Att F_Material Lab Submit Form.pdf
PDF 224 KB Posted
- Attached to
- RFCQ - BR08306 and BR20060 Deck Testing State and local contract opportunity
- Solicitation number
- S-73000-00012966
- Issued by
- Clackamas County, Oregon
About this file
This document is a Sample Data Sheet from the Oregon Department of Transportation (ODOT) Bridge Preservation Unit for a highway project involving bridge deck core samples. The project, identified as US101: Oregon Coast Highway over New Youngs Bay (Contract BR08306), involves collecting sixteen 4" x 6" bridge deck cores, with one core per bag. The samples are being submitted for specific testing protocols, including 4 cores for compression testing and 12 cores for chloride content testing, with detailed instructions for sample preparation and analysis.
The document provides technical details for laboratory testing, including specific instructions for handling chloride content samples, such as discarding the top 1/4" and cutting sections at 1/2" increments for testing. The sample submission is associated with contract number 22BRAI-021-P51, and the primary contact is Jason Rice from the ODOT Bridge Section - Preservation Engineering, located in Salem, Oregon. The form follows AASHTO T-260 / ASTM C39 testing standards and includes comprehensive tracking information for sample identification, source, and testing requirements.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 00012966_Sample Contract~2.docx | DOCX document | |
| Att D_BR08306 Plan View Sheet.pdf | ||
| Att E_BR20060 Plan View Sheet.pdf | ||
| 00012966_RFCQ~2.doc | DOC document | |
| Att A_Coring Plan.pdf | ||
| Att C_Example Core Log.pdf | ||
| Att B_Blank Core Log form.pdf |
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Text version
F - -
COMPLETE THIS SECTION FOR ALL SAMPLES
* CLASS OF SAMPLE
QUALITY CONTROL VERIFICATION THIRD PARTY
SOURCE/PRODUCT COMPLIANCE x OTHER (SPECIFY IN REMARKS)
* Required information. If information is missing, testing will be delayed.
** Additional information required for Asphalt Cement samples.
CREW NUMBER
* MATERIAL (DESCRIPTION, SIZE, GRADE, BRAND)
PROJECT NAME (SECTION)
PROJECT MANAGER
NUMBER OF SAMPLES (BAGS, BOXES, OTHER) QUANTITY REPRESENTED BY SAMPLE
~4" x 6" Bridge Deck Cores
One Data Sheet Per Asphalt Cement Type or Aggregate Size
SIGNATURE
AASHTO T-260 / ASTM C39
US101: Oregon Coast Highway over New Youngs Bay (BR08306)
C0NTRACTOR OR SUPPLIER
STREET ADDRESS
ODOT Bridge Preservation Unit
DATE SHIPPED
DATE SAMPLED
4040 Fairview Industrial Drive SE, MS#4
CREW NUMBER
LABORATORY REPORT NUMBER
SAMPLE DATA SHEET
SAMPLE NUMBER
CONTRACT NUMBER
* USE OF MATERIAL
Salem, OR 97302 503-798-7506
* FIELD TESTED OR SUBMITTED BY (PRINT NAME)
Jason Rice
ODOT Bridge Section - Preservation Engineering
BR08306 Deck See Core Tags
* PHONE NUMBER
COMPANY NAME
* SOURCE OF MATERIAL (MANUFACTURER, SUPPLIER, OR SOURCE NO. & NAME FOR NATURAL MATERIALS) SAMPLED AT (LOCATION OR STATION NUMBERS)
** Lot & Sublot ** Date
* CONTACT PHONE NUMBER
REMARKS / SPECIAL REQUIREMENTS
1 core per bag16
CITY, STATE AND ZIP CODE
ASPHALT CEMENT
Note:
BID ITEM NUMBER
* PROJECT CONTACT PERSON
Jason Rice
22BRAI-021-P51
* CON NO. & EA * DATA SHEET NUMBER
Test 4 cores for compression.
Test 12 cores for chloride content.
For samples for chloride test:
Cut off top 1/4" and discard. Cut sections at 1/2" increments and test as many as can safely be cut.
Please use "Project Name (Section)" field on this form for "Project Title" on online Lab Reports
Jason.J.RICE@odot.oregon.gov
734-4000 (10-2008)
File details come from the government source that posted it. Updated .