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-73000-00013318
- Issued by
- Clatsop County, Oregon
About this file
This document is a Sample Data Sheet from the Oregon Department of Transportation (ODOT) for the US101: Oregon Coast Highway over New Youngs Bay Bridge Rehabilitation Project (Contract No. BR08306). The sample data sheet relates to bridge deck core samples, with 16 total cores collected (1 core per bag), specifically 4" x 6" in size. The document specifies testing requirements, including 4 cores to be tested for compression and 12 cores to be tested for chloride content, with specific instructions for chloride testing that involve cutting and examining core sections at 1/2" increments.
The sample is being processed by the ODOT Bridge Preservation Unit located in Salem, Oregon, with Jason Rice from the Bridge Section - Preservation Engineering serving as the project contact. The sample is classified under the contract number 22BRAI-021-P51, and the testing will follow AASHTO T-260 and ASTM C39 standards. The document provides detailed contact information, including a phone number (503-798-7506) and an email address (Jason.J.RICE@odot.oregon.gov) for further communication about the project and sample testing.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Att D_BR08306 Plan View Sheet.pdf | ||
| 00012966_RFCQ~2.doc | DOC document | |
| Att E_BR20060 Plan View Sheet.pdf | ||
| 00012966_Sample Contract~2.docx | DOCX document | |
| Att A_Coring Plan.pdf | ||
| Att B_Blank Core Log form.pdf | ||
| Att C_Example Core Log.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 .