HomeMy WebLinkAboutRAM 043 01 Bid Item A86-87 Signal System Poles - ResponseRequest for Approval of Material
Contract Number FA Number SR Date
Section / Title of Project County
Contractor Subcontractor
For assistance in completing, see Instructions and Example
Bid
Item No.
Material or
Product/Type
Name and Location of Fabricator,
Manufacturer or Pit Number
Specification
Reference
PE/QPL
Code
Hdqtr./QPL
Code
Acceptance Action Codes for use by Project Engineer and State Materials Laboratory
1. Acceptance Criteria:
2. Acceptance Criteria:
3. Acceptance Criteria:
4. Acceptance Criteria:
5. Acceptance Criteria:
6. Acceptance Criteria:
7. Acceptance Criteria:
8. Source Approved:
Acceptance based upon 'Satisfactory' Test Report for samples of materials to be incorporated into project.
Mfg. Cert. of Compliance for 'Acceptance' prior to use of material.
Catalog Cuts for 'Acceptance' prior to use of material.
Submit Shop Drawings for 'Approval' prior to fabrication of material.
Only 'Approved for Shipment', 'WSDOT Inspected' or 'Fabrication Approved Decal' material shall be used.
Submit Certificate of Materials Origin to Project Engineer Office.
Request Transmitted to State Materials Laboratory for Approval Action.
9. Approval Withheld:
10. Approval Withheld:
11. Miscellaneous Acceptance Criteria.
Remarks:
Submit samples for preliminary evaluation.
Project Engineer Distribution State Materials Engineer Distribution
General FileContractor
DOT Form 350-071 EF
Revised 12/2012
Project Engineer Date State Materials Engineer Date
RAM #
Region Operations Engineer
Region Materials
State Materials Lab
Fabrication Inspection
Signing Inspection
Other
For WSDOT Use Only
M/S 47365
This form 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.
Catalog Cut Approved Yes No
CAG-15-134 STPUL-1131(002)
Logan Ave N - Airport Way to N 6th Street - Project King
Johansen Excavating, Inc.
TA-4951
A86
A87
Traffic Signal Standards Valmont Industries
Valley NB
A86
A87
A86
A87A87
PPB Post
PS Pole
Type I Pole
Valmont Industries
Valley NB
Valmont Industries
Valley NB
Valmont Industries
Valley NB
9-29.6(1)A86,
A87 Load Calculations
Pgs 2-94
Valmont Industries
Valley NB 9-29.6(1)
9-29.6(1)
9-29.6(1)
9-29.6(1)
12/11/2015
A86
A87
Anchor Bolts
Portland Nut and Bolt
Portland OR
QPL
Resubmtl 1/15/2016
This is the resubmittal of RAM 043
043.01
1. All standards shall be fabricated according to dimensions and orientations shown in the Contract.
2. Perteet will notify the WSDOT fabrication inspection office of the material coded above with a "5", which indicates a WSDOT inspection
is required by project TA-4951. For the anchor bolts, the code "5" is applies to the ASTM F1554 Grade 105 anchor bolts.
3. Please use WSDOT form 350-109 when submitting the Certificate of Material Origin.
4. Please include Mill Certifications with the Cert of Compliance for the Traffic Signal Standards.
5. Please submit non-destructive weld test reports for all of the poles.
5, 6
8
2, 5, 6
2, 6, 11
2, 6, 11
2, 6, 11
See comment related to pole quantities and WSDOT standard plans on page 100 of this submittal.
Justin Sencer
02/01/16
The pole bases identified in the callouts on sheets SG1 and SG5 are correct. The Foundation Depth (FT) column
for #10 on SG3 and #4 on SG7 are incorrect—both of these should be “WSDOT STD. J-20.11-02”.
2
2
A86 A87