HomeMy WebLinkAboutLt Poles Luminaires Anchor Bolts (Updated 12-20-17) (002).pdfPE
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 12/2012
9-29.6
Garmire Iron Works
Marysville, WA PPB Poles 3
Request for Approval of Material
Contract Number FA Number SR Date
AVAYA RIDGE KING Contractor Subcontractor
GALA CONSTRUCTION TRANSPORTATION SYSTEMS INC.
11/10/2017
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
assistance In completing , see Instructions and Example
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
1,2 Decorative Light Poles
Philips Lumec
Somerset, NJ 9-29.6
1,2 Luminaires
Philips Lumec
Somerset, NJ 9-29.10(2)
1,2,3 Anchor Bolts
Portland Bolt
Portland, OR 9-06.5(4)
2 40' Light Pole
Hapco
Arlington,VA 9-29.6
Project Engineer 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. Cer 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 EF
10. Approval Withheld:
11. Miscellaneous Acceptance Criteria.
Remarks:
Washington State
Department of Transportation
Garmire IronWorks, Inc.
5620-48th Drive N.E. • Marysville, WA 98270
(360) 651-1001 • Fax (360) 651-1002 • garmireironworks@frontier.com
PPB POST DETAIL
3" Threaded Cap
1/4-20" Tapped Hole
BASE PLATE DETAIL
Plate Size:1/2" ASTM A-36
Base Plate:7"x7" Square
Bolt Circle:6"
3"I.D. Sch40 Steel Pipe
ASTM A500/53-Gr B
All HDG After Fabrication
Per ASTM A123
1/8"
3/16"
5'-0"
(NO SCALE)