2009 Forms Booklet Final Version - Ohio Department of ...



State of OhioDepartment of Transportation~Construction Inspection Forms~7/17/2009Ohio Department of TransportationDivision of Construction Management1980 W. Broad StreetColumbus, Ohio 43223Phone: (614) 466-3598Web Address: WWW.DOT.STATE.OH.US Construction Inspection Documentation FormsIntroductionThe Ohio Department of Transportation is devoted to maintaining high levels of project inspection and documentation across the State. The forms and instructions contained herein are provided to project personnel to assist in the proper determination of compliance with the provisions of the contract, the measurement of quantities for payment, and the documentation of compliance and measurements. In no instance does this document alter the provisions of the contract.These procedures will be used to provide a uniform and fair basis of operations wherever the Ohio Department of Transportation provides supervision or engineering services for the acquisition, construction, or maintenance of materials or services. This is not a contract document, and is not to be construed in any way to obligate the Ohio Department of Transportation to perform any duties. These forms should be used in conjunction with the Construction Inspection Manual of Procedures.Reference DocumentsDocuments normally used for detailed interpretation of substantiation requirements, practices, and test methods are:Ohio Manual of Uniform Traffic Control DevicesSampling and Testing Manual, Testing Administration ManualTraffic Engineering ManualConstruction Inspection Manual of ProceduresOther documents may also be used as they are developed and published.More testing forms (those beginning with TE) can be found online here: are permitted to customize forms as long as all of the data listed on the standard forms published here is also included on the modified forms.Many of these forms are available in Excel format with automated calculation fields. They can be found online here: CodesThe following instructions, grouped by measurement type, supplement the general instructions and have particular application to specific pay items. Match the Instruction Code listed in the Index of Pay Items tables (starting on page 4) to the following Instruction Codes to determine specific documentation requirements. Special and unlisted pay items will be documented using the guidelines outlined in the Construction Inspection Manual of Procedures.Instruction CodeDescriptionConversion Type MeasurementsC-1Summarize the final weight to nearest ton (metric ton) from validated weight tickets and determine the final volume to the nearest cubic yard (cubic meter) by using conversion factor.C-2Summarize and convert to nearest ton (metric ton) for the final quantity by conversion from validated tickets. Convert sack and brine shipments to weight as specified.C-3Summarize the final quantity to nearest cubic yard (cubic meter) by conversion from validated weight tickets. Include a daily coordination of weight tickets with placement and location. Where there is a moisture limitation, at least one moisture test must be made (more if necessary) to provide for an appropriate deduction.C-4Determine volume to nearest gallon (liter) by conversion from validated weight tickets. Where source validation is missing, or for partial loads, determine volume by conversion from weigh-back or by measurement of tank. Where basic measurement is by volume, record temperature.C-5Determine the final quantity to nearest cubic yard (cubic meter) from plan quantity adjusted for errors and changes. Use for new construction on new subgrade. For variable thickness or resurfacing determine quantity to nearest cubic yard (cubic meter) by conversion from validated weight tickets.C-6For direct volume measurements determine volume to nearest cubic yard (cubic meter) from cross-sections before and after removal. For converted volume measurements, summarize validated weight tickets and convert to nearest cubic yard (cubic meter) using density tests as basis for conversion. Adjust measured quantity by deducting embankment in excess of allowable tolerances, if any, in accordance with the Earthwork Construction section of this manual.C-7Determine the area by field measurement to nearest square yard (square meter). Substantiate rates of application by means of at least one test area made at time of application. Determine rate of application on test area by calculation from verified quantities of material placed and measured in the area over which it is applied. For seeding and mulching, record number of square yards (square meters) having substantiated rates of application.Volume Type MeasurementsV-1Determine volume to nearest cubic yard (cubic meter) using recorded verified plan dimensions, which include a verification of depth and thickness.V-2Record verified plan dimensions of the forms and calculate the volume of each unit. Summarize the final quantity to the nearest cubic yard (cubic meter) or decimal as indicated by the estimated bid quantity (Ref. No.).V-3Determine the volume before removal or determine the volume from verified plan dimensions to the nearest cubic yard (cubic meter).V-4Plan quantity must be paid as per specification 203.09. Any plan changes must be documented using cross-sections per C-6 or measurements per V-1.V-5Determine the volume loose in a vehicle at the point of delivery and summarize to the nearest cubic yard (cubic meter).V-6Determine the volume to the nearest cubic yard (cubic meter) using specified dimensions and vertical measurements between bottom plane of footing and top of rock or shale excavation.V-7Determine the volume to the nearest cubic yard (cubic meter) from summarization of validated delivery tickets. Tickets must record cubic yard (cubic meter) from predetermined tank size or sizes, converted weight, or meter readings. Tickets for each load must be issued by the contractor and must be collected, identified, and validated by the inspector at the point of delivery.V-8Determine the volume to the nearest cubic yard (cubic meter) by using horizontal dimensions established by 503.10 of the specifications.Weight Type MeasurementsW-1Summarize the weight to the nearest 100 pounds (50 kilograms) by using validated scale weight tickets or weights calculated from the verified dimensions and steel handbook.W-2Obtain a copy of a memorandum from the Office of Structural Engineering for approved pay weights. See structural steel screen on CMS (SSREF).W-3Summarize the validated delivery tickets to the nearest ton (metric ton). Determine the volume of the embankment, if any, in excess of the allowable tolerances, convert to tons (metric tons), and deduct from the summarized weight.W-4Summarize to the nearest ton (metric ton) from the validated weight tickets.W-5Summarize to the nearest pound (kilogram) from the validated weight tickets.Linear Type MeasurementsL-1Measure the length of the item and summarize to the nearest foot (meter).L-2Measure the length of an item to the nearest foot (meter), include data as to its re-use and storage.L-3Measure the length of the item to the nearest 1/100th mile (1/100 kilometer, e.g. 19.98 kilometer), etc.L-4Measure the length to the nearest 0.1 ft (0.1 meter, e.g. 14.8 meter), etc.L-5Guardrail quantities are normally determined in standard 12 feet 6 inch (3.81 meter) panel lengths with adjustments for end assemblies, in multiples of 6.25 feet (1.905 meter).L-6Measure the length of an item to the nearest 1/100th mile (1/100 kilometer, e.g. 19.98 kilometer), etc. and include deficiency data as per the specifications.L-7Measure the length of piles between extreme point and cut-off to the nearest 0.1 ft (25 millimeters). Measure the inside of cast-in-place piles and make a conformance statement relative to the measurement and length marks. Summarize the measurements to the nearest foot (meter). Locate the piles by use of the numbering system on the piling layout.L-8For items 603 and 605 measure the length of the item and round up to the next foot (0.5 meter).Area Type MeasurementsA-1Measure the surface dimensions of the item, calculate the area, and summarize to the nearest square yard (square meter).A-2Adjust the plan area for changes, errors, and deviations in excess of the allowable tolerances, and summarize to the nearest square yard (square meter).A-3Determine the specified plan areas of each size and type from verified shop drawings and summarize to the nearest 1/10 square yard (1/10 square meter).A-4Plan quantity as per specification 659.24. Check application rates and deduct area if the application rates are below specifications for seed, mulch, and emulsion.Unit (each) Type MeasurementsU-1Determine the number of units.U-2Determine the number of units visible on completion and make a statement relative to the conformance with the contract requirements.U-3Determine the number of units and include the data as to reuse or storage or disposal by Contractor.Lump Sum Type MeasurementsLS-1Verify that the work is in accordance with the plans.LS-2Record driving log of first test pile or the results of the test loads and locate by use of the numbering system on the piling layout.Miscellaneous Type MeasurementsM-1Summarize the final rolling time to the nearest hour. Include the data on weight and tire pressure.Index of Pay Items for the Construction Inspection FormsEarthwork (200)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS201Clearing and Grubbing201trees or stumps removed, _____ size eachU-1CA-D-1A/1B or 3201clearing and grubbinglumpLS-1CA-D-3202Removal of Structures and Obstructions202structures removedlumpLS-1CA-D-3202portions of structures removedportions of structures removedportions of structures removedlump1 yd3100 poundLS-1V-3W-1CA-D-3CA-D-1A/1B weightX202pipe removed for reuse or storage1 footL-2CA-D-1A/1B or 3202pipe removed1 footL-1CA-D-1A/1B or 3202pavement removed0.1 yd2A-1CA-D-1A/1B 202wearing course removed0.1 yd2A-1CA-D-1A/1B 202base removed0.1 yd2A-1CA-D-1A/1B 202walk removed0.1 yd2A-1CA-D-1A/1B 202steps removedlumpLS-1CA-D-3202curb removed1 footL-1CA-D-1A/1B or 3202curb and gutter removed1 footL-1CA-D-1A/1B or 3202gutter removedgutter removed1 foot0.1 yd2L-1A-1CA-D-1A/1B or 3CA-D-1A/1B 202curb removed for storage1 footL-2CA-D-1A/1B or 3202precast traffic dividers removed for re-use and storageeachU-3CA-D-1A/1B or 3202buildings demolishedlumpLS-1CA-D-3202underground storage tank removedeachU-1CA-D-3 202regulated storage tank removedeachU-1CA-D-3 202septic tank removedeachU-1CA-D-3202privy vault removedeachU-1CA-D-3202guardrail removed1 footL-1CA-D-2 or 3 202guardrail removed for re-use or storage1 footL-2CA-D-2 or 3202fence removed for re-use or storage1 footL-2CA-D-2 or 3202rpm’s removed for disposal by contractoreachU-3CA-D-2 or 3202manhole removedeachU-1CA-D-3202manhole abandonedeachU-1CA-D-3202catch basin of inlet removedeachU-1CA-D-3202catch basin or inlet abandonedeachU-1CA-D-3203Roadway Excavation and Embankment203excavation 1 yd3V-4CA-EW-1CA-D-3203embankment1 yd3V-4CA-EW-1CA-D-3203granular embankment1 yd3V-4CA-EW-1XCA-D-3203granular material, type-__1 yd3V-4CA-EW-1XCA-D-3203borrow1 yd3C-6X-SEC’Sborrow1 tonW-3WEIGHT204Subgrade Compaction and Proof Rolling204subgrade compaction1 yd2A-2CA-D-1A/1B 204proof rolling0.1 hourM-1CA-EW-2204excavation of subgrade1 yd3V-4CA-EW-8CA-D-3204embankment1 yd3V-4CA-EW-8XCA-D-3204granular embankment1 yd3V-4CA-EW-8XCA-D-3204granular material, type-__1 yd3V-4CA-EW-8XCA-D-3204geotextile fabric1 yd2 A-2CA-D-3205Lime Modified SoilCA-EW-8205lime modified soil-dry method1 yd3V-1CA-D-1A/1B CA-EW-1205lime modified soil-wet method1 yd3V-1CA-D-1A/1B CA-EW-1205Contractor designed lime soilLumpLS-1CA-D-3A205lime0.1 tonW-4WEIGHTX205water0.1 m galV-7CA-D-1 and 2206Lime Stabilized Subgrade206lime soil stabilized subgrade0.1 yd2A-1CA-D-1A/1B 206Contractor designed lime soilLumpLS-1CA-D-3A206lime0.1 ton W-4WEIGHTX206water0.1 m galV-7CA-D-1 and 2206Test rolling0.1 hourM-1CA-EW-2804Cement Stabilized Subgrade804Cement stabilized subgrade0.1 yd2A-1CA-D-1A/1B 804Cement0.1 tonW-4WeightX804Test rolling0.1 hourM-1CA-EW-2804Contractor designed cement soilLumpLS-1CA-D-3A207Temporary Erosion Control207construction seeding and mulching1 yd2C-7A-1CA-EC-2207slope drains1 footL-1CA-D-3207benches, dams, sediment basin1 yd3V-1CA-D-1A/1B 207straw or hay baleseachU-1CA-D-3207filter fabric fence1 footL-1CA-D-3207temporary dikes1 yd3V-1CA-D-1A/1B 207Construction ditch protection1 yd2A-1CA-D-1A/1B 207rock channel protection1 yd3V-1CA-D-1A/1B 207sediment removal1 yd3V-1CA-D-1A/1B 207filter fabric ditch check1 footL-1CA-D-3207sediment basins and dams1 yd3V-1CA-D-1A/1B 207bale filter dike1 footL-1CA-D-3207inlet protection1 footL-1CA-D-3207construction fence1 footL-1CA-D-3208Rock Blasting208pre-splitting1 yd2A-1CA-D-1 and 2 208pre-blast condition surveylump sumLS-1CA-D-3208Scaling0.5 hr.M-1CA-D-3208blasting consultantlump sumLS-1CA-D-3208airblast and noise controllump sumLS-1CA-D-3208vibration control and monitoringlump sumLS-1CA-D-3208Hydrologistlump sumLS-1CA-D-3Pavement Repairs (250)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS251Partial Depth Pavement Repair251partial depth pavement repair0.1 yd2A-1CA-D-6252Full Depth Rigid Pavement Removal and Flexible Replacement252full depth rigid pavement removal and flexible replacement0.1 yd2A-1CA-D-6252full depth pavement sawing0.1 footL-1CA-D-6253Pavement Repair253pavement repairpavement repair0.1 yd20.1 yd3A-1V-1CA-D-6CA-D-6254Pavement Planing254pavement planing, bituminous0.1 yd2A-1CA-D-1A/1B 254pavement planing, concrete0.1 yd2A-1CA-D-1A/1B 254patching planed surfaces0.1 yd2A-1CA-D-1A/1B 255Full Depth Pavement Removal and Rigid Replacement255full depth pavement removal and rigid replacement, class ______0.1 yd2A-1CA-D-6255full depth pavement sawing0.1 footL-1CA-D-6256Bonded Patching of Portland Cement Concrete Pavement256bonded patching of Portland cement conc., type __0.1 ft2A-1CA-D-6 Bases (300)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS301Asphalt Concrete Base301bituminous aggregate base0.1 yd3C-5CA-D-1A/1B CA-FP-3, 4, and 5X302Asphalt Concrete Base302asphalt concrete base0.1 yd3C-5CA-D-1A/1B CA-FP-3, 4, and 5X304Aggregate Base304aggregate base0.1 yd3V-1C-5CA-D-1 and 2 X305Portland Cement Concrete Base305concrete base0.1 yd2A-2CA-D-1A/1B 320Rubblize and Roll320rubblize and roll0.1 yd2A-1CA-D-3 320filler aggregate0.1 yd3V-1CA-D-3 321Cracking and Seating Existing Plain Concrete Pavement321cracking and seating existing plain concrete pavement0.1 yd2A-1CA-D-1A/1B Flexible Pavement (400)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS407Tack Coat407tack coat1 gallonC-4CA-FP-6X407tack coat for intermediate course1 gallonC-4CA-FP-6X408Prime Coat408bituminous prime coat1 gallonC-4CA-FP-6X409Sawing and Sealing Asphalt Concrete Pavement Joints409Saw and seal asphalt joints 0.1 ftL-4CA-D-1A/1B X410Traffic Compacted Surface410traffic compacted surface type a or b0.1 yd30.1 tonC-3W-4CA-D-1A/1B WEIGHTXX410traffic compacted surface type c0.1 yd30.1 ton C-3W-4CA-D-1A/1B WEIGHTXX411Stabilized Crushed Aggregate411stabilized crushed aggregate0.1 yd3C-5CA-D-1A/1B X421Microsurfacing421microsurfacing, surface course0.1 yd2A-1CA-D-1A/1B 421microsurfacing, leveling course0.1 yd2A-1CA-D-1A/1B 421microsurfacing, rut fill course0.1 tonW-4CA-D-1A/1B X422Chip Seal with Polymer Binder422single chip seal with polymer binder0.1 yd2A-1CA-D-1A/1B, CA-D-2 422double chip seal with polymer binder0.1 yd2A-1CA-D-1A/1B, CA-D-2 423Crack Sealing, Hot Applied423crack sealing1 poundW-5CA-D-1A/1B X442SuperPave Asphalt Concrete442asphalt concrete, intermediate course, __ mm, type __0.1 yd3C-5CA-D-1A/1B CA-FP-3 and 4X442asphalt concrete, surface course, __ mm, type __0.1 yd3C-5CA-D-1A/1B CA-FP-3 and 4X446Asphalt Concrete446asphalt concrete, intermediate course type_0.1 yd3C-5CA-D-1A/1B CA-FP-3 and 4, TE 217X446asphalt concrete, surface course type_0.1 yd3C-5CA-D-1A/1B CA-FP-3 and 4, TE 217X448Asphalt Concrete448asphalt concrete, intermediate. course type_0.1 yd3C-5CA-D-1A/1B CA-FP-3 and 4X448asphalt concrete, surface course type_0.1 yd3C-5CA-D-1A/1BCA-FP-3 and 4XRigid Pavement (450)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS451Reinforced Portland Cement Concrete Pavement451reinforced concrete pavement0.1 yd2A-2CA-D-3A, CA-D-9 452Non-Reinforced Portland Cement Concrete Pavement452plain concrete pavement0.1 yd2A-2CA-D-3A, CA-D-9 Structures (500)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS502Structures for Maintaining Traffic502temporary structureslump sumLS-1CA-D-3503Excavation for Structures503cofferdams, cribs, and sheetinglump sumLS-1CA-D-3503unclassified excavation1 yd3V-8CA-D-1A/1B 503unclassified excavationlump sumLS-1CA-D-3503unclassified excavation including rock1 yd3V-8CA-D-1A/1B 503unclassified excavation including shale1 yd3V-8CA-D-1A/1B 503unclassified excavation including shale or rock1 yd3V-8CA-D-1A/1B 503rock excavation1 yd3V-8CA-D-1A/1B 503shale excavation1 yd3V-8CA-D-1A/1B 504Sheet Piling Left in Place504steel sheet piling left in place _____0.1 ft2A-1CA-D-1A/1B 505Pile Driving Equipment Mobilization505pile driving equipment mobilizationlump sumLS-2CA-D-3506Static Load Test506static load testlump sumLS-2CA-D-3506subsequent static load testeachLS-2CA-D-3507Bearing Piles507steel piles hp______x______, furnished0.1 footL-7CA-D-3507steel piles hp_____x_____, driven0.1 footL-7CA-S-3, BR-2-75A507__in cast-in-place, reinforced concrete piles, furnished0.1 footL-7CA-D-3507__in cast-in-place, reinforced concrete piles, driven0.1 footL-7CA-S-3, BR-2-75A, TE-45507timber piles, creosoted0.1 footL-7CA-S-3, BR-2-75A507timber piles, untreated0.1 footL-7CA-S-3, BR-2-75A507pre-bored holes0.1 footL-1CA-D-3507steel points or shoeseachU-1CA-D-3509Reinforcing Steel509epoxy coated reinforcing steel1 poundW-5CA-D-1A/1B, CA-S-9 510dowel holes with cement grouteachU-1CA-D-3510dowel holes with nonmetallic grouteachU-1CA-D-3511Concrete for Structures511class ____ concrete,____________________0.1 yd3V-2CA-D-1A/1B, TE-45 511class_____ concrete, bridge deck0.1 yd30.1 yd2V-2A-2CA-D-1A/1B, TE-45, CA-S-4, CA-S-6, CA-S-22, D10-S-31 512Waterproofing512type______ waterproofing0.1 yd2lump sumA-1LS-1CA-D-1A/1B CA-D-3512Sealing of Concrete Surfaces0.1 yd2A-1CA-D-1A/1B CA-D-3, CA-S-21513Structural Steel Members513structural steel (___________________)100 poundlump sumW-2LS-1SEE W-2CA-D-3, CA-S-20513welded stud shear connectorseachU-1CA-D-3514Painting of Structural Steel514surface preparation, existing steel, system __lump sumSq. Ft.LS-1CA-D-3, CA-S-7, CA-S-11, CA-S-12,CA-S-13,CA-S-14, D10-S-32514field painting of existing steel, prime coat, system_______lump sumSq. Ft.LS-1CA-D-3, CA-S-2, CA-S-7, CA-S-15,D10-S-32514Field painting of structural steel, intermediate coat, system_______lump sumSq. Ft.LS-1CA-D-3, CA-S-2, CA-S-7, CA-S-16, CA-S-17, D10-S-37514field painting of structural steel, finish coat, system _______lump sumSq. Ft.LS-1CA-D-3, CA-S-2, CA-S-7, CA-S-17, D10-S-32514Grinding fins, tears, slivers on existing structural steelLump sumLS-1CA-D-3, CA-S-16514Final Inspection RepairEachU-1CA-D-3, CA-S-18, CA-S-19515Prestressed Concrete Bridge Members515prestressed concrete bridge memberseach0.1 footU-1L-4CA-D-3, CA-S-20CA-D-3515intermediate diaphragmseachU-1CA-D-3516Expansion and Contraction Joints, Joint Sealers, and Bearing Devices516structural steel expansion joints0.1 foot100 poundL-4W-2CA-D-3SEE W-2516structural expansion joints including elastomeric ________ seals0.1 footL-4CA-D-3516elastomeric compression seals for structural steel joints, _____ width0.1 footL-4CA-D-3516folder copper strip __________0.1 footL-4CA-D-3516vertical extension of structural expansion joints0.1 footL-4CA-D-3516_____ preformed expansion joint filler0.1 yd2A-1CA-D-1A/1B 516joint sealer0.1 footL-4CA-D-3516bearing deviceseach0.1 foot0.1 yd2100 poundU-1L-4A-1W-2CA-D-3CA-D-3CA-D-1A/1B SEE W-2516_____in elastomeric bearing padeach0.1 yd2U-1A-1CA-D-3CA-D-1A/1B 516elastomeric bearing with internal laminates only ___x___x___eachU-1CA-D-3516elastomeric bearing with internal laminates with load plate___x___x___eachU-1CA-D-35161/8 inch preformed bearing pads0.1 yd2A-1CA-D-1A/1B 517Railings517railing (____________________________)0.1 footL-1CA-D-3518Drainage of Structures518porous backfill0.1 yd3lump sumV-1LS-1CA-D-1A/1B CA-D-3518porous backfill with filter fabric0.1 yd3lump sumV-1LS-1CA-D-1A/1B CA-D-3518____in _____ pipe include specials0.1 footL-4CA-D-3518scuppers, including supportseachU-1CA-D-3518trough horizontal conductors100 pound0.1 footW-2L-1SEE W-2CA-D-3518pipe horizontal conductors100 pound0.1 footW-2L-1SEE W-2CA-D-3518___ in ___ pipe downspout1 footL-1CA-D-3519Patching Concrete Structures519patching concrete structures0.1 ft2A-1CA-D-1A/1B 520Pneumatically Placed Mortar520pneumatically placed mortar0.1 ft2A-1CA-D-1A/1B 522Structural Plate Corrugated Metal Structures on Footings522___in ___ structural plate corrugated metal structure, _____in0.1 footL-1CA-D-3523Dynamic Load Test523dynamic load testingeachU-1CA-D-3523re-strikeeachU-1CA-D-3524Drilled Shafts524drilled shafts, ___in diameter, above bedrock0.1 footL-1CA-S-1, TE-45, D10-S-30524drilled shafts, ___in diameter, into bedrock0.1 footL-1CA-S-1, TE-45, D10-S-30524drilled shafts, ___in diameter0.1 footL-1CA-S-1, TE-45, D10-S-30526Approach Slabs526reinforced concrete approach slabs0.1 yd2A-1CA-D-1A/1B Incidentals (600)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS601Slope and Channel Protections601riprap0.1 yd2A-1CA-D-1A/1B 601crushed aggregate slope protection0.1 yd2A-1CA-D-1A/1B 601concrete slope protection0.1 yd2A-1CA-D-1A/1B 601dump rock fill, type ______0.1 yd3V-1CA-D-1A/1B 601rock channel protection, type ____with filter0.1 yd3V-1CA-D-1A/1B 601rock channel protection, type ____without filter0.1 yd3V-1CA-D-1A/1B 601paved gutter0.1 footL-1CA-D-3602Masonry602brick masonry0.1 yd3V-2CA-D-1A/1B 602block masonry0.1 yd3V-2CA-D-1A/1B 602concrete masonry0.1 yd3V-2CA-D-1A/1B 603Pipe Culverts, Sewers, and Drains603____ in conduit, type ________0.1 footL-8CA-P-1603________x________ conduit, type _____0.1 footL-8CA-P-1603____ in conduit reconstructed, type ___0.1 footL-8CA-P-1603type a precast reinforced concrete flat topped three-sided culvert ___in span x ___in rise0.1 footL-8CA-P-1603type a precast reinforced concrete arch section ___in span x ___in rise0.1 footL-8CA-P-1603___in rise x ___in span conduit, type a corrugated steel box culvert, ___in min. cover, ___in max. cover0.1 footL-8CA-P-1603___in rise x ___in span conduit, type a corrugated aluminum box culvert, ___in min. cover, ___in max. cover0.1 footL-8CA-P-1603___in conduit, type ___, field paving0.1 footL-8CA-P-1603___in conduit, type ___, field paving of existing pipe0.1 footL-8CA-P-1604Manholes, Catch Basins, Inlets, Inspection Wells, Junction Chambers, Precast Reinforced Concrete Outlets, or Monuments604manholeseachU-1CA-P-3604inletseachU-1CA-P-3604catch basinseachU-1CA-P-3604monuments assemblieseachU-1CA-D-3604reference monumentseachU-1CA-D-3604inspection wellseachU-1CA-D-3604junction chamberseachU-1CA-D-3604manhole, catch basin, or inlet reconstructed to gradeeachU-1CA-D-3604manhole, catch basin, inlet, or monument bas adjusted to gradeeachU-1CA-D-3604precast reinforced concrete outleteachU-1CA-D-3605Underdrains605___in unclassified pipe underdrains0.1 footL-8CA-P-2605___in shallow pipe underdrains0.1 footL-8CA-P-2605___in deep pipe underdrains0.1 footL-8CA-P-2605aggregate drains0.1 footL-8CA-D-3605___in rock cut underdrain 0.1 footL-8CA-P-2605___in prefabricated edge underdrain0.1 footL-8CA-P-2606Guardrail606guardrail, type_____0.1 footL-5CA-D-2 OR 3606guardrail, barrier design, type_____0.1 footL-5CA-D-2 OR 3606guardrail, rebuilt, type______0.1 footL-5CA-D-2 OR 3606anchor assembly, type_____eachU-1CA-D-3606anchor assembly, type ___, barrier designeachU-1CA-D-3606bridge terminal assembly, type _____eachU-1CA-D-3606guardrail posteachU-1CA-D-3607Fence607fence, type _____0.1 footL-1CA-D-2 OR 3607gate, type _____eachU-1CA-D-3608Walks, Curb Ramps, and Steps608concrete walk0.1 yd2A-1CA-D-1A/1B 608bituminous walk0.1 yd2A-1CA-D-1A/1B 608aggregate walk0.1 yd2A-1CA-D-1A/1B 608curb ramps0.1 yd2eachA-1U-1CA-D-1A/1B CA-D-3608concrete steps0.1 footL-1CA-D-3609Curbing, Concrete Medians, and Traffic Islands609sandstone curb0.1 footL-1CA-D-3609curb, type______0.1 footL-1CA-D-3609combination curb and gutter0.1 footL-1CA-D-3609asphalt concrete curb0.1 footL-1CA-D-3609concrete traffic island0.1 yd20.1 yd3A-1V-1CA-D-1A/1B CA-D-1A/1B 609concrete median0.1 yd20.1 yd3A-1V-1CA-D-1A/1B CA-D-1A/1B 610Cellular Retaining Walls610cellular retaining wall0.1 yd2A-1CA-D-1A/1B613Low Strength Mortar Backfill613low strength mortar backfill0.1 yd3V-1CA-D-1A/1B 613low strength mortar backfill, type___0.1 yd3V-1CA-D-1A/1B 614Maintaining Traffic614maintaining trafficlump sumLS-1CA-D-3614temporary pavement markingseach1 foot0.01 mileU-1L-1L-3CA-D-3CA-D-3CA-D-3614temporary raised pavement markereachU-1CA-D-3614portable changeable message boardEach1 monthU-1U-1CA-D-3CA-D-3614Work zone speed limit signEachU-1CA-D-3614Work zone marking signEachU-1CA-D-3614law enforcement officer w/patrol car1 hourU-1CA-D-3614barrier reflectorEachU-1CA-D-3614temporary crossover lighting systemEachU-1CA-D-3614temporary impact attenuatorEachU-1CA-D-3614temporary lane line class_____0.01 mileL-3CA-D-3614temporary center line class _____0.01 mileL-3CA-D-3614temporary channelizing line, class I ___1 footL-1CA-D-3614temporary edge line class I, ______0.01 mileL-3CA-D-3614temporary gore marking, class II , ____1 footL-1CA-D-3614temporary stop line, class I , _____1 footL-1CA-D-3614temporary crosswalk line, class I , _____1 footL-1CA-D-3614temporary dotted line, class I ,_____1 footL-1CA-D-3614bituminous concrete for maintaining traffic0.1 yd3C-5CA-D-1A/1B X615Roads and Pavements for Maintaining Traffic615temporary pavement, class a0.1 yd2A-1CA-D-1A/1B X615temporary pavement, class b0.1 yd2A-1CA-D-1A/1B X615temporary roadslump sumLS-1CA-D-3616Dust Control616water0.1 m galV-7CA-D-3 X616calcium chloride0.1 tonC-2CA-D-3 X617Reconditioning Shoulders617shoulder preparation1 yd2A-1CA-D-1 and 2 617compacted aggregate, type___0.1 yd3C-1WEIGHTX617water0.1 m galV-7CA-D-1 and 2X618Rumble Strips on Shoulders618rumble strips, type 11 foot0.1 mileL-1L-3CA-D-3CA-D-3618rumble strips, type 2 (asphalt)1 foot0.1 mileL-1L-3CA-D-3CA-D-3618rumble strips, type 2 (concrete)1 foot0.1 mileL-1L-3CA-D-3CA-D-3618rumble strips, type 31 foot0.1 mileL-1L-3CA-D-3CA-D-3619Field Office619field office, type _____lump sumLS-1CA-D-3619field office, type _____? monthU-1CA-D-3620Delineators620delineator, type____, post mountedEachU-1CA-D-3620delineator, type ____, bracket mountedEachU-1CA-D-3620temporary delineator, type_____EachU-1CA-D-3620delineator removed for storage or removalEachU-3CA-D-3620reflector, type _____EachU-1CA-D-3621Raised Pavement Markers (RPM)621raised pavement markerEachU-1CA-D-3B621raised pavement marker, reflectorEachU-1CA-D-3B621two-way radio equipmentlump sumLS-1CA-D-3B622Concrete Barrier622concrete barrier, type_____0.1 footL-1CA-D-3622portable concrete barrier, _____in0.1 footL-1CA-D-3622portable concrete barrier, __in bridge mount0.1 footL-1CA-D-3623Construction Layout Stakes623construction layout stakeslump sumLS-1CA-D-3A624Mobilization624mobilizationlump sumLS-1CA-D-3625Highway Lighting625light poleEachU-2CA-D-3 625light pole foundationEachU-2CA-D-3 625light towerEachU-2CA-D-3 625light tower foundationEachU-2CA-D-3 625light tower maintenance platformEachU-2CA-D-3 625luminaireEachU-2CA-D-3 625bracket armEachU-2CA-D-3 625glare shieldEachU-2CA-D-3 625ground rodEachU-2CA-D-3 625pull box, (type), (size)EachU-2CA-D-3 625trench0.1 footL-1CA-D-2625trench in paved areas, type____0.1 footL-1CA-D-2625conduit, (type), (size)0.1 footL-1CA-D-2625conduit jacked or drilled under pavement (size ___)0.1 footL-1CA-D-2625no.___awg,__ volt distribution cable0.1 footL-1CA-D-2 625no.___awg,__, pole and bracket cable0.1 footL-1CA-D-2 625__in duct-cable w/ __no.__awg,__-volt cable0.1 footL-1CA-D-2 625connector kit, type____EachU-2CA-D-2 625cable splicing kitEachU-2CA-D-2 625power serviceEachU-2CA-D-3 625structural grounding systemEachU-2CA-D-3 625light pole anchor bolts on structureEachU-2CA-D-3 625junction boxEachU-2CA-D-3 625portable power unitEachU-2CA-D-3 625high voltage testlump sumLS-1CA-D-3626Barrier Reflectors626barrier reflector, type aEachU-1CA-D-3626barrier reflector, type bEachU-1CA-D-3626barrier reflector, type a2EachU-1CA-D-3626barrier reflector, type b2EachU-1CA-D-3630Traffic Signs and Sign Supports630ground mounted beam support foundation.EachU-1CA-D-3630rigid overhead sign support foundationEachU-1CA-D-3630span wire sign support foundationEachU-1CA-D-3630ground mounted support, ______post0.1 footL-4CA-D-2630ground mounted support, _____beam0.1 footL-4CA-D-2630one way support, _____post0.1 footL-4CA-D-2630temporary sign support0.1 footEachL-4U-1CA-D-2CA-D-3630street name sign support0.1 footL-4CA-D-2630breakaway beam connectionEachU-1CA-D-3630overhead sign support, type tc-_______, design _____EachU-1CA-D-3630combination overhead sign support, type___, design____EachU-1CA-D-3630sign attachment assemblyEachU-1CA-D-3630luminaire support assembly, type tc-____EachU-1CA-D-3630span wire sign support, type tc-17.10, design___EachU-1CA-D-3630overpass structure mounted sign support, type tc - _____, design___EachU-1CA-D-3630sign hanger assembly, (span, wire, mast arm)EachU-1CA-D-3630sign support assembly, (pole or bridge mount)EachU-1CA-D-3630sign, (flat sheet, extrusheet, temp. overlay)0.1 ft2A-3CA-D-2630sign, double faced, (street name, mile marker)EachU-1CA-D-3630sign erected, (flat sheet, extrusheet, temp. overlay)0.1 ft2A-3CA-D-2630sign backing assemblyEachU-1CA-D-3630covering sign0.1 ft2A-3CA-D-1A/1B 630barrier wall assembly, type tc-designeachU-1CA-D-3630removal of ground mounted (major) sign and (storage, re-erection, or disposal)eachU-1CA-D-2630removal of ground mounted (beam, post) support and (storage or disposal)eachU-1CA-D-2630removal of overhead mounted sign and (storage, re-erection, or disposal)eachU-1CA-D-2630removal of overhead sign support and (storage, re-erection, of disposal), type tc- _____eachU-1CA-D-2630removal of overlay signeachU-1CA-D-2631Sign Lighting and Electrical Signs631sign serviceeachU-1CA-D-2631sign wiredeachU-1CA-D-2631sign wired, overpass structure mountedeachU-1CA-D-2631disconnect switch with enclosure, type_eachU-1CA-D-2631switch enclosure mounting bracket assemblyeachU-1CA-D-2631ballast (integral or remote), type ___eachU-1CA-D-2631ballast wiring enclosure, type ___eachU-1CA-D-2631ballast wiring enclosure mounting bracketeachU-1CA-D-2631photoelectric controleachU-1CA-D-3631mercury vapor luminaire, type ___, with _____-watt lampeachU-1CA-D-2631changeable message sign, electrical type(limited, unlimited) messageeachU-1CA-D-3631changeable message sign, drum typeeachU-1CA-D-3631internally illuminated fixed message sign, type ______eachU-1CA-D-3631sign flasher assemblyeachU-1CA-D-3631school speed limit sign assembly, __ineachU-1CA-D-3631timer with enclosureeachU-1CA-D-3631removal of (luminaire, disconnect switch, ballast, etc.) and (storage or re-erection)eachU-1CA-D-2632Traffic Signal Equipment632vehicular signal head,__-section___ in lens _____-wayeachU-1CA-D-3632vehicular signal head, optically programmed, __ -section, ___in lens, __wayeachU-1CA-D-3632pedestrian signal head, type ____eachU-1CA-D-3632pedestrian pushbuttoneachU-1CA-D-3632loop detector uniteachU-1CA-D-3632detector loopeachU-1CA-D-3632magnetometer detector uniteachU-1CA-D-3632magnetometer sensor probeeachU-1CA-D-3632strain pole foundationeachU-1CA-D-3632signal support foundationeachU-1CA-D-3632pedestal foundationeachU-1CA-D-3632signal support, type tc-____,design___eachU-1CA-D-3632combination signal support, type tc-___, design___eachU-1CA-D-3632strain pole, type tc-___, design___eachU-1CA-D-3632combination strain pole, type tc-___, design ____eachU-1CA-D-3632strain pole embedded, type tc-__,design_eachU-1CA-D-3632comb. strain pole embedded, type tc-___design -____eachU-1CA-D-3632wood pole, class ____, (length) fteachU-1CA-D-3632down guyeachU-1CA-D-3632pedestal, (length) fteachU-1CA-D-3632pedestal, (length) ft, transformer baseeachU-1CA-D-3632conduit riser, __________in dia.eachU-1CA-D-3632messenger wire, (no.) strand _____in0.1 footL-1CA-D-3632signal cable, _____-conductor no.__awg0.1 footL-1CA-D-3632interconnect cable,____-conductor no.__0.1 footL-1CA-D-3632interconnect cable, integral messenger wire type, ____-conductor no.___awg0.1 footL-1CA-D-3632loop detector lead-in cable0.1 footL-1CA-D-3632magnetometer lead-in cable0.1 footL-1CA-D-3632power cable, ___-conductor no.___awg0.1 footL-1CA-D-3632service cable, ___-conductor no.____awg0.1 footL-1CA-D-3632power serviceeachU-1CA-D-3632covering of vehicular signal headeachU-1CA-D-3632removal of traffic signal installationeachU-1CA-D-3632removal of (item) and (storage or re-erection)eachU-3CA-D-3632reuse of (item)eachU-3CA-D-3633Traffic Signal Controllers633controller unit, type ___, with cabinet, type ___ eachU-1CA-D-3633controller unit, type ___ eachU-1CA-D-3633controller unit, type ___, furnish only eachU-1CA-D-3633cabinet, type ___ eachU-1CA-D-3633cabinet, type___, furnish onlyeachU-1CA-D-3633cabinet risereachU-1CA-D-3633controller, master, traffic responsiveeachU-1CA-D-3633controller, master, traffic responsive, furnish onlyeachU-1CA-D-3633remote monitoring stationeachU-1CA-D-3633telephone serviceeachU-1CA-D-3633trainingeachU-1CA-D-3633system analysiseachU-1CA-D-3633cabinet foundation eachU-1CA-D-3 633controller work padeachU-1CA-D-3 633flasher controllereachU-1CA-D-3638Water Mains and Service Branches638___in water main, ductile iron, ANSI class___, joints and fittings0.1 footL-1CA-D-3638___in water main, polyvinyl chloride pipe and fittings0.1 footL-1CA-D-3638___in copper service branch0.1 footL-1CA-D-3638___in polyethylene service branch0.1 footL-1CA-D-3638___in polybutylene service branch0.1 footL-1CA-D-3638polyethylene encasement0.1 footL-1CA-D-3638___in steel pipe encasement (open cut, bored)0.1 footL-1CA-D-3638___in gate valve and valve boxeachU-1CA-D-3638___in inserting valve and valve boxeachU-1CA-D-3638___in cutting-in sleeve, valve, and boxeachU-1CA-D-3638__in x __in tapping sleeve, valve & boxeachU-1CA-D-3638meter, setting, stop and chambereachU-1CA-D-3638fire hydrant extended and adjusted eachU-1CA-D-3638fire hydrant adjusted to gradeeachU-1CA-D-3638fire hydrant removed and reseteachU-1CA-D-3638fire hydrant and gate valve removed and reseteachU-1CA-D-3638fire hydrant removed and disposed ofeachU-1CA-D-3638valve box adjusted to gradeeachU-1CA-D-3638service box adjusted to gradeeachU-1CA-D-3638meter and chamber removed and reseteachU-1CA-D-3638sheeting and bracing left in place0.1 yd3V-2CA-D-1A/1B Pavement Marking (640)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS642Traffic Paint642edge line, type____0.01 mileL-6CA-D-3642lane line, type _____0.01 mileL-6CA-D-3642center line, type ___0.01 mileL-6CA-D-3642channelizing line, type _____1 footL-1CA-D-3642stop line, type _____1 footL-1CA-D-3642crosswalk line, type _____0.1 footL-1CA-D-3642transverse line, type _____0.1 footL-1CA-D-3642curb marking, type _____0.1 footL-1CA-D-3642island marking, type _____0.1 yd2A-1CA-D-1A/1B 642handicap symbol marking, type _____eachU-1CA-D-3642railroad symbol marking, type _____eachU-1CA-D-3642school symbol marking, __in, type ____eachU-1CA-D-3642parking lot stall marking, type _____0.1 footL-1CA-D-3642lane arrow, type _____eachU-1CA-D-3642word on pavement, ____in, type _____eachU-1CA-D-3642dotted line, ___in, type _____1 footL-1CA-D-3642removal of pavement marking1 foot0.1 yd2L-1A-1CA-D-3CA-D-1A/1B 642two-way radio equipmentlump sumLS-1CA-D-3643Polyester Pavement Marking643edge line0.01 mileL-6CA-D-3643lane line0.01 mileL-6CA-D-3643center line0.01 mileL-6CA-D-3643channelizing line0.1 footL-1CA-D-3643stop line0.1 footL-1CA-D-3643crosswalk line0.1 footL-1CA-D-3643transverse line0.1 footL-1CA-D-3643curb marking0.1 footL-1CA-D-3643island marking0.1 yd2A-1CA-D-3643handicap symbol markingeachU-1CA-D-3643railroad symbol markingeachU-1CA-D-3643school symbol marking, ____ineachU-1CA-D-3643parking lot stall marking0.1 footL-1CA-D-3643lane arroweachU-1CA-D-3643word on pavement ____ineachU-1CA-D-3643dotted line, ___in1 footL-1CA-D-3643removal of pavement marking1 foot0.1 yd2L-1A-1CA-D-3CA-D-1A/1B 643two-way radio equipmentlump sumLS-1CA-D-3644Thermoplastic Pavement Marking644edge line0.01 mileL-6CA-D-3644lane line0.01 mileL-6CA-D-3644center line0.01 mileL-6CA-D-3644channelizing line0.1 footL-1CA-D-3644stop line0.1 footL-1CA-D-3644crosswalk line0.1 footL-1CA-D-3644transverse line1 footL-1CA-D-3644handicap symbol markingeachU-1CA-D-3644railroad symbol marking, ____ineachU-1CA-D-3644school symbol marking, ____ineachU-1CA-D-3644parking lot stall marking0.1 footL-1CA-D-3644lane arroweachU-1CA-D-3644word on pavement, ____ineachU-1CA-D-3644dotted line, _____in1 footL-1CA-D-3644removal of pavement marking1 foot0.1 yd2L-1A-1CA-D-3CA-D-1A/1B 644two-way radio equipmentlump sumLS-1CA-D-3645Preformed Pavement Marking645edge line, type_____0.01 mileL-6CA-D-3645lane line, type_____0.01 mileL-6CA-D-3645center line, type _____0.01 mileL-6CA-D-3645channelizing line, type _____0.1 footL-1CA-D-3645stop line, type _____0.1 footL-1CA-D-3645crosswalk line, type _____0.1 footL-1CA-D-3645transverse line, type _____0.1 footL-1CA-D-3645handicap symbol marking, type _____eachU-1CA-D-3645railroad symbol marking, type _____eachU-1CA-D-3645school symbol marking, ___in, type ___eachU-1CA-D-3645parking lot stall marking, type_____0.1 footL-1CA-D-3645lane arrow, type _____eachU-1CA-D-3645word on pavement, ___in , type ___eachU-1CA-D-3645dotted line, _____in, type _____1 footL-1CA-D-3645removal of pavement markings1 foot0.1 yd2L-1A-1CA-D-3CA-D-1A/1B 645two-way radio equipmentlump sumLS-1CA-D-3646Epoxy Pavement Marking646epoxy pavement markingssee items above647Heat-Fused Preformed Plastic Pavement Marking647heat-fused preformed plastic pavement markingssee items aboveRoadsides (650)ITEMDESCRIPTION UNITSRequired AccuracyDaily EntriesCODEFORMTKTS651Topsoil Stockpiled651topsoil stockpiled1 yd3V-3CA-D-1A/1B 652Placing Stockpiled Topsoil652placing stockpiled topsoil1 yd3V-5CA-D-1A/1B 653Topsoil Furnished and Placed653topsoil furnished and placed1 yd3V-5CA-D-1A/1B 654Renovating Existing Soil654renovation existing sod1 ft2A-1CA-D-1A/1B 654commercial fertilizer0.01 tonW-4CA-D-3655Seeding and Renovating Existing Sod655seeding and renovating existing sod1 yd2A-1CA-D-1A/1B 655commercial fertilizer0.01 tonW-4CA-D-3656Roadside Cleanup656roadside cleanup1 ft2A-1CA-D-1A/1B657Riprap for Tree Protection657riprap for tree protection1 yd2A-1CA-D-1A/1B 658Tree Root Aeration658tree root aeration1 yd3V-5CA-D-1A/1B 659Seeding and Mulching659Commercial fertilizer0.01 tonW-4CA-D-3659Agricultural liming0.01 tonW-4CA-D-3659seeding and mulching1 yd2A-4CA-D-1A/1B 659seeding and mulching for wildlife1 yd2A-4CA-D-1A/1B659repair seeding and mulching1 yd2A-1CA-D-1A/1B659Water1 m galV-7CA-D-3 X659Mowing1 yd2A-1CA-D-1A/1B 660Sodding660sodding unstaked1 yd2A-1CA-D-1A/1B 660sodding staked1 yd2A-1CA-D-1A/1B 660sodding reinforced1 yd2A-1CA-D-1A/1B 661Planting Trees, Shrubs, and Vines661tree seedling, (size), (species)eachU-2CA-D-3661perennials, (size), (species)eachU-2CA-D-3661ground cover , (size), (species)eachU-2CA-D-3661deciduous shrub , (size), (species)eachU-2CA-D-3661evergreen shrub, (size), (species)eachU-2CA-D-3661deciduous tree, (size), (species)eachU-2CA-D-3661evergreen tree, (size), (species)eachU-2CA-D-3662Landscape Watering662landscape wateringgallonV-7CA-D-3 X664Planting Salvaged Plants664planting salvaged plantseachU-2CA-D-3665Large Trees Moved and Reset665large trees moved and reseteachU-2CA-D-3665aggregate for drain pits and tree holes0.1 yd3V-2CA-D-1A/1B 666Pruning Existing Trees666pruning existing trees __in to __in dia.eachU-2CA-D-3667Seeding and Jute Matting667seeding and jute matting0.1 yd2A-1CA-D-1A/1B 668Seeding and Excelsior Matting668seeding and excelsior matting0.1 yd2A-1CA-D-1A/1B 670Erosion Protection670slope erosion control0.1 yd2A-1CA-D-1A/1B 670ditch erosion control0.1 yd2A-1CA-D-1A/1B 671Temporary Erosion Control Mats671seeding and paper blanket0.1 yd2A-1CA-D-1A/1B 672Seeding and Mulching with Erosion Control Netting672seeding and mulching w/ erosion control netting0.1 yd2A-1CA-D-1A/1B 673Seeding and Erosion Control Blanket673seeding and erosion control blanket0.1 yd2A-1CA-D-1A/1B List of Forms TOC \o "1-4" \h \z \u CA-S-1Inspection Record for Drilled Shafts PAGEREF _Toc236011742 \h 33CA-S-2Paint Thickness (QCP #5, #8, #10) PAGEREF _Toc236011744 \h 35CA-S-3(BR-2-75) Pile Driving Log PAGEREF _Toc236011746 \h 37CA-S-3A(BR-2-75A) Pile Driving Log Summary PAGEREF _Toc236011748 \h 39CA-S-4High Performance Concrete Pre-Pour Meeting - 1/3 PAGEREF _Toc236011750 \h 41CA-S-4High Performance Concrete Pre-Pour Meeting - 2/3 PAGEREF _Toc236011752 \h 42CA-S-4High Performance Concrete Pre-Pour Meeting - 3/3 PAGEREF _Toc236011754 \h 43CA-S-5Micro-Silica Overlay Pre-Pour Meeting - 1/3 PAGEREF _Toc236011756 \h 45CA-S-5Micro-Silica Overlay Pre-Pour Meeting - 2/3 PAGEREF _Toc236011757 \h 46CA-S-5 Micro-Silica Overlay Pre-Pour Meeting - 3/3 PAGEREF _Toc236011759 \h 47CA-S-6Class S Concrete Pre-Pour Meeting - 1/2 PAGEREF _Toc236011761 \h 49CA-S-6Class S Concrete Pre-Pour Meeting - 2/2 PAGEREF _Toc236011763 \h 50CA-S-7QCS Inspection Documentation PAGEREF _Toc236011764 \h 51CA-S-8(BR-5) Piling Record PAGEREF _Toc236011767 \h 53CA-S-9Reinforcing Steel Verification PAGEREF _Toc236011769 \h 55CA-S-11QCS & Visual Standards Information PAGEREF _Toc236011771 \h 57CA-S-12Bridge Painting Quality Control Points (QCP #1 & #2) PAGEREF _Toc236011775 \h 59CA-S-13Abrasive Blasting (QCP#3) PAGEREF _Toc236011779 \h 61CA-S-14Disposal of Hazardous / Non- Hazardous Waste for Bridge Painting (QCP#4) PAGEREF _Toc236011782 \h 63CA-S-15Prime Coat Application (QCP#5) PAGEREF _Toc236011785 \h 65CA-S-16Bridge Painting: Grinding Fins, Tears, and Slivers; and Caulking (QCP #6 & #9) PAGEREF _Toc236011788 \h 67CA-S-17Intermediate & Finish Coat Application (QCP #8 & #10) PAGEREF _Toc236011792 \h 69CA-S-17Intermediate & Finish Coat Application (QCP #8 & #10) (back) PAGEREF _Toc236011794 \h 70CA-S-18Bridge Painting Destructive Test Log (QCP #11) PAGEREF _Toc236011795 \h 71CA-S-19Bridge Painting Final Review (QCP #11) PAGEREF _Toc236011799 \h 73CA-S-20Erection (Demolition) Procedure Checklist PAGEREF _Toc236011802 \h 75CA-S-21Sealing of Concrete Surfaces Checklist PAGEREF _Toc236011804 \h 77TE-45Concrete Inspectors Daily Report PAGEREF _Toc236011806 \h 79CA-C-1Concrete Control Test Form PAGEREF _Toc236011808 \h 81CA-EW-1Earthwork Quantity Calculations PAGEREF _Toc236011810 \h 83CA-EW-2Proof Rolling Documentation PAGEREF _Toc236011812 \h 85CA-EW-3Log of Test Pit Investigation PAGEREF _Toc236011814 \h 87CA-EW-4Moisture Density Curve Calculation PAGEREF _Toc236011816 \h 89CA-EW-5Nuclear Gauge Compaction Form PAGEREF _Toc236011819 \h 91CA-EW-6Nuclear Gauge Compaction with Aggregate Correction PAGEREF _Toc236011822 \h 93Typical Moisture Density Curves - Set C - May, 1949 PAGEREF _Toc236011825 \h 94Zero Air Voids Curve PAGEREF _Toc236011827 \h 96CA-EW-8Authorization of Undercuts PAGEREF _Toc236011829 \h 97CA-EW-9Rock Blasting Inspection Form PAGEREF _Toc236011831 \h 99CA-EW-10Rock Blasting Drilling Log PAGEREF _Toc236011833 \h 101CA-EW-11Blast Site Security Plan PAGEREF _Toc236011835 \h 103CA-EW-12Daily Earthwork Inspection Form PAGEREF _Toc236011837 \h 105CA-EC-1 Weekly and Rain Event Checklist PAGEREF _Toc236011840 \h 107CA-EC-2Seeding Calculations PAGEREF _Toc236011842 \h 109CA-FP-1Warranty Asphalt Checklist PAGEREF _Toc236011844 \h 111CA-FP-2 Random Selection of Asphalt Field Samples (448, 403) PAGEREF _Toc236011846 \h 113CA-FP-3Summary of Asphalt Concrete Quantities PAGEREF _Toc236011848 \h 115CA-FP-4Asphalt Concrete inspection PAGEREF _Toc236011850 \h 117CA-FP-5Roller Capacity and Placement Rate PAGEREF _Toc236011852 \h 119CA-FP-6Calculation of Liquid Asphalt Materials PAGEREF _Toc236011855 \h 121TE-217Bituminous Concrete Density Determination - 446 Cores PAGEREF _Toc236011860 \h 123TE-217Bituminous Concrete Density Determination - 446 Form Instructions PAGEREF _Toc236011863 \h 125TE-217Bituminous Concrete Density Determination - 446 Random Number Table PAGEREF _Toc236011865 \h 127CA-P-1Pipe Construction Inspection Form - 1/2 PAGEREF _Toc236011867 \h 129CA-P-1Pipe Construction Inspection Form 2/2 PAGEREF _Toc236011868 \h 130CA-P-2Underdrain Construction Inspection Form 1/2 PAGEREF _Toc236011869 \h 131CA-P-2Underdrain Construction Inspection Form 2/2 PAGEREF _Toc236011870 \h 132CA-P-3Drainage Structure Inspection Form 1/2 PAGEREF _Toc236011871 \h 133CA-P-3Drainage Structure Inspection Form 2/2 PAGEREF _Toc236011872 \h 134CA-D-1AField Calculation and Measurement PAGEREF _Toc236011873 \h 135CA-D-1BField Calculation and Measurement PAGEREF _Toc236011875 \h 137CA-D-2Field Calculation and Measurement PAGEREF _Toc236011877 \h 139CA-D-3AODOT Inspectors Daily Report PAGEREF _Toc236011879 \h 141CA-D-3BODOT Inspectors Daily Report PAGEREF _Toc236011881 \h 143CA-D-4ODOT P.E. / P.S. Daily Report PAGEREF _Toc236011884 \h 145CA-D-5Daily Account of Force Account Work PAGEREF _Toc236011886 \h 147CA-D-6Pavement Repair and Sawing Measurement PAGEREF _Toc236011888 \h 149CA-D-7Short Term Work Zone Review PAGEREF _Toc236011890 \h 151CA-D-8Long Term Work Zone Review - 1/2 PAGEREF _Toc236011893 \h 153CA-D-8Long Term Work Zone Review - 2/2 PAGEREF _Toc236011894 \h 154CA-D-9Daily Concrete Pavement Documentation Form - 1 / 5 PAGEREF _Toc236011895 \h 155CA- D-9Daily Concrete Pavement Documentation Form - 2 / 5 PAGEREF _Toc236011896 \h 156CA- D-9Daily Concrete Pavement Documentation Form - 3 / 5 PAGEREF _Toc236011897 \h 157CA- D-9Daily Concrete Pavement Documentation Form - 4 / 5 PAGEREF _Toc236011898 \h 158CA- D-9Daily Concrete Pavement Documentation Form - 5 / 5 PAGEREF _Toc236011900 \h 159CA-L-1Report of Electrical Tests PAGEREF _Toc236011902 \h 161CA-L-2Report of Electrical Tests PAGEREF _Toc236011904 \h 163CA-L-3Report of Electrical Tests PAGEREF _Toc236011909 \h 165CA-L-4Report on Sign Lighting PAGEREF _Toc236011911 \h 167CA-L-5Report on High Voltage Direct Current Tests PAGEREF _Toc236011913 \h 169CA-T-1DLS Report Format - Weight-Based System PAGEREF _Toc236011915 \h 171CA-T-2DLS Short Report Format - Weight-Based System PAGEREF _Toc236011916 \h 172CA-T-3DLS Report Format – Stroke Counter System PAGEREF _Toc236011917 \h 173CA-T-4DLS Short Report Format – Stroke Counter System PAGEREF _Toc236011918 \h 174CA-T-5DLS Report Format – Flow Meter Based System PAGEREF _Toc236011919 \h 175CA-T-6DLS Short Report Format – Flow Meter Based System PAGEREF _Toc236011920 \h 176CA-T-7DLS Report Format – ThermoPlastic System PAGEREF _Toc236011921 \h 177CA-T-8DLS Short Report Format – ThermoPlastic System PAGEREF _Toc236011922 \h 178TE-31Sample Data PAGEREF _Toc236011923 \h 179Noise Barrier Wall Shop Drawing Review Checklist PAGEREF _Toc236011928 \h 183Preconstruction Meeting Agenda / Checklist PAGEREF _Toc236011929 \h 184CA-S-1Inspection Record for Drilled ShaftsProject No:Bridge No:SFN:Drilling Contractor:Project Engineer:Date:Type of Equipment:Inspector:Item No: Max Continuous Torque (FtLb)(Nm): Cost Above Rock($/LF):CROWD (Max cont. Downward Force )-(Lbs)(N):Cost in Rock($/LF):Cost of Concrete pumping($/LF): Type of Rock:Drilled Shaft Number:UnitsDate & Time of DrillingStartedDateTimeFinishedDateTimeElevation of Top of OverburdenFt (m)Length of Drilled Shafts above Bedrock SocketThrough airFt (m)Through OverburdenFt (m)Pay LengthFt (m)Obstructions EncounteredNumber-SizeFt (m)Time of RemovalHoursLength of Drilled Shaft in the Rock SocketElev. Top of SocketFt (m)Elev. Bottom of SocketFt (m)Length of SocketFt (m)Steel CasingCasing ThicknessIn(mm)Casing Left in PlaceFt (m)Reinforcing SteelVerticalBar Size Number---No. of Bars---SpiralBar Size Number---PitchIn(mm)ConcreteSlumpIn(mm)Cylinder StrengthPSI(MPa)Air TempF(C) Time to Place ConcreteHrTolerancesDeviations from PlumbN-SIn(mm)E-WIn(mm)Deviations of column top center from plan In(mm)Plan Shaft Diameter (Bedrock / Overburden)In(mm)Constructed Diameter (Bedrock / Overburden)In(mm) CA-S-1Inspection Record for Drilled Shafts (back)CA-S-2Paint Thickness (QCP #5, #8, #10)CA-S-2Paint Thickness (QCP #5, #8, #10) (back)CA-S-3(BR-2-75) Pile Driving LogProject No:County/Route/Section:Bridge No:Object Bridge Over:SFN:Date: Substructure Unit:Date Driven:Pile Number:Pile Type:Wall Thickness:Hammer:Required Ultimate Bearing:Batter:Drop Hammer Ram Weight: Cutoff Elevation:Ground Elevation:No. of Splices:PenetrationBlows /FtStroke or PressurePenetrationBlows/FtStroke or PressureRemarksInspectors Name:Signature: CA-S-3(BR-2-75) Pile Driving Log (back)CA-S-3A(BR-2-75A) Pile Driving Log SummaryCA-S-3A(BR-2-75A) Pile Driving Log Summary (back)CA-S-4High Performance Concrete Pre-Pour Meeting - 1/3PROJECT: ____________________________________________ DATE: ___________________LOCATION: ________________________________________ TIME: ___________________ PRESENT: _______________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________ DRY RUN: ? Check height of rail over enddams at all four corners - *Equal heights for left rear and fwd and for right rear and fwd ? Check any change in cross-slope and discuss method of performance– Confirm appropriate depth of roller fins– Check reinforcing steel clearancesTIME AND LOCATION OF POUR: ? Date: __________________ Time:__________________ ? Pour to begin on __________________ side and commence on the __________________ side ? Location of pumps, if used ? Lighting plan if at night PLAN AND SPECIFICATION REVIEW: ? Need a written statement, from the admixture supplier verifying the compatibility of materials, a mix design, and a batching sequence ? Need successful test pour prior to concrete placement ? A technical representative is required during concrete placement ? Calendar restrictions for flyash are waived ? Need verification of vibration frequencies on finishing machine ? No rain to be forecasted during placement; if rain occurs, operations cease ? Surface evaporation rate must be equal to or less than 0.1 pound per square foot per hour DURING the pour as determined and documented by the contractor ? Vibrators shall be used ? Mix characteristics shall be adjusted off the deck before placement ? Maximum mix temperature is 90 degrees ? 7 day water cure: 1 layer of burlap with continuous water covered with plastic sheeting, apply membrane cure as per 511.19 method (b) within 12 hours of burlap removal ? Prior to opening to traffic, check top and bottom for cracks and, if necessary, reseal from the top ? Can open to traffic after membrane cure is applied, unless between October 15 and March 30, then must wait 30 days – Seal joints with HMWM – Re-apply membrane cure after grooving, unless concrete is older than 30 daysCA-S-4High Performance Concrete Pre-Pour Meeting - 2/3PROJECT: __________________________________________ DATE: ___________________CONCRETE PLANT: ? Presoak limestone 24 hours and allow to drain overnight - *Don’t charge bins with dry material ? Batching to begin at _____________ ? Expel all water from the mixers before loading / reloading (especially important for micro-silica mixes) ? Dissolvable micro-silica bags are not allowed ? A slow ribbon feed of cement is required ? Mix 5 minutes at plant ? Pour consists of approximately _____________ C.Y. ? Time between trucks _____________ minutes ? Pour _____________ cy./hr. ? Radio communication with plant for mix design changes ? Haul distance: _____________ minutesQUALITY CONTROL ? High Performance Concrete ? Mix no. _____________ ? Proportioning and batching changes are contractor’s responsibility ? W/C max = 0.40, (mix 3 and 4), based on total cementitious material ? Maximum slump = 8 inches ? Air 7% ± 2 ? Flyash, unless use slag, shall be type C ? Type F or G admixture is required for workability; suggest using type A for finishing advantages ? Any admixtures added at the jobsite shall be mixed a minimum of 5 minutes ? Air and slump tests are to be taken at point of placement ? Discharge time = 90 minutes– No “balling” of mix, if balling occurs load will be rejected and mixing process revisedCONTRACTOR’S OPERATION ? Tools* broom finish* vibrating pan or rollers* straightedge* presoaked burlap* plastic for bad weather protection* extra vibratorCA-S-4High Performance Concrete Pre-Pour Meeting - 3/3PROJECT: _____________________________________________ DATE: ___________________CONTRACTOR’S OPERATION (Continued) ? Concrete Placement* wet deck continuously in front of placement* place plastic sheeting to avoid deck contamination* straightedge checking at bulkheads and enddams* need 2 walk-bridges (1 for finishers and 1 for burlap)* smooth finish along curbs and/or parapets only* burlap shall follow as close as possible to deck overlayPROJECT INSPECTIONPersonnel (If available) ? Moisture tests to be run at _____________ ? 1 Plant Inspector * Checking aggregate moistures* checking revolutions* checking no wash water, no wash down water after batching ? 2 Concrete Quality Control Testers __________________________* chase air on every truck _____________ * Air, slump, yield* Cylinders made every 200 CY.* various pump, if used, configuration correlation tests* make beams* check concrete temperature ? 1 Concrete Quality Control Inspector __________________________* documenting any added materials* check batch tickets* time from start to discharge* insuring 5 minute mixing time if materials added* documenting test results* fill out TE-45 ? 1 Placement Inspector__________________________ * make depth checks* make reinforcing steel depth checks* insure curing is placed ASAP MISCELLANEOUS ? Traffic ControlCA-S-4High Performance Concrete Pre-Pour Meeting - 3/3 (back)CA-S-5Micro-Silica Overlay Pre-Pour Meeting- 1/3PROJECT: ____________________________________________________ DATE: ___________________LOCATION: __________________________________________________ TIME: ___________________ PRESENT: _________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________ DRY RUN: ? Check height of rail over enddams at all four corners - *Equal heights for left rear and fwd and for right rear and fwd ? Check any change in cross-slope and discuss method of performance– Confirm appropriate depth of roller finsTIME AND LOCATION OF POUR: ? Date: __________________ Time:__________________ ? Pour to begin on __________________ side and commence on the __________________ side ? Lighting plan if at night PLAN AND SPECIFICATION REVIEW: ? The Contractor shall obtain a written statement from the manufacturer of the micro-silica admixture stating that he is satisfied with the compatibility of the combination of materials and the sequence in which they are combined. ? At the option of the laboratory, a trial batch may be made (4) four days prior to overlay ? Manufacturer representative shall be present during overlay ? No micro-silica overlays after October 15 ? No rain to be forecasted during placement; if rain occurs, operations cease ? Air temperature must be below 85 degrees and not predicted to go over during concrete placement* Must be a minimum of 45 degrees during placement and curing period ? Surface evaporation rate must be equal to or less than 0.1 pound per square foot per hour as determined and documented by the contractor ? Wet deck prior to concrete placement but no ponding ? Mix characteristics shall be adjusted off the deck before placement of the overlay ? Maximum mix temperature is 90 degrees ? Vibrators shall be used in variable depth areas, edges and along enddams or bulkheads ? During short delays, overlay and grout shall be covered with wet burlap*Excess delays require bulkheads ? 3 day water cure: 1 layer of burlap with continuous water covered with plastic sheeting ? Contractor to stencil date of construction and the letters MS into the overlay ? Deck to be sounded after overlay to insure no delaminated areasCA-S-5Micro-Silica Overlay Pre-Pour Meeting- 2/3PROJECT: ____________________________________________ DATE: ___________________CONCRETE PLANT: ? Presoak limestone 24 hours and allow to drain overnight *Don’t charge bins with dry material ? Batching to begin at ________________ ? Expel all water from the mixers before loading / reloading ? Add super on jobsite if long haul distance ? Minimum of 70 revolutions on mixers before leaving plant unless central mixed ? Pour consists of approximately ________________ CY ? Time between trucks ________________ minutes ? Pour ________________ cy./hr. ? Radio communication with plant for mix design changes ? Haul distance: ________________ minutesQUALITY CONTROL ? Modified micro-silica concrete ? W/C max = 0.36 ? Slump 6 inches ± 2 ? Air 8% ± 2 ? Type A or D and F admixture shall be used ? Transit mixers are limited to carrying ? of its rated capacity or 6 cy whichever is less ? Any admixtures added at the jobsite shall be mixed a minimum of 5 minutes ? Discharge time = 90 minutesCONTRACTOR’S OPERATION ? Tools* turf drag or broom finish, * straightedge, * finishing aid, * tining tool, * presoaked burlap* plastic for bad weather protection, * extra vibrator ? Concrete Placement* abrasive or water blast deck within 24 hours of overlay* air blast deck immediately before overlay* place plastic sheeting to avoid deck contamination* straightedge checking at bulkheads and enddams* need 2 walk-bridges (1 for finishers and 1 for burlap)* texture deck with tining tool (0.15" deep)* smooth finish along curbs and/or parapets only* burlap shall follow as close as possible to deck overlayCA-S-5 Micro-Silica Overlay Pre-Pour Meeting - 3/3PROJECT: ________________________________________ DATE: ___________________PROJECT INSPECTIONPersonnel (If available) ? Moisture tests to be run at _______________ followed by design of the mix. ? 1 Plant Inspector ____________________________ * check moistures* checking revolutions* checking no wash water ? 2 Concrete Control Testers _____________________________ * full test on every truck ______________________________ * Cylinders as required every 50 CY* check concrete temperature ? 1 Concrete Quality Control Inspector _____________________________ * documenting any added materials* check batch tickets* time from start to discharge* insuring 5 minute mixing time if materials added* documenting test results* fill out TE-45 ? 1 Placement Inspector _____________________________ * make depth checks* Ensure curing is placed ASAP MISCELLANEOUS ? Traffic ControlCA-S-5 Micro-Silica Overlay Pre-Pour Meeting - 3/3 (back)CA-S-6Class S Concrete Pre-Pour Meeting- 1/2PROJECT: _____________________________________________________ DATE: ___________________LOCATION: ___________________________________________________ TIME: ___________________ PRESENT: __________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________ DRY RUN: _________________ ? Check height of rail over enddams at all four corners - *Equal heights for left rear and fwd and for right rear and fwd ? Check any change in cross-slope and discuss method of performance– Confirm appropriate depth of roller fins– Check reinforcing steel clearancesTIME AND LOCATION OF POUR: ? Date: __________________ Time:__________________ ? Pour to begin on __________________ side and commence on the __________________ side ? Location of pumps, if used ? Lighting plan if at night PLAN AND SPECIFICATION REVIEW: ? Air temperature must be below 85o and not predicted to go over during concrete placement ? Surface evaporation rate must be equal to or less than 0.2 lbs/sq. ft. per hour ? Must water cure: 2 layers of burlap with continuous water, or plastic coated/covered burlap with positive moisture seal.– Cure (5) five days with beam testCONCRETE PLANT: ? Presoak limestone 24 hours and allow to drain overnight*Don’t charge bins with dry material ? Batching to begin at __________________ ? Expel all water from the mixers before loading / reloading ? Add super on jobsite if long haul distance ? Minimum of 70 revolutions on mixers before leaving plant unless central mixed ? Pour consists of approximately __________________ C.Y. ? Time between trucks __________________ minutes ? Pour __________________ cy./hr. ? Radio communication with plant for mix design changes ? Haul distance:__________________ minutesCA-S-6Class S Concrete Pre-Pour Meeting- 2/2PROJECT: ____________________________________________ DATE: ___________________QUALITY CONTROL (Air and Slump tests to be checked at the point of Placement) ? Class S Concrete? Slump 2-4 inches (6" nom. And 7" max. with addition of type F or G admixture) ? W/C max = 0.44? Type B or D admixture (retarder) to be used if over 60o F. ? Air 6% ± 2? Discharge time = 60 minutes (90 minutes with retarder)CONTRACTOR’S OPERATION ? Tools* broom finish, * straightedge, * wet burlap, * plastic for bad weather protection, * extra vibrator,* weather gauges ? Concrete Placement* air blast deck before pour* wet forms before placement* straightedge checking at bulkheads and enddams* need 2 walk-bridges (1 for finishers and 1 for burlap)* Groove as per 511.20* smooth finish along curbs and/or parapets only* wet burlap shall follow immediately after finishingPROJECT INSPECTIONPersonnel (if available) ? Moisture tests to be run at ______________________________________ followed by design of the mix.? 1 Plant Inspector: ______________________________________* writing tickets, * checking revolutions, * checking no wash water? 2 Concrete Control Testers ______________________________________ * chase air on every truck, * various pump, if used, configuration correlation tests* make beams, * check concrete temperature? 1 Concrete Quality Control Inspector ______________________________________ * documenting any added materials, * checking rev’s* documenting test results, * fill out TE-45? 1 Placement Inspector ______________________________________ * make depth checks, * make reinforcing steel depth checks* insure curing is placed ASAP without marring surfaceMISCELLANEOUS?Traffic ControlCA-S-7QCS Inspection DocumentationCA-S-7QCS Inspection Documentation (back)CA-S-8(BR-5) Piling RecordProject No:County/Route/Section:Bridge No:Object Bridge Over:SFN:Date: Substructure Unit:Date Driven:Hammer:Pile Type:Required Resistance:Required Ultimate Bearing:Batter:Drop Hammer Ram Weight: Cutoff Elevation:Ground Elevation:Pile NumberPile LengthBlows/Ft at end of DrivingStroke or Pressure at end of DrivingBatterNo. of SplicesRemarksInspectors Name:Signature: CA-S-8(BR-5) Piling Record (back)CA-S-9Reinforcing Steel VerificationCA-S-9Reinforcing Steel Verification (back)CA-S-11QCS & Visual Standards InformationCA-S-11QCS & Visual Standards Information (back)CA-S-12Bridge Painting Quality Control Points (QCP #1 & #2)CA-S-12Bridge Painting Quality Control Points (QCP #1 & #2) (back)CA-S-13Abrasive Blasting (QCP#3) CA-S-13Abrasive Blasting (QCP#3) (back)CA-S-14Disposal of Hazardous / Non- Hazardous Waste for Bridge Painting (QCP#4)CA-S-14Disposal of Hazardous / Non- Hazardous Waste for Bridge Painting (QCP#4) (back)CA-S-15Prime Coat Application (QCP#5) CA-S-15Prime Coat Application (QCP#5) (back)CA-S-16Bridge Painting: Grinding Fins, Tears, and Slivers; and Caulking (QCP #6 & #9)CA-S-16Bridge Painting: Grinding Fins, Tears, and Slivers and Caulking (QCP #6 & #9) (back)CA-S-17Intermediate & Finish Coat Application (QCP #8 & #10)CA-S-17Intermediate & Finish Coat Application (QCP #8 & #10) (back)CA-S-18Bridge Painting Destructive Test Log (QCP #11)CA-S-18Bridge Painting Destructive Test Log (QCP #11) (back)CA-S-19Bridge Painting Final Review (QCP #11)CA-S-19Bridge Painting Final Review (QCP #11) (back)CA-S-20Erection (Demolition) Procedure ChecklistName (print clearly): ____________________________________________________________Project: _________ Bridge (Co, Rt, Section): _________________________________________Description: _____________________________________________________________________Items Inspected:Plan:□ Contractor’s Erection (Demolition) Plan stamped by two PE’s.□ Contractor’s Erection (Demolition) Plan accepted by regulatory agencies, Railroads, Coast Guard, U.S. Army Corps of Engineers, etc., if applicable.Details: □ Erection (Demolition) sequence for all members. □ Maintenance of Traffic during erection (demolition) operations.□ Location of permanent support structures, roads, railroads, waterways, utilities.□ Member delivery location and orientation for erection.□ Member removal location and orientation for demolition.□ Location and radius of each crane during each pick.□ Location of crane support (barges, mats, etc.) , during each pick.□ Crane capacities shown for each crane configuration and boom length used.□ Lifting weights of primary member picks, including all rigging. □ Rigging weights, capacities, and arrangements for primary member picks.□ Locations of the centers of gravity and lifting points for primary members.□ Temporary supports or bracing.□ Blocking for bridge bearings.Calculations:□ Load capacity and stability of crane(s), temporary supports and rigging for each pick and release. □ Structural adequacy and stability of members for each erection (demolition) step.Signature: _______________________________________ Date: ___________ CA-S-20Erection (Demolition) Procedure Checklist (back)CA-S-21Sealing of Concrete Surfaces ChecklistName (print clearly): _________________________________________________________Project: _________ Bridge (Co, Rt, Section): ______________________________________Description: _________________________________________________________________Items Inspected:Storage:□ Thermometer to check for manufacturer’s acceptable range□ Sealer stored not frozen nor in sun □ Shelf lifeSubmittals made:□ Technical and application data □ Material Safety Data Sheet□ 100 Grit Sandpaper supplied by Contractor for comparisonEquipment for proper preparation:□ Correct water blast equipment (7000 psi minimum)□ Correct abrasive blast equipment (followed by cleaning)Equipment mixing and application:□ Equipment meets manufacturer’s requirements:Surface Preparation, clean concrete with 100 grit sandpaper texture:□ Test site set up □ Test all surfaces, (not just vertical) □ Surface checked for texture □ Acid Test performed if curing compound usedMixing:□ Material used within manufacturer’s shelf life □ Mix time and pot life marked□ Mixed per manufacturer’s recommended proceduresApplication:□ Conditions acceptable □ Material applied within pot life □ Minimum coating rates met in test sectionsEpoxy – 120 Ft2/gal, (150 Ft2/gal if authorized)Urethane - 200 Ft2/gal,(even coverage, no skips or sags)Non-Epoxy – 100 Ft2/gal, Decks, 125 Ft2/gal, Vert. Surfaces Signature: ____________________________________________ Date: ____________ CA-S-21Sealing of Concrete Surfaces Checklist (back)TE-45Concrete Inspectors Daily ReportTE-45Concrete Inspectors Daily Report (back)CA-C-1Concrete Control Test FormProject No.: ____________________________ Co./Rt./Sec.: ______________________________Name: ________________________________ Date: ___________ Truck No.: ______________Arrival Time: _______________________ Discharge Time: ______________________________Placement Description: ____________________________________________________________Placement Location: _______________________________________________________________Cylinder Sample Numbers: ________________________________________ Class ____ ConcreteFull Pot Weight = (+) ___________________ lbs.Empty Pot Weight = (-) ___________________ lbs.Concrete Weight = ___________________ lbs.Air Pot Factor = ADVANCE \d 2\s \* MERGEFORMATADVANCE \u 2 ____________________Weight of One Cubic Foot (Unit Weight) = ____________________ lbs / ft3Batch Weight Fine Aggregate Weight: ________ lbs / _______ yd3 = _________________ lbsCoarse Aggregate Weight ________ lbs / _______ yd3 = _________________ lbsCement Weight________ lbs / _______ yd3 = _________________ lbs Water Batch Weight________ lbs / _______ yd3 = _________________ lbs Additional Weight________ lbs / _______ yd3 = _________________ lbs One Cubic Yard Batch Weight = _________________ lbsYield Test Results \s \* MERGEFORMAT____________________ Cubic FeetAir = ____ % , Slump = _____ inch , Air Temp. = ____ , Concrete Temp.= _____CA-C-1Concrete Control Test Form (back)CA-EW-1Earthwork Quantity CalculationsCA-EW-1Earthwork Quantity Calculations (back)CA-EW-2Proof Rolling DocumentationCA-EW-2Proof Rolling Documentation (back)CA-EW-3Log of Test Pit InvestigationCA-EW-3Log of Test Pit Investigation (back)CA-EW-4Moisture Density Curve CalculationCA-EW-4Moisture Density Curve Calculation (back)CA-EW-5Nuclear Gauge Compaction FormCA-EW-5Nuclear Gauge Compaction Form (back)CA-EW-6Nuclear Gauge Compaction with Aggregate CorrectionCA-EW-6Nuclear Gauge Compaction with Aggregate Correction(back)Typical Moisture Density Curves - Set C - May, 1949Zero Air Voids CurveCA-EW-8Authorization of UndercutsCA-EW-8Authorization of Undercuts (back)CA-EW-9Rock Blasting Inspection FormCA-EW-9Rock Blasting Inspection Form (back)CA-EW-10Rock Blasting Drilling LogCA-EW-10Rock Blasting Drilling Log (back)CA-EW-11Blast Site Security PlanCA-EW-11Blast Site Security Plan (back) CA-EW-12Daily Earthwork Inspection FormCA-EW-12Daily Earthwork Inspection Form (back)CA-EC-1 Weekly and Rain Event ChecklistCA-EC-1 Weekly and Rain Event Checklist (back)CA-EC-2Seeding CalculationsProject No:County/Route/Section:Ref. No:Item & Description:LeftRightStationWidthSumDistSq. Yd.StationWidthSumDistSq. Yd.------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------TotalTotalRemarks: _______________________________________________________________________________________________________________________________________________________Test conducted by:Inspected By:Date:Checked By:Date:CA-EC-2Seeding Calculations (back)CA-FP-1Warranty Asphalt ChecklistCA-FP-1Warranty Asphalt Checklist (back)CA-FP-2 Random Selection of Asphalt Field Samples (448, 403)CA-FP-2 Random Selection of Asphalt Field Samples (448, 403) (back)CA-FP-3Summary of Asphalt Concrete Quantities CA-FP-3Summary of Asphalt Concrete Quantities (back)CA-FP-4Asphalt Concrete inspectionCA-FP-4Asphalt Concrete inspection (back)CA-FP-5Roller Capacity and Placement Rate CA-FP-5Roller Capacity and Placement Rate (back)CA-FP-6Calculation of Liquid Asphalt MaterialsCA-FP-6Calculation of Liquid Asphalt Materials (back)Notes:This formula calculates volume at the specified pay temperature (109.01) for the asphalt material. If the actual temperature, as measured in the tank truck or distributor, differs from the specified pay temperature, the pay volume must be adjusted as per Supplement 1060.Values for Temperature Factor, ""K"", and Coefficient of Expansion are included in ODOT Supplement 1060, Table A. Table B provides Pay Temperature and an index of formulas to be used for calculating volume based on actual measured temperature." TE-217Bituminous Concrete Density Determination - 446 CoresTE-217Bituminous Concrete Density Determination - 446 CoresTE-217Bituminous Concrete Density Determination - 446 Form InstructionsTE-217Bituminous Concrete Density Determination - 446 Cores InstructionsTE-217Bituminous Concrete Density Determination - 446 Random Number TableTE-217Bituminous Concrete Density Determination – (Blank)CA-P-1Pipe Construction Inspection Form- 1/2Project # _____________________County, Route & Section _________________________________________ Sample ID _____________________ Personnel ID _____________________ Date Sampled _____________________Item # _____________________ Ref. # Producer Code Contractor _____________________Description ____________________________________________________________________________________Location _________________ Balloon Ref. # __________Plan Page __________ Pipe Material (RCP, Metal, HDPE, Other) Type of Pipe (circle one) A B C D E F Pipe Markings ____________Provide a 2 to 1 slope from top of pipe in a cut to the top of excavation Provide a 2 to 1 slope from spring-line of pipe in a fill to the top of excavation W = Width of trench at Top of Pipe. Refer to Spec. 603.03W = Width of trench at Top of Pipe. ______ Refer to Spec. 603.03B = Thickness of bedding under pipe. _______________________T = Outside diameter of pipe to trench wall. _____________________S = Depth of bedding. ____________ OD = Outside diameter of pipe. ____________________________ * Type 2 is Shown See Specification For Type 1,3,4For Type 2 Bedding Plastic: B= 6"(150 mm) S= B + 30% ODFor Type 2 Bedding Non Plastic: B= 3"(75 mm) S= B + 30% ODTRENCH & BEDDING CHECKS (ACTUAL FIELD MEASUREMENTS)Check Stations & Location *TWBSO.D.InitialDate* Recommended checks every 50 feet, with a minimum of two checks per run. Check locations may be related to starting point such as outlet end, catch basin, C/L station, etc.Field Measurements Lf. (meter)Plan Pay Length Lf. (meter)Grade Check MethodBackfillCompaction Form#Initials & DateCompaction Method Tamp, Flood, etc.Type: Soil or Structural Backfill 1,2 or 3Lift DepthType of Joints (603.06) _____________________ Joints Installed Satisfactorily? ? Yes ? NoMaterials: All tested and approved prior to incorporation into the project.CA-P-1Pipe Construction Inspection Form2/2Balloon Ref. # (s):______________________ Plan Page (s):___________________________________Station to Station: ____________________________________________________________________________Plan Quantity: __________________________ LF (meters) Remarks: __________________________________________________________________________ _________Daily Total Field Measured: ________________ LF (meters) *Remarks: ___________________________________________________________________________ _________Daily Total Authorized Pay: ________________ LF (meter)**:_________________________________*Explain field measurements and authorized pay. Pay in accordance with 603.12 Method of Measurement? a) Structure or pipe end location moved or least cost to State when accommodating full sections.b) Measured to C/L of structure when inside structure dimension is over 6 linear feet (2 meters) in direction of flow or only one structure on the run of pipe.c) You must account to "Lab" for pipe length due to creep & measurements to C/L of structures.**Round all Items Reference to nearest 0.1 foot (0.03 meter).Remarks: Record problems, soft foundations, under cuts, rock, instructions, utilities encountered, etc. Describe and note location of existing conduits encountered, whether connected, plugged and abandoned, reconnected, etc.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Sketch area:____________________________________________ ___________________________________Inspector’s SignatureDate P.E./P.S. SignatureCA-P-2Underdrain Construction Inspection Form1/2Project # __________________ County, Route & Section __________________________________________________ Sample ID_________ Personnel ID__________________ Date Sampled______________________________________Item # _________ Ref. #_________ Producer Code_________ Contractor_____________________________________ Description ______________________________________________________________________________________Location _________Balloon Ref. # _________Plan Page_________ Pipe Material (RCP, Metal, HDPE, Other) Underdrain Markings_______ Filter Fabric Required _______Underdrain Joint Type_________ (coupler, bell & Spigot ) W = Width of trench.__________ D= Depth of Trench ____________ DT =Outside pipe to trench wall. _____________ID = Inside diameter of pipe.___________ TRENCH & BACKFILL CHECKS (ACTUAL FIELD MEASUREMENTS)Station to StationRight, Left SideEvery 50 feet (20m)TWI.D.BackfillMaterial8,9,89’sOutletStationHow OutletCatch BasinSlopeInitialDateDatePav’tPlacedCA-P-2Underdrain Construction Inspection Form2/2Balloon Ref. # (s):_____________________ Plan Page (s):____________________________________Station to Station: ____________________________________________________________________________Plan Quantity: __________________________ LF (meters) Remarks: ________________________________________________________________________________________Daily Total Field Measured: ________________ LF (meters) *Remarks: _______________________________________________________________________________________Daily Total Authorized Pay: ________________ LF (meter)**:____________________________________________*Explain field measurements and authorized pay. Pay in accordance with 603.12 Method of Measurement? a) Structure or pipe end location moved or least cost to State when accommodating full sections.b) Measured to C/L of structure when inside structure dimension is over 6 linear feet (2 meters) in direction of flow or only one structure on the run of pipe.c) You must account to "Lab" for pipe length due to creep & measurements to C/L of structures.**Round all Items Reference to nearest 0.1 foot (0.03 meter).Remarks: Record problems, soft foundations, under cuts, rock, instructions, utilities encountered, etc. Describe and note location of existing conduits encountered, whether connected, plugged and abandoned, reconnected, etc.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Sketch area:__________________________________________________________________________________________Inspector’s SignatureDate P.E./P.S. SignatureCA-P-3Drainage Structure Inspection Form1/2Project # _____________________County, Route & Section Sample IDPersonnel IDDate Sampled Item # Ref. # Producer Code Contractor DescriptionLocation _________________ Balloon Ref. # ____Plan Page ____ Material (Precast, Brick-Block, Other) Temperature _________ Structure Temperature ______ Mortar Temperature ______________Type of Pipe being placed in structure (circle all that apply) A B C D E F , Structure Markings ______Lifting Devices are to remain in place. Manhole top type furnished _________________________ W = Width of trench at Top of the Structure.___________B = Thickness of bedding under Structure. ___________T = Structure to trench wall thickness ___________ Type of Bedding Material Furnished _______________Type of Backfill material furnished _______________ Type of Structure (Catch Basin, Inlet, Manhole, 604.02) ________ Type of Joint Material being used (604.06) ________Pipe ODStructure Opening Dia.BackfillCompaction MethodTamp, Flood, etc.Type: Soil orStructural Backfill 1, 2, 3LiftDepthCompactionFormInitialsAnd DateCA-P-3Drainage Structure Inspection Form2/2Circle the Application: 1 Proposed Structure, 2 Reconstruction Structure, 3 Adjustment to GradeBalloon Ref. # ___________ Plan Page ________ Plan Station __________ Offset ___________ Elevation ____________Structure Top Field Station _______________ Field Offset___________________ Field Elevation____________________Manhole Plan Base Station _____________________ Offset _____________________ Elevation ____________________Manhole Field Base Station _________________ Field Offset__________________ Field Elevation__________________Reconstruction Structure removal depth________ Outlet Pipe Elevation __________ Field Outlet Pipe Elevation________Is the Sump Finished Per the Standard Drawing: YES __ NO__ Explain: _______________________________________ Is the Consults Finished Per the Standard Drawing: YES __ NO__ Explain: _____________________________________Authorized Pay: YES _______NO______ Reference Number____________________________Explain field measurements and authorized pay. Pay in accordance with 604.08 Method of MeasurementRemarks: Record problems, soft foundations, under cuts, rock, instructions, utilities encountered, etc. Describe and note location of existing conduits encountered, whether connected, plugged and abandoned, reconnected, etc. Provide locations and size of any laterals that are not part of a 603 pay Item in a sketch.____________________________________________________________________________________Sketch area:__________________________________________________________________________________________Inspector’s SignatureDate P.E./P.S. SignatureCA-D-1AField Calculation and Measurement Project No:County/Route/Section:Ref. No:Item & Description: SEQ CHAPTER \h \r 1Station LocationPlanSheetPlanRef.PlanQuantityFieldQuantityUnitFromToSideDescribe Location SEQ CHAPTER \h \r 1Calculation/Sketch/Additional Remarks:Special Notes:Inspected By:Date:Checked By:Date:CA-D-1AField Calculation and Measurement (back)CA-D-1BField Calculation and MeasurementProject No:County/Route/Section:Ref. No:Item & Description: SEQ CHAPTER \h \r 1Station LocationPlanSheetPlanRef.PlanQuantityFieldQuantityUnitFromToSideDescribe Location SEQ CHAPTER \h \r 1Calculation/Sketch/Additional Remarks:Special Notes:Prepared By:Date:Checked By:Date:CA-D-1BField Calculation and Measurement (back)CA-D-2Field Calculation and MeasurementProject No:County/Route/Section: SEQ CHAPTER \h \r 1LocationRef. #:Ref. #:Ref. #:Ref. #:Item:Item:Item:Item:Unit:Unit:Unit:Unit:DateStation or Plan PageL/RPlanQuantityMeasuredQuantityPlanQuantityMeasuredQuantityPlanQuantityMeasuredQuantityPlanQuantityMeasuredQuantityTOTALSSpecial Notes:Inspected By:Date:Checked By:Date:CA-D-2Field Calculation and Measurement (back)CA-D-3AODOT Inspectors Daily Report Project No:County/Route/Section:Report No:Date:Weather:Temperature:Precipitation:Contractor:Sublet No: SEQ CHAPTER \h \r 1Wo ? Ws ? Wc? Lost Day? Yes ? No ?Hours: From /ToSuperintendent / ForemanSupervisorSkilledOtherTotalContractor:Sublet No: SEQ CHAPTER \h \r 1Wo ? Ws ? Wc? Lost Day? Yes ? No ?Hours: From /ToSuperintendent / ForemanSupervisorSkilledOtherTotal SEQ CHAPTER \h \r 1DESCRIPTION OF WORK (DDCON) SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1DAILY DIARY PAY ITEMS (DDWAP) SEQ CHAPTER \h \r 1Ref #EW#PartCodePlanPagePlanCodeLocationQuantityUnit SEQ CHAPTER \h \r 1STATE EMPLOYEE HOURS (DDHRS) SEQ CHAPTER \h \r 1EmployeeHoursWorkedOvertimeHours WorkedWork CodeVehicle License No.PE/PS ApprovalCMSOvertime Explanation:Attachments: Y ? N ? Sketches/Calculations on reverse: Y ? N ?(DDRMK) Remarks on reverse:Y ? N ?CA-D-3AODOT Inspectors Daily Report (back) SEQ CHAPTER \h \r 1CONTRACTOR’S EQUIPMENT (DDCEQ) SEQ CHAPTER \h \r 1Sublet#Equipment TypeEquipment ID #IdleSublet #Equipment TypeEquipment ID #IdleSublet#Equipment TypeEquipmentID#Idle SEQ CHAPTER \h \r 1PAY ITEM NOTES (DDRMK): SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1REMARKS ( MOT/C-95/ACCIDENTS - DDRMK): SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1Inspector Signature: SEQ CHAPTER \h \r 1PE/PS Initials:CA-D-3BODOT Inspectors Daily Report Project No:County/Route/Section:Report No:Date:Weather:Temperature:Precipitation:Contractor:Sublet No: SEQ CHAPTER \h \r 1WO ? WS ? WC? Lost Day? Yes ? No ?Hours: From /ToSuperintendent / ForemanSupervisorSkilledOtherTotal SEQ CHAPTER \h \r 1DESCRIPTION OF WORK (DDCON) SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1CONTRACTOR’S EQUIPMENT (DDCEQ) SEQ CHAPTER \h \r 1Sublet#Equipment TypeEquipment ID #IdleSublet #Equipment TypeEquipment ID #IdleSublet#Equipment TypeEquipmentID#Idle SEQ CHAPTER \h \r 1STATE EMPLOYEE HOURS (DDHRS) SEQ CHAPTER \h \r 1EmployeeHoursWorkedOvertimeHours WorkedWork CodeVehicle License No.PE/PS ApprovalCMSOvertime Explanation:Attachments: Y ? N ? Sketches/Calculations on reverse: Y ? N ?(DDRMK) Remarks on reverse:Y ? N ?CA-D-3BODOT Inspectors Daily Report (back) SEQ CHAPTER \h \r 1DAILY DIARY PAY ITEMS (DDWAP) SEQ CHAPTER \h \r 1Ref #EW#PartCodePlanPagePlanCodeLocationQuantityUnit SEQ CHAPTER \h \r 1PAY ITEM NOTES (DDRMK): SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1REMARKS ( MOT/C-95/ACCIDENTS - DDRMK): SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1Inspector Signature: SEQ CHAPTER \h \r 1PE/PS Initials / Date:CA-D-4ODOT P.E. / P.S. Daily Report Project No:County/Route/Section:Date:TemperatureHigh:Low:Precipitation: Rain / Snow / Ice / FogLost day due to weather?Lost day due to other reason?Reason: SEQ CHAPTER \h \r 1ContractorDate Work StartedDate Work StoppedWork Complete(Yes/No)Additional Pay Items SEQ CHAPTER \h \r 1 (DDWAP) SEQ CHAPTER \h \r 1Ref #EW #Part CodePlan PagePlan CodeLocationQuantityUnitCA-D-4ODOT P.E. / P.S. Daily Report (back) SEQ CHAPTER \h \r 1Project Activities SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1General Remarks [ ] Potential Claim [ ] C-95 Related [ ] Partnering Related SEQ CHAPTER \h \r 1 SEQ CHAPTER \h \r 1P.E. / P.S. Signature: CA-D-5Daily Account of Force Account WorkProject No: County/Route/Section:Date:Contractor:Sub-Contractor:Description of Work:LaborNameClassFromToRegular HrsOT HrsEquipmentA-Owned/ Bid Work, B-Rented/ Bid Work, C-Owned/ Non-Bid work, D-Rented/ Non-Bid workA,B,C,DHrs UsedHrs IdleYearTypeModelHP, GVW, CapacityGas/Diesel/ElectEquip No.MaterialQuantityUnitDescriptionSignatures/DateContractor:ODOT:Original to ODOT File, Copy to ContractorCA-D-5Daily Account of Force Account Work (back)CA-D-6Pavement Repair and Sawing MeasurementProject No:County/Route/Section:Ref. No:Item & Description:StationStationLaneLength (ft)Width (ft)Depth (in)Quantity of Repair (sy)Length of Sawing (ft)Plan PageTOTALSSpecial Notes:Inspected By:Date:Checked By:Date:CA-D-6Pavement Repair and Sawing Measurement (back)CA-D-7Short Term Work Zone ReviewProject No: County/Route/Section:Date:Weather:Temperature:Time:Type Of Traffic Control: Road Closed / Lane Closed / Stationary / Moving / Shoulder / OtherWork performed by: ODOT / Permit / Utility / Contractor Name: A. Traffic Control / Safety Devices Signs, Flaggers, Cones, Drums, Arrow Boards, Signals, PCMS, etc.NoneDeficiency And Corrective Action To Be TakenDate CorrectedB. Traffic FlowEvidence of crashes, incidents, congestion points, delays, etc.NoneDeficiency And Corrective Action To Be TakenDate CorrectedC. Conformance with Standards Tapers, buffer areas, etcNoneDeficiency And Corrective Action To Be TakenDate CorrectedD. Interaction of Work Vehicles and Traffic Entering/exiting work zone, mud on road, etcNoneDeficiency And Corrective Action To Be TakenDate CorrectedE. Storage of Equipment and Materials Protected or outside of clear zoneNoneDeficiency And Corrective Action To Be TakenDate CorrectedAction taken Notification: Verbal / WrittenCorrect By Date:Section Requiring Action:A / B / C / D / ECorrected promptly? Yes / NoWork Stoppage Orders?Yes / NoDate corrected:Estimate Held?Yes / NoField Review by:Copy to: DWZTM, County Manager, Contractor , Construction or Other (Identify)CA-D-7Short Term Work Zone Review (back)CA-D-8Long Term Work Zone Review- 1/2 CA-D-8Long Term Work Zone Review - 2/2CA-D-9Daily Concrete Pavement Documentation Form - 1 / 5Project: ___________________ County/Route/Section: ___________________________Reference #: _______________Item #: ________________Contractor: __________________________________________Station: ______________ to _______________ Lane: _______Placement Width: __________ Placement Depth: __________Date: ____________Temperature and Weather: __________________________________________PCJMF: __________________________SUBBASESubbase material and condition: ______________________________________Was the subbase thoroughly moistened before placing concrete? __________ (451.06)Method used to water subbase: __________________________________________________JOINTS (451.08)Longitudinal Joints (451.08A) – Tie Bars Length: __________ Size: __________ Depth placed: __________Are tie bars epoxy coated? __________Method of placing tie bars: ______________________________________________________Are tie bars being kept horizontal in the slab? ___________Tie bar spacing? ___________ Number of tie bars placed per typical panel? ___________ Longitudinal joint located at _________ feet from left edge of slab _________ feet from right edge of slabCA- D-9Daily Concrete Pavement Documentation Form - 2 / 5Load Transfer Devices (451.08 B) - Transverse Joints Dowel Length: __________ Diameter: __________ Depth placed: __________Are dowel bars epoxy coated? __________ Were the dowel bars oiled? __________ Entire bar or alternating ends? _______________Are dowel bars being kept in the proper alignment? ____________________________Method of placing dowel bars? ________________________________________________Dowel bar spacing? _______________ beginning ______________ from edge of slab Number of dowels placed per panel? _________ for _________ panel width _________ for _________ panel width Transverse joint spacing: ______________Expansion Joints (451.08C)Dowel Length: __________ Diameter: __________ Depth placed: __________Are dowel bars epoxy coated? __________ Were the dowel bars oiled? __________ Were expansion sleeves installed? __________On opposite ends of adjacent dowels? _______Transverse joint spacing: ______________Construction Joints (451.08E)Construction joint type: ______________________________________________________Method of doweling construction joint: __________________________________________ Location of construction joint with respect to contraction joint: _______________________ CA- D-9Daily Concrete Pavement Documentation Form - 3 / 5PLACING CONCRETE (451.06)Method of Construction – Fixed Form or Slip Formed? ________________________________Formed ConstructionForms made of steel? ___________Form depth equal to pavement thickness? _______Forms cleaned and oiled? _________Slip Form ConstructionSlip form paver make/ model: _________________________________________ Number of internal vibrators: __________________________________________ Vibrator monitors working? ___________Were all vibrators working properly? _______ Vibration frequency range _______ to ______ ipmWas vibrator information recorded? ________Method of aligning paver: _________________________________________________ Paver advancement rate: ____________ feet/minuteIs the longitudinal face of the slab being kept vertical? ____________ Any projections or ridges exceeding tolerances in 451.03B? ____________Method of depositing concrete:Is a spreader required/used? _____________________________________________Was its use waived? / Reason: _______________________________________________CA- D-9Daily Concrete Pavement Documentation Form - 4 / 5FINISHING (451.09)Hand finishing methods used: ____________________________________________________Was 10’ straightedge used? _____________Were pavement edges rounded? ___________Micro texture type: _____________________ applied using: ____________________________ Macro texture type: _____________________ applied using: ____________________________ Tine groove spacing: ____________________ Tine depth: ______________________________Were station numbers stamped into the shoulder pavement? ______________ Spacing? _______Station number position: ________________________________________________________CURING (451.10)Method of applying curing compound: _____________________________________________Curing compound required: Width = _____ (slab width) + 2 x _____ (slab thickness) = _____ Gallons Required = ________ (length) x ______ (width) / 150 = _________ Gallons Used = __________ (begin tank) - __________ (end tank) = ___________Curing compound applied approximately ___________ minutes after final finishingJOINT SAWING (451.08)Was a HIPERPAV file submitted for this pour? ___________HIPERPAV predicts early age cracking beginning at _____________ without joint sawing.Joint sawing began at ____________Method of sawing: Early-entry saw? ______ Wet Sawing? ________Width of Saw CutDepth of Saw CutLongitudinal Joints: _________________________________Contraction Joints:_________________________________CA- D-9Daily Concrete Pavement Documentation Form - 5 / 5INSTRUCTIONS GIVEN TO THE CONTRACTOR__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________COMMENTS __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature: ________________________________ Date: ___________________CA- D-9Daily Concrete Pavement Documentation Form - (Back)CA-L-1Report of Electrical Tests For Traffic SignalsProject No:County/Route/Section:Ref. No:Item & Description:Short Circuit Test (CMS 632.28C) (Infinite or very high OHMS required)Circuit Continuity Test (CMS 632.28D) (Zero or negligible OHMS required) SEQ CHAPTER \h \r 1Pairs Measured SEQ CHAPTER \h \r 1OHMS SEQ CHAPTER \h \r 1Pairs Measured SEQ CHAPTER \h \r 1OHMS SEQ CHAPTER \h \r 1Pairs MeasuredZero- SEQ CHAPTER \h \r 1OHMS SEQ CHAPTER \h \r 1Pairs MeasuredZero- SEQ CHAPTER \h \r 1OHMSSignal CableInterconnectCable (7 cond.)LOOP UNSPL.InterconnectCable (7 cond.) SEQ CHAPTER \h \r 1W/R SEQ CHAPTER \h \r 1W/R SEQ CHAPTER \h \r 1loop unspl. SEQ CHAPTER \h \r 1W/R SEQ CHAPTER \h \r 1W/ORG SEQ CHAPTER \h \r 1W/ORG SEQ CHAPTER \h \r 1loop unspl. SEQ CHAPTER \h \r 1W/ORG SEQ CHAPTER \h \r 1W/G SEQ CHAPTER \h \r 1W/G SEQ CHAPTER \h \r 1loop unspl. SEQ CHAPTER \h \r 1W/G SEQ CHAPTER \h \r 1W/BK SEQ CHAPTER \h \r 1W/BL SEQ CHAPTER \h \r 1 loop + L.I. SEQ CHAPTER \h \r 1W/BL SEQ CHAPTER \h \r 1R/ORG SEQ CHAPTER \h \r 1W/WBK SEQ CHAPTER \h \r 1 loop + L.I. SEQ CHAPTER \h \r 1W/WBK SEQ CHAPTER \h \r 1R/G SEQ CHAPTER \h \r 1W/BK SEQ CHAPTER \h \r 1 loop + L.I. SEQ CHAPTER \h \r 1W/BK SEQ CHAPTER \h \r 1R/BK SEQ CHAPTER \h \r 1R/ORG SEQ CHAPTER \h \r 1 loop + L.I. SEQ CHAPTER \h \r 1R/ORG SEQ CHAPTER \h \r 1ORG/G SEQ CHAPTER \h \r 1 R/G SEQ CHAPTER \h \r 1Signal Cable SEQ CHAPTER \h \r 1 R/G SEQ CHAPTER \h \r 1ORG/BK SEQ CHAPTER \h \r 1R/BL SEQ CHAPTER \h \r 1W/R SEQ CHAPTER \h \r 1R/BL SEQ CHAPTER \h \r 1G/BK SEQ CHAPTER \h \r 1R/WBK SEQ CHAPTER \h \r 1W/ORG SEQ CHAPTER \h \r 1R/WBK SEQ CHAPTER \h \r 1ETC. SEQ CHAPTER \h \r 1 R/BK SEQ CHAPTER \h \r 1W/G SEQ CHAPTER \h \r 1R/BK SEQ CHAPTER \h \r 1ORG/G SEQ CHAPTER \h \r 1W/BK SEQ CHAPTER \h \r 1ORG/G SEQ CHAPTER \h \r 1ORG/BL SEQ CHAPTER \h \r 1R/ORG SEQ CHAPTER \h \r 1ORG/BL SEQ CHAPTER \h \r 1ORG/WBK SEQ CHAPTER \h \r 1R/G SEQ CHAPTER \h \r 1ORG/WBK SEQ CHAPTER \h \r 1ORG/WB SEQ CHAPTER \h \r 1R/BK SEQ CHAPTER \h \r 1ORG/WB SEQ CHAPTER \h \r 1G/BL SEQ CHAPTER \h \r 1ORG/G SEQ CHAPTER \h \r 1G/BL SEQ CHAPTER \h \r 1ALL GRDG/WBK SEQ CHAPTER \h \r 1ORG/BK SEQ CHAPTER \h \r 1G/WBK SEQ CHAPTER \h \r 1G/BK SEQ CHAPTER \h \r 1G/BK SEQ CHAPTER \h \r 1G/BK SEQ CHAPTER \h \r 1Power Cable SEQ CHAPTER \h \r 1BL/WBK SEQ CHAPTER \h \r 1Power Cable SEQ CHAPTER \h \r 1BL/WBK SEQ CHAPTER \h \r 1W/BK SEQ CHAPTER \h \r 1BL/BK SEQ CHAPTER \h \r 1W/BK SEQ CHAPTER \h \r 1BL/BK SEQ CHAPTER \h \r 1W/R (3 cond.) SEQ CHAPTER \h \r 1WBK/BK SEQ CHAPTER \h \r 1W/R (3 cond.) SEQ CHAPTER \h \r 1WBK/BK SEQ CHAPTER \h \r 1BK/R (3 cond.)Jumpered together SEQ CHAPTER \h \r 1(9 cond. ETC.)Add sheet SEQ CHAPTER \h \r 1BK/R (3 cond.) SEQ CHAPTER \h \r 1 (9 cond. ETC.)Add sheetTest conducted by:Inspected By:Date:Checked By:Date:CA-L-1Report of Electrical Tests (back)CA-L-2Report of Electrical TestsSignal-Ten Day Test (CMS 632.28G)Project No:County/Route/Section:Ref. No:Item & Description:Test Conducted By: ______________ Representing _________________________Test Witnessed By:________________ Representing _______________________CertificationI hereby certify that the above test was conducted in conformance with the plans and specifications for Project No.____________, that the test results as indicated below and that the requirements of the plans and specifications have been met.Contractor’s Representative: _________________________________________Title: _________________________________________________________________________Signal Control System Ten Day Performance TestTime and Date Started: __________________________________________________________Time and Date Completed: _______________________________________________________Details of Outages, Trouble, Repairs, Etc., Including Locations: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________NOTE: If this report does not include all of the (electrical) (lighting) systems proposed on the project, indicate here the separate circuits or components covered by this test:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Test Conducted By: ________________________ Representing: _________________________CA-L-2Report of Electrical Tests (back)CA-L-3Report of Electrical Tests Sign Lighting Test (CMS 625.19)Project No:County/Route/Section:Ref. No:Item & Description:Note: This report shall be accompanied by a written certification that test equipment used was last calibrated by an acceptable testing agency not more than 60 days prior to the date of the test. SEQ CHAPTER \h \r 1Ground Test [] Circuit Test [] SEQ CHAPTER \h \r 1Location SEQ CHAPTER \h \r 1Light/Sign Structure No.Circuit No. SEQ CHAPTER \h \r 1 Station SEQ CHAPTER \h \r 1Route, Street, Etc SEQ CHAPTER \h \r 1LT./RT. SEQ CHAPTER \h \r 1Resistance in:Ohms- ? Megohms-?Test Conducted By: _______________________________ Date: ________________________ Representing: ____________________________________________________________________Test Witnessed By: _____________________________________ Date: ___________________Representing: ____________________________________________________________________CertificationI hereby certify that the above test was conducted in conformance with the plans and specifications for Project No.____________, that the test results were as indicated above and that the requirements of the plans and specifications have been met. Contractor’s Representative: ___________________________________ Date: ____________ Title: ___________________________________________________________________________CA-L-3Report of Electrical Tests (back)CA-L-4Report on Sign Lighting (CMS 625.09 and CMS 631)Project No:County/Route/Section:Ref. No:Item & Description:RefGround Rod Reading:RefDisconnect Switch Amps:Type Enclosure:SIGN “A” - (Length) __________ X (Width) __________ = __________ SQ. FT.RefBallast TypeRefLamp SizeType QuantityRefLamp SizeType Quantity HEIGHT: BOTTOM OF SIGN TO TOP OF PAVEMENT: __________ RefSign Wired CompleteSIGN “B” - (Length) __________ X (Width) __________ = __________ SQ. FT.RefBallast TypeRefLamp SizeType QuantityRefLamp SizeType Quantity HEIGHT: BOTTOM OF SIGN TO TOP OF PAVEMENT: __________ RefSign Wired CompleteSIGN “C” - (Length) __________ X (Width) __________ = __________ SQ. FT.RefBallast TypeRefLamp SizeType QuantityRefLamp SizeType Quantity HEIGHT: BOTTOM OF SIGN TO TOP OF PAVEMENT: __________ RefSign Wired CompleteSIGN “D” - (Length) __________ X (Width) __________ = __________ SQ. FT.RefBallast TypeRefLamp SizeType QuantityRefLamp SizeType Quantity HEIGHT: BOTTOM OF SIGN TO TOP OF PAVEMENT: __________ RefSign Wired CompleteTest Conducted By:Inspected by:Date:Checked by:Date:CA-L-4Report on Sign Lighting (back)CA-L-5Report on High Voltage Direct Current Tests(CMS 625.19E and SS 1003)Project No:County/Route/Section:Ref. No:Item & Description:Circuit NumberPower 1Power 2NeutralAir TemperatureRelative HumidityNotes: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Test Conducted By:Inspected by:Date:Checked by:Date:CA-L-5Report on High Voltage Direct Current Tests (back)CA-T-1DLS Report Format - Weight-Based SystemCA-T-2DLS Short Report Format - Weight-Based SystemCA-T-3DLS Report Format – Stroke Counter SystemCA-T-4DLS Short Report Format – Stroke Counter SystemCA-T-5DLS Report Format – Flow Meter Based SystemCA-T-6DLS Short Report Format – Flow Meter Based SystemCA-T-7DLS Report Format – ThermoPlastic SystemCA-T-8DLS Short Report Format – ThermoPlastic SystemTE-31Sample Data Envelope No: __________Sample ID: __________ Sample Origin: _____________________ Personnel ID: _________Type of Inspection: ______________________________________ Date Sampled: __________P/S Code (1): _______________________________ at ________________________________Mix Plant Code (1): __________________________ at ________________________________Material Code: __________________________________________________________________Brand Name: ___________________________________________________________________Description 1: ___________________ 2: __________________ 3: _________________________Represents Quantity (2): __________________________ Unit of Measure:________________Number of Items: __________________________ Consigned to: _________________________Sampled from: ______________________________ Mfg. Control Number: ________________Responsible Location: ________________________________ Test Lab: ___________________Assign ToProject POPO IndItem CodeRef NoQuantityLot/Day (3): ____________________________ JMF (3): _______________________________Concrete Cylinder Specimen Numbers (4): _____________ Bill of Lading No: ____________Remarks: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Same materials are used at a Bituminous or PC Concrete mix plant and are sampled and tested by plant and not by project. For these samples the producer/supplier is identified in the P/S field and the mix plant where the material is sampled is identified in the mix plant field.Job control samples require a quantity. Rice and Extraction Samples require a JMF, 411 materials require Lot/Day No.Identifies concrete cylinders being shipped to the Test lab (TE-31 not to be entered into CIVIS - data already entered from corresponding TE-45)TE-31Sample Data (back)Noise Barrier Wall Shop Drawing Review ChecklistThe purpose of this checklist is to assist the Engineer with the Department’s review of shop drawings submitted by the Contractor in accordance with Standard Bridge Drawing, NBS-1-09.The shop drawings are signed, sealed and dated by an Ohio Registered Professional Engineer. See footnote ( ).The Contractor has accepted the shop drawings in writing. See footnote (1).The acceptance letter documents all issues raised by the contractor, fabricator and Department including disposition of issues. See footnote (1).For absorptive walls, the absorptive wall material supplier is a pre-approved supplier in accordance with NBS-1-09 or all certified test data and performance history documentation has been provided and is in accordance with NBS-1-09. See footnote (1).The shop drawing top of wall elevation at each panel meets or is above the plan requirements. See footnote ( ).The shop drawing bottom of wall elevation at each panel meets or is lower than the plan requirements. See footnote (2).The total panel height at each location meets the plan requirements and is consistent with the top and bottom of wall elevations as provided in the shop drawings. See footnote (2).The shop drawing post height at each location meets the plan requirements. See footnote (2).The shop drawing individual panel designs are in accordance with NBS-1-09. See footnote (3).The shop drawing individual post designs are in accordance with NBS-1-09. See footnote (3).The shop drawing wall alignment is in accordance with the contract requirements. See footnote (3).The shop drawing material requirements are in accordance with NBS-1-09. See footnote (3).The shop drawing aesthetic treatments are in accordance with the contract requirements, including alignment of horizontal joint lines for at least 96-ft. See footnote ( ).The shop drawing base plate and anchor bolt requirements are in accordance with NBS-1-09. See footnote (3).If all checklist items are met, mark documents as “ACCEPTED”.Footnotes: 1. If missing, mark documents as “NOT ACCEPTED”. 2. Document all discrepancies and mark documents “ACCEPTED AS NOTED”. Resubmittal is not required. 3. Document all discrepancies and mark documents “ACCEPTED AS NOTED – RESUBMIT”.Noise Barrier Wall Shop Drawing Review Checklist – (Back)Preconstruction Meeting Agenda / Checklist, Page -1/2 Preconstruction Meeting Agenda/MinutesAttach signed attendance sheet with Name/Representing/PhoneDate of Conference: _________ Location: _______________________________Name of Person Presiding over meeting: ________________________________State Project No: __________, C-R-S: _____________, PID: ________________Project Type / Description: ___________________________________________Bid date: _________ Awarded date: _________ Completion date: ____________Estimate dates: __________ and _____________ of each month, accepted payroll and certification of estimates is required (109.09)Distribute and discuss applicable Plans, Specifications, Addenda information: _______________________________________________________________________________________________________________________________________Status of Utilities, RR and Local requirements: ________________________________________________________________________________________________________________________________________________________________107.20, 108.01, DBE/EEO/Prevailing wage bulletin and submittal discussion: _______________________________________________________________________________________________________________________________________PN 10, ARRA (Stimulus Project) data submission requirements discussion: _____ ____________________________________________________________________________________________________________________________________107.19, SS832 - Erosion Control and Best Management Practices discussion: ___ ____________________________________________________________________________________________________________________________________Initial Schedule received? _____ (Bar Chart or CPM)Use extra pages as necessary for each topic.Preconstruction Meeting Agenda / Checklist, Page -2/2Prime Contractor: ____________________________Phone No: ______________Superintendent: ______________________________Phone No: ______________Normal Work Hours: _________ to _____________ WeekdaysNormal Work Hours: _________ to _____________ WeekendsExpected Construction Start Date: ______________Locations, Dates, and Descriptions of major work phases: _______________________________________________________________________________________________________________________________________________________105.13, Haul roads designated: ____________________________________________________________________________________________________________________________________________________________________________105.16, Borrow/ Waste/ Agreements: _______________________________________________________________________________________________________________________________________________________________________108.02, List Subcontractors to be used: __________________________________ ____________________________________________________________________________________________________________________________________108.02, AC / PCC plants to be used: ____________________________________ ____________________________________________________________________________________________________________________________________108.02, List of major material suppliers: _____________________________________________________________________________________________________________________________________________________________________208.12, Blast prequalification information: _______________________________ ____________________________________________________________________________________________________________________________________501.04, List of steel fabricators and precast concrete fabricators: ______________ ____________________________________________________________________________________________________________________________________514.09, List of MSDS for all paints, thinners, and abrasives: _________________ ____________________________________________________________________________________________________________________________________641.04, Method of DLS for Traffic Paint data reporting: _____________________ ____________________________________________________________________________________________________________________________________Distribute the Preconstruction Minutes with all attachments to: Project Engineer, Prime Contractor Superintendent, Designer, Construction Office, LPA, and others expressing interest. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download