APPENDIX_B-_Materials_accepted_by_certificate.pdf

California Department of Transportation Construction Manual September 2019

Page 6-2.26 Acceptance of Manufactured or Fabricated Materials and Products

Table 6-2.3. Materials Accepted by Certificate of Compliance (1 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Alternative earth retaining systems

Must state that the supplied material complies with the index criteria for the system at the time of prequalification.

Asphalt

Certificates of compliance must include the following:

1. Name and location of the supplier.

2. Grade of the asphalt.

3. The date and time of shipment.

4. A unique shipment number, such as a bill of lading number or manifest number.

5. A statement confirming that the transport vehicle was checked before loading and was found acceptable for the asphalt shipped.

6. The following wording: " (Supplier name) hereby certifies that the asphalt product accompanying this certification was produced in accordance with the California Department of Transportation's Certification Program for Suppliers of Asphalt, and that this product complies in all respects with the requirements of the applicable specifications for the asphalt product identified on this document.

I hereby certify by my signature that I have the authority to represent the supplier providing the accompanying asphalt product."

Asphaltic emulsion

Certificate of compliance must include the following:

1. Shipment number and shipment date.

2. Source refinery, consignee, and destination.

3. Type and description of material with specific gravity and quantity.

4. Contract or purchase order number.

5. Signature by the manufacturer of the material and a statement that the material complies with the contract.

Asbestos cement pipe

Asbestos sheet packing

Asphalt modifier Test results required with each truckload.

Asphalt rubber joint sealant A certified test report of the results for the required tests performed within 12 months before the proposed use.

Backer rods Must include manufacturer’s statement of compatibility with the joint sealant to be used.

Barbed wire

Acceptance of Manufactured or Fabricated Materials and Products Page 6-2.27

Table 6-2.3. Materials Accepted by Certificate of Compliance (2 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Blast cleaning material

Bonding agent for repairing spalled surface area

Submittal of certificate of compliance required for contracts of less than 60 working days.

Bonding material

Brick

Cable-type restrainers

Lock nuts

Certificate of compliance must be submitted with a copy of each required test report.

Cast iron pipe

Cast iron maintenance access rings and covers

Chemical adhesive for bonding tie bars and dowel bars in concrete pavement

Chemical adhesive for structures

Certificate of compliance must state compliance with ICBO AC58 and Caltrans. Augmentation/Revisions to ICBO AC58.

Concrete

Admixture

Certificate of compliance from the manufacturer must certify that the admixture furnished is the same as that previously authorized for the Authorized Material List.

Concrete

Cementitious material

Certificate of compliance must include the source name and location.

If the cementitious material is delivered directly to the job site, the certificate of compliance must be signed by the cementitious material supplier.

If the cementitious material is used in ready-mixed concrete, the certificate of compliance must be signed by the concrete manufacturer.

If blended cement is used, the certificate of compliance must include a statement signed by the blended cement supplier that shows the actual percentage of supplementary cementitious material, by weight, in the blend.

Concrete

Curing compound

Certificate of compliance must include:

1. Test results for the tests specified in Section 90-1.01D(6), “Curing Compound,” of the Standard Specifications.

2. Certification that the material was tested within 12 months before use.

Page 6-2.28 Acceptance of Manufactured or Fabricated Materials and Products

Table 6-2.3. Materials Accepted by Certificate of Compliance (3 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Concrete

Minor concrete

Before placing minor concrete from a source not previously used on the contract, a certificate of compliance stating that the minor concrete to be furnished complies with the contract requirements, including the specified minimum cementitious material content.

Ceramic tile

Chain link fencing and railing Certificate required for protective coating system.

Concrete anchorage devices

Concrete pipe

Circular reinforced direct design method, less than 60 inches in diameter

Certificate of compliance must:

1. Be signed by the manufacturer's quality control representative.

2. State that all materials and work quality comply with the specifications and authorized shop drawings.

Copper pipe

Corrugated metal pipe

Crack sealant

Certificate of compliance must include:

1. Manufacturer's name

2. Production location

3. Product brand or trade name

4. Product designation

5. Batch or lot number

6. Crack treatment material type

7. Contractor or subcontractor name

8. Contract number

9. Lot size

10. Shipment date

11. Manufacturer's signature

Crash cushions

Crumb rubber modifier Test results required with each truckload.

Culvert markers

Delineators

Certificate of compliance required for:

• Metal target plates

• Enamel coating

• Retroreflective sheeting

Acceptance of Manufactured or Fabricated Materials and Products Page 6-2.29

Table 6-2.3. Materials Accepted by Certificate of Compliance (4 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Dowel bar baskets

Drop inlet grates and frames

Drain tile

Drip irrigation line

Elastomeric bearing pads

Plain

Certified test results for the elastomer.

METS samples and tests bearing pads.

Elastomeric bearing pads

Steel-reinforced

Certified test results.

METS samples and tests bearing pads.

Electrical

Battery backup system

Certificates of compliance are required for:

• External cabinet

• Batteries

Electrical

Conductor

Conduit (galvanized and plastic)

Equipment

Pull boxes (concrete and plastic)

Service cabinets

Epoxy

Epoxy powder coating for dowel bars and tie bars

METS samples and tests epoxy coating.

Erosion control

Certificate of compliance is required for:

• Straw

• Fiber

• Rolled erosion control product

• Fasteners

Page 6-2.30 Acceptance of Manufactured or Fabricated Materials and Products

Table 6-2.3. Materials Accepted by Certificate of Compliance (5 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Erosion control (continued)

Certificate of compliance with attachments is required for:

• Tackifier

• Bonded fiber matrix

Polymer-stabilized fiber matrix

Certificates of compliance attachments include:

1. Safety data sheet

2. Product label

3. List of applicable, nonvisible pollutant indicators for soil amendment and stabilization products as shown in the table "Pollutant Testing Guidance Table" in the Caltrans Construction Site Monitoring Program Guidance Manual

4. Report of acute and chronic toxicity tests on aquatic organisms conforming to EPA methods

5. List of ingredients, including chemical formulation

6. Properties of polyacrylamide in tackifier including: (1) percent purity by weight, (2) percent active content, (3) average molecular weight, and (4) charge density.

Expansion joint filler

Fiberglass pipe Certificate of compliance must be submitted with laboratory test results.

Filler material for repairing spalled surface areas

Submittal of certificate of compliance required for contracts of less than

60 working days.

Gabions If PVC coating is shown, a suitable UV resistant additive must be blended with the PVC and the additive must be shown on the certificate of compliance.

Geocomposite drain Certificate of compliance must certify that the drain produces the specified flow rate. The certificate must be accompanied by a flow capability graph for the geocomposite drain showing flow rates and the externally applied pressures and hydraulic gradients.

Verification must be by an authorized laboratory for the flow capability graph.

Geosynthetics Test sample representing each lot and minimum average roll value.

Acceptance of Manufactured or Fabricated Materials and Products Page 6-2.31

Table 6-2.3. Materials Accepted by Certificate of Compliance (6 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Glass beads Certificate of compliance by lot or batch and test data from an independent laboratory.

Glue laminated timbers and decking

Guide markers

Irrigation hose

Irrigation pipe Certificate of compliance required for:

• Polyethylene pipe

Plastic pipe supply line for pipe with wall thickness of the bell less than the specified minimum wall thickness of the pipe

Joint filler material

Joint seals (Type A and

AL)

Certified test report for each batch of sealant.

Joint seal (Type B) Certificate of compliance required for:

• Elastomeric joint seal

• Lubricant-adhesive

Certificate of compliance must be submitted with certified test report for each lot of elastomeric joint seal and lubricant-adhesive.

Test reports must include the seal movement rating, the manufacturer's minimum uncompressed width, and test results.

METS samples and tests joint seal.

Joint seal

Alternate joint seal assemblies

For alternative joint seal assemblies, a certificate of compliance must be submitted for each shipment of joint seal materials. The certificate must state that the materials and fabrication involved comply with the specifications and the data submitted in obtaining the authorization for the alternative joint seal assembly.

METS samples and tests joint seal assemblies.

Joint seal

Joint seal assemblies METS samples and tests joint seal assemblies.

Lime Certificate of compliance must include a statement certifying the lime furnished is the same as on the Authorized Material List.

Page 6-2.32 Acceptance of Manufactured or Fabricated Materials and Products

Table 6-2.3. Materials Accepted by Certificate of Compliance (7 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Machine spiral wound PVC pipeliners

Certificate of compliance for each reel of PVC strip must include:

1. Name of manufacturer

2. Plant location

3. Date of manufacture and shift

4. Cell classification

5. Unit mass

6. Average pipeliner stiffness and profile type

Markers

Certificate of compliance required for:

• Metal target plates

• Enamel coating

• Retroreflective sheeting

Masonry block

Certificate of compliance required for:

• Concrete masonry units

• Aggregate for grout

• Grout

Micro surfacing emulsion

Mulch

Open steel flooring and grating

Overside drains Certificate of compliance based on steel materials, aluminum materials or plastic materials.

Parking area seal material

Pavement markers

Plastic lumber Certificate of compliance for each shipment of plastic lumber, that must be accompanied by a laboratory test report.

Plastic traffic drums

Plastic pipe for drainage

Certificate of compliance must include average pipe stiffness, resin material cell classification, and date of manufacture.

For corrugated polyethylene pipe, manufacturer’s copy of plant audits and test results from the National Transportation Products Evaluation Program for the current cycle of testing for each pipe diameter furnished.

Acceptance of Manufactured or Fabricated Materials and Products Page 6-2.33

Table 6-2.3. Materials Accepted by Certificate of Compliance (8 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Portable changeable message sign

Precast concrete

Cementitious material used in precast concrete products

Certificate of compliance must be signed by the precast concrete product manufacturer.

Precast concrete

Box culverts

Certificate of compliance must signed by the manufacturer's quality control representative for each shipment.

Precast concrete members

Certificate of compliance is for materials incorporated in the work, and for testing and inspections that have been performed.

Precast raised traffic bars

Preformed compression seal for concrete pavement

Preformed membrane sheet

Must include type of sheet and the conditioner or primer application rates.

PTFE bearing materials

Rapid strength concrete

Certificate of compliance is required for each delivery of aggregate, cementitious material, and admixtures used for calibration tests.

The certificate of compliance must state that the source of the materials used for the calibration tests is the same source as to be used for the planned work.

Reinforcement

You may request that the contractor submits with certificate of compliance:

1. Copy of the certified mill test report for each heat and size of reinforcing steel showing physical and chemical analysis.

2. Two copies of a list of all reinforcement before starting reinforcement placement.

Reinforcement

Epoxy-coated

Certificate of compliance for each shipment of epoxy-coated reinforcement must be submitted with:

1. Certification that the coated reinforcement complies with ASTM

A 775/A 775M for bar reinforcement or ASTM A 884/A 884M, Class A, Type 1, for wire reinforcement.

2. All certifications specified in ASTM A 775/A 775M for bar reinforcement or ASTM A 884/A 884M for wire reinforcement.

METS samples and tests epoxy coating.

Page 6-2.34 Acceptance of Manufactured or Fabricated Materials and Products

Table 6-2.3. Materials Accepted by Certificate of Compliance (9 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Reinforcement

Epoxy-coated prefabricated reinforcement

Certificate of compliance for each shipment of epoxy-coated prefabricated reinforcement must be submitted with:

1. Certification that the coated reinforcement complies with ASTM A 934/A 934M for bar reinforcement or ASTM A 884/A 884M Class A, Type 2 for wire reinforcement.

2. All certifications specified in ASTM A 934/A 934M for bar reinforcement or ASTM A 884/A 884M for wire reinforcement.

METS samples and tests epoxy coating.

Reinforcement

Epoxy-coating patching materials

Certificate of compliance for the patching material must include certification that the patching material is compatible with the epoxy powder to be used.

Reinforcement

Headed bar

Certificate of compliance for each shipment of headed bar reinforcement must be submitted with:

1. Mill test reports for the:

1.1. Bar reinforcement

1.2. Head material

2. Production test reports

3. Daily production logs

METS samples and tests headed bar.

Reinforcement

Splice material

Certificate of compliance for each shipment of splice material must be submitted with:

1. Type or series identification of the splice material, including tracking information for traceability.

2. Grade and size number of reinforcement to be spliced.

3. Statement that the splice material complies with the type of mechanical splice on the Authorized Material List.

4. For resistance-butt-welded material:

4.1. Heat number

4.2. Lot number

4.3. Mill certificates

METS samples and tests reinforcement splices.

Sheet metal

Acceptance of Manufactured or Fabricated Materials and Products Page 6-2.35

Table 6-2.3. Materials Accepted by Certificate of Compliance (10 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Sign panels

Certificates of compliance required for:

• Aluminum sheeting

• Retroreflective sheeting

• Screened-process colors

• Nonreflective, opaque, black film

• Protective-overlay film

Silicone joint sealant

A certified test report of the results for the required tests performed within

12 months before the proposed use.

Slotted edge drain

Snow poles

Snow plow deflectors polyethylene material

Soil amendment

Steel crib wall

Steel pipe piles

The certificate of compliance must be signed by the plant's quality control representative. The quality control representative must be on record with Structural Materials. Certificate of compliance must include:

1. Statement that all materials incorporated in the work and all required tests and inspections of this work have been performed as described.

2. Certified mill test reports for each heat number of steel used in pipe piles being furnished.

3. Test reports for tensile, chemical, and any specified nondestructive test must be based on test samples taken from the base metal, steel, coil, or from the manufactured or fabricated piles.

4. Calculated carbon equivalent. The carbon equivalent may be shown on the mill test report.

Structural plate culverts

Certificate of compliance required for:

• Structural metal plate pipe

• Arches

• Pipe arches Metal liner plate pipe

Page 6-2.36 Acceptance of Manufactured or Fabricated Materials and Products

Table 6-2.3. Materials Accepted by Certificate of Compliance (11 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Structural shape steel piles Certificate of compliance must include a statement that all materials incorporated in the work and all required tests and inspections of this work have been performed as described.

Structural composite lumber used in falsework

Structural steel thermal spray coat

Wire feedstock

Styrofoam filler

Subsurface drain

Temporary concrete washout

Certificate of compliance required for:

• Gravel-filled bag

• Plastic liner

Temporary fence (Type

ESA)

Certificate of compliance required for:

• High visibility fabric

• Safety caps for metal posts

Temporary linear sediment barrier

Certificate of compliance required for:

• Fiber roll

• Safety cap for metal posts

• Silt fence fabric

• Sediment filter bag

• Foam barrier

• Gravel-filled bag fabric

Temporary railing (Type K)

Thermoplastic traffic stripes and pavement markings

Certificate of compliance by lot of batch and test data report from an independent laboratory.

Obtain a minimum 1-foot length of stripe test sample.

Tie bars METS samples and tests epoxy coating.

Tie bar baskets METS samples and tests epoxy coating.

Timber products (treated and untreated)

Certificate of compliance for timber and lumber must state the species of the material to be shipped and include a certified grading report. If treated, certified treating report.

Threaded tie bar splice couplers

Table 6-2.3. Materials Accepted by Certificate of Compliance (12 of 12)

Material/Product Remarks (Including Requirements for Additional Backup

Information Required with Certificate of Compliance)

Turf sod

Two-component paint traffic stripes and pavement markings

Certificate of compliance by lot or batch. Obtain a 50-foot test section before application of paint.

Underdrains

Certificate of compliance required for:

• Type of pipe

• Tubing

• Fitting

Waterproofing fabric

Waterstop Certificate of compliance for waterstop material must state compliance with paragraph 6 of Army Corps of Engineers CRD-C 572.

Welded wire fabric

Wire mesh fencing

Wood Structures

Certificate of compliance for timber and lumber stating the species of the material to be shipped and including a certified grading report. If timber is treated, include a certified treating report.

Certificate of compliance for glued laminated timbers and decking.

SAMPLE

Sample Certificate of Compliance

COMPANY LETTERHEAD

CERTIFICATE OF COMPLIANCE

For Contract ___________________

I certify that the material listed below complies with the material and workmanship requirements of the Caltrans Contract Plans, Special Provisions, Standard Specifications and Standard Plans for the contract listed above.

I also certify that I am an official representative for __________________, the manufacturer of the material listed below. Furthermore, I certify that where California Test methods, physical, or chemical test requirements are part of the specifications, that the manufacturer has performed the necessary quality control to substantiate this certification.

Material Description:

Manufacturer: ____________________________

Model: _________________________________

Serial Number (if applicable): ________________________

Quantity to be supplied: ____________________________

Remarks: ______________________________________________________

Signed by: __________________________

Printed Name: ________________________

Title: ______________________________

Company: __________________________

Date: ______________________________