AE 90 admixture is required to obtain the desired air content, consult your local sales representative. In such cases, it may be necessary to determine that, in addition to a proper air content in the fresh concrete, a suitable air-void system is achieved in the hardened concrete. Dispensing and Mixing: Add MasterAir AE 90 admixture to the concrete mixture using a dispenser designed for air-entraining admixtures, or add manually using a suitable measuring device that ensures accuracy within plus or minus 3% of the required amount. For optimum, consistent performance, the air-entraining admixture should be dispensed on damp, fine aggregate. If the concrete mixture contains fine lightweight aggregate, field evaluations should be conducted to determine the best method to dispense the air-entraining admixture. Precaution In a 2005 publication from the Portland Cement Association (PCA R&D Serial No. 2789), it was reported that problematic air- void clustering that can potentially lead to above normal decreases in strength was found to coincide with late additions of water to air- entrained concretes. Late additions of water include the conventional practice of holding back water during batching for addition at the jobsite. Therefore, caution should be exercised with delayed additions of water to air-entrained concrete. Furthermore, an air content check should be performed after post-batching addition of any other materials to an air- entrained concrete mixture. Product Notes Corrosivity – Non-Chloride, Non-Corrosive: MasterAir AE 90 admixture will neither initiate nor promote corrosion of reinforcing and prestressing steel embedded in concrete, or of galvanized floor and roof systems. No calcium chloride or other chloride-based ingredients are used in the manufacture of this admixture. Compatibility: MasterAir AE 90 admixture may be used in combination with any Master Builders Solutions admixture, unless stated otherwise on the data sheet for the other product. When used in conjunction with other admixtures, each admixture must be dispensed separately into the concrete mixture. Storage and Handling Storage Temperature: MasterAir AE 90 admixture should be stored and dispensed at 31 °F (-0.5 °C) or higher. Although freezing does not harm this product, precautions should be taken to protect it from freezing. If MasterAir AE 90 admixture freezes, thaw at 35 °F (2 °C) or above and completely reconstitute by mild mechanical agitation. Do not use pressurized air for agitation. Shelf Life: MasterAir AE 90 admixture has a minimum shelf life of 18 months. Depending on storage conditions, the shelf life may be greater than stated. Please contact your local sales representative regarding suitability for use and dosage recommendations if the shelf life of MasterAir AE 90 admixture has been exceeded. Safety: Chemical goggles and gloves are recommended when transferring or handling this material. © Master Builders Solutions „ 07/23 „ DAT-0013 ® registered trademark of Master Builders Solutions in many countries of the world www.master-builders-solutions.com/en-us Master Builders Solutions Admixtures US, LLC 23700 Chagrin Boulevard Beachwood, Ohio, 44122-5544 USA „ 800-628-9990 Master Builders Solutions Canada, Inc. 1800 Clark Boulevard Brampton, Ontario L6T 4M7 CANADA „ 289-360-1300 page 3 of 3 MasterAir AE 90 Technical Data Sheet Packaging MasterAir AE 90 admixture is supplied in 55 gal (208 L) drums, 275 gal (1040 L) totes and by bulk delivery. Related Documents Safety Data Sheets: MasterAir AE 90 admixture Additional Information For additional information on MasterAir AE 90 admixture, or its use in developing a concrete mixture with special performance characteristics, contact your local sales representative. Master Builders Solutions creates technologies for the construction industry inspiring people to build better. We are active in ~40 countries and operate 35 production sites with over 1,600 employees. We develop, produce, and market high-quality chemical admixtures, as well as adjacent core technologies, to master the challenges of today and support a decarbonized future. Our people are pivotal and pair leading technologies and a strong brand heritage to surpass our customers’ expectations and drive continuous value creation. Limited Warranty Notice Master Builders Solutions Admixtures US, LLC (“Master Builders Solutions”) warrants this product to be free from manufacturing defects and to meet the technical properties on the current Technical Data Guide, if used as directed within shelf life. Satisfactory results depend not only on quality products but also upon many factors beyond our control. MASTER BUILDERS SOLUTIONS MAKES NO OTHER WARRANTY OR GUARANTEE, EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO ITS PRODUCTS. The sole and exclusive remedy of Purchaser for any claim concerning this product, including but not limited to, claims alleging breach of warranty, negligence, strict liability or otherwise, is shipment to purchaser of product equal to the amount of product that fails to meet this warranty or refund of the original purchase price of product that fails to meet this warranty, at the sole option of Master Builders Solutions. Any claims concerning this product must be received in writing within one (1) year from the date of shipment and any claims not presented within that period are waived by Purchaser. MASTER BUILDERS SOLUTIONS WILL NOT BE RESPONSIBLE FOR ANY SPECIAL, INCIDENTAL, CONSEQUENTIAL (INCLUDING LOST PROFITS) OR PUNITIVE DAMAGES OF ANY KIND. Purchaser must determine the suitability of the products for the intended use and assumes all risks and liabilities in connection therewith. This information and all further technical advice are based on Master Builders Solutions' present knowledge and experience. However, Master Builders Solutions assumes no liability for providing such information and advice including the extent to which such information and advice may relate to existing third party intellectual property rights, especially patent rights, nor shall any legal relationship be created by or arise from the provision of such information and advice. Master Builders Solutions reserves the right to make any changes according to technological progress or further developments. The Purchaser of the Product(s) must test the product(s) for suitability for the intended application and purpose before proceeding with a full application of the product(s). Performance of the product described herein should be verified by testing and carried out by qualified experts. Washington State Department of Transportation February 13, 2026 Qualified Product List Contractor Product Information Contractor: Contract No: Sub Contractor: Date: Bid Item: Manufacturer: Ash Grove Cement Company - Seattle, WA Product Name: Type IL(X) Blended Hydraulic Cement Standard Spec : 9-01.2(1)B, Concrete - Blended Hydraulic Cement Product Description : Blended Hydraulic Cement Type IL(X), Manufactured by Ash Grove Cement Co. - Seattle Plant, Seattle WA. Per WSDOT Standard Specification 9-01.2(1)B, the value of (X) shall be a minimum of 5% and a maximum of 15%. Product Restriction : Acceptance Code : 2525 Code Description : Acceptance based upon the cement Manufacturer's Mill Test Report number being shown on each concrete producer's certificate of compliance. Last Updated : Jan 29, 2021 To be completed by the field inspector: Quantity: _________ Verified By: _________ Date: _________ 2/13/26, 9:30 AM Qualified Product List https://wsdot.wa.gov/biz/mats/QPL/QPLPrint.cfm?Product_no=2020037&product_origin=QPL&location_id=46&Std_spec_minor=9-01.2(1)B&Product_…1/1 WSDOT MATERIALS LAB 09/09/2024 Aggregate Source Approval Report Owner: Miles Sand and Gravel Aggregate Source: PS-B-345 Lessee: Known as: Miles Fennel Pit Located in: NW1/4 SE1/4 AND POR OF GOV'T LOT 5 Section 7 T19N R5E County: Pierce Address: 11621 McCutcheon Rd E, Bonney Lake 98391 Remarks: 47.147041592,-122.216032908 Mineral Agg. and Surfacing: Test Date: 05/13/2021 Expiration Date: 05/13/2026 Absorption: 1.12 Apparent Sp. G.: 2.755 Bulk Sp. G. (SSD): 2.703 Bulk Sp. G.: 2.673 Deg: 71 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: 03/01/2023 Expiration Date: 03/01/2028 ASR - 14 Day : 0.48 ASR - One Year: 0.036 CCA Absorption: 0.97 CCA Sp.G: 2.738 Deg: 81 FCA Absorption: 1.67 FCA Organics: 1 FCA Sp. G: 2.834 LA: 12 Remarks: 1-Year ASR (C1293) results expire 08/31/2028 Currently approved for: Coarse Concrete Aggregates, Pea Gravel Fine Concrete Aggregates Acceptance tests need to be performed as necessary Acceptance tests need to be performed as necessary Riprap, Quarry Spalls, Rock for Rock Wall, Erosion and Scour Protection: Test Date: Expiration Date: Absorption:Apparent Sp. G.:Bulk Sp. G. (SSD):Bulk Sp. G.: Deg:LA: Remarks: NOT Approved for: 9/9/24, 11:42 AM Aggregate Source Approval Report. https://wsdot.wa.gov/biz/mats/ASA/ASAReport.cfm?prefix=B&pit_no=345 1/2 WSDOT MATERIALS LAB 10/22/2025 Aggregate Source Approval Report Owner: La Pianta Limited Partnership Aggregate Source: PS-A-464 Lessee: Icon Materials, Inc. Known as: Auburn Pit Located in: SW1/4 SW1/4 SEC 28 & 29 Section 28,29, T21N R5E County: King Address: 4040 Kersey Way SE. Auburn WA 98092 Remarks: 47.272618, -122.191378 Mineral Agg. and Surfacing: Test Date: 02/13/2023 Expiration Date: 02/13/2028 Absorption: 1.44 Apparent Sp. G.: 2.754 Bulk Sp. G. (SSD): 2.687 Bulk Sp. G.: 2.649 Deg: 50 LA: 18 Remarks: Currently Approved 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: 05/12/2023 Expiration Date: 05/12/2028 ASR - 14 Day : 0.45 ASR - One Year: 0.037 CCA Absorption: 1.41 CCA Sp.G: 2.638 Deg: 65 FCA Absorption: 2.73 FCA Organics: 1 FCA Sp. G: 2.528 LA: 14 Remarks: Current 1 Year ASR (ASTM C1293) results: 0.037%. Results expire on 12/9/2025 Currently Approved for: Coarse Concrete Aggregates (Other as defined in 6-02.3(2)) Fine Concrete Aggregates Coarse Concrete Agg (Structural and Paving Concrete) Acceptance tests need to be performed as necessary Acceptance tests need to be performed as necessary Riprap, Quarry Spalls, Rock for Rock Wall, Erosion and Scour Protection: Test Date: Expiration Date: Absorption:Apparent Sp. G.:Bulk Sp. G. (SSD):Bulk Sp. G.: Deg:LA: Remarks: 10/22/25, 1:48 PM Aggregate Source Approval Report. https://wsdot.wa.gov/biz/mats/ASA/ASAReport.cfm?prefix=A&pit_no=464 1/3