Forms Type (A, B, C, or D) Start of Drilling (date & time) Drill Rig/Drill Method End Drilling Flushing Media (air/water) Start of Grouting Drill Rig #, Operator Pile Completion

Appendix C

Forms

SIZ

E, C

APA

CIT

Y,

HP

CFM

,A

XLE

CO

NFI

G.

734-3

428(3

-05)

LABORD

AIL

Y F

ORC

E A

CC

OU

NT R

ECO

RD

CO

NTRA

CTO

RPR

OJE

CT N

AM

E (S

ECTIO

N)

CO

NTRA

CT N

O.

SU

B-C

ON

TRA

CTO

RH

IGH

WA

YC

OU

NTY

EWO

NO

.D

ATE

OF

WO

RK

DES

CRIP

TIO

N O

F W

ORK

REM

ARK

S

EQUIPMENT

NA

ME

CR

AF

TG

RO

UP

NO

.H

OU

RS

QU

AN

TIT

YU

NIT

MATERIALSC

ON

TR.

TY

PE O

F EQ

UIP

MEN

TM

AN

UFA

CTU

RER

MO

DEL

NO

.Y

EAR A

ND

/OR S

ERIA

L #

GA

SD

IESEL

PAY

ATTA

CH

MEN

TO

PER

STD

BY

ST

O

T

SE

E T

HE

INS

TR

UC

TIO

NS

ON

TH

E C

OV

ER

.The

Dai

ly F

orce

Acc

ount

Rec

ord

is p

repa

red

each

day

by

the

Insp

ecto

r an

d si

gned

by

the

Con

trac

tor's

Rep

rese

ntat

ive.

Orig

inal

to

the

Con

trac

tor

Rep

rese

ntat

ive,

cop

y on

e to

Con

stru

ctio

n C

ontr

act

Ser

vice

s w

ith C

ontr

acto

r'sbi

lling

, co

py tw

o to

Pro

ject

Man

ager

, cop

y th

ree

to O

rigin

ator

.

CO

NTRA

CTO

R'S

REP

RES

ENTA

TIV

E SIG

NA

TU

RE

PREP

ARED

BY

SIG

NA

TU

RE

Ordered by Engineer

Ordered by Engineer

DO

NO

T L

IST

:"A

LL"

"LU

MP

SU

M"

OR

"PE

R A

TT

AC

HE

D IN

VO

ICE

"

DES

CRIP

TIO

N

CER

T N

O.

Fo

rms

mu

stb

eo

rder

ed.S

elec

th

ere

too

pen

up

ord

erfo

rm

REPORT NO. FOR BID ITEM NO.

REASON FOR THIS REPORT

TYPE OF MATERIAL DATE DELIVERED

SOURCE OF MATERIAL (MANUFACTURER OR FABRICATOR)

QUANTITY APPROVED

TOTAL APPROVEDTO DATE

ESTIMATED TOTAL REQUIRED

SUPPORTING DATA I- TEST

WHERE INSPECTED DATE INSPECTOR SIGNATURE CERT NO.

734-3469 (1-2007)

REMARKS AND EXPLANATIONS, MATERIALS DESCRIPTIONS, DATES OF MANUFACTURE, HEAT AND LOT NOS. DAMAGED OR SUBSTANDARD MATERIALS, REASONS FOR REJECTION AND DISPOSITION OF REJECTED MATERIALS.

UNITQUANTITY DELIVERED

MATERIALS

DELIVERED

FOR

PROJECT

DELIVERED TO (NAME OFCONTRACTOR/SUBCONTRACTOR)

QUANTITY REJECTED (EXPLAIN)

LABORATORY REPORT NO.

SAMPLE DATA SHEET NO. FOR SAMPLE SENT TO MATERIALS LAB FOR TESTS

HIGHWAY F.A. PROJECT NO.

PROJECT MANAGER

FIELD INSPECTION REPORT

CONTRACT NO.PROJECT NAME (SECTION)

INSPECTION OF MATERIAL MATERIALS ON HAND

OTHER (EXPLAIN)

MATERIALS INSPECTION LABORATORY REPORT NO.

MATERIALS LABORATORY INSPECTION LABEL OR MARK.

TEST RESULTS CERTIFICATE

QUALITY COMPLIANCE CERTIFICATE

CONFORMANCE TO EQUIPMENT LIST AND DRAWINGS (EXPLAIN)

CERTIFICATE OF MATERIAL ORIGIN FOR PERMANENTLY INCORPORATED IRON OR STEEL MATERIALS AND THEIR COATINGS ON FEDERAL AID PROJECTS

FIELD TESTS OR OBSERVATIONS (EXPLAIN)

QPL ITEM

734-3474-d (07-2016) 1

Prepared by Cert No. Signature

Shift

Sunday Monday Tuesday Wednesday Thursday Friday SaturdayWork Date

General Daily Progress Report

Project Information

Project Name (Section) Contract No.

Highway Federal Aid No.

Contractor / Subcontractor On-Site Supervisor

Supervisor Present? NoYes

Weather

Clear Fair Cloudy Shower Rain Snow

TEMP10-32 32-50 50-70 70-83 Over 83

WINDStill Low Med High

HUMIDITYDry Low Med High

Contractor/Subcontractor Hours

Add Contractor

Number of Personnel and Major Equipment Reset

The first four columns are fixed and cannot be changed. In each of the remaining columns, please enter a heading specific to your job (e.g., Trainees, Backhoe, Flaggers) and record the numbers used by each contractor or sub.

Supe

rvis

ors

Ope

rato

rs

Truc

k D

river

s

Labo

rers

Location and/or Description of Work Estimated Quantities

Add Item Item No. This Date Total

Temporary Traffic Control Photo(s) Yes No

All traffic control items have been inspected and found to be satisfactory Yes No (if no, explain below)

Equipment Photo(s) Yes No

734-3474-d (07-2016) 2

Prepared by Cert No. Signature

Shift

Sunday Monday Tuesday Wednesday Thursday Friday SaturdayWork Date


Project Name (Section) Work Date

Effects on Work (weather, accidents, breakdowns, delays, personnel, etc.) Photo(s) Yes No

Materials Rejected Photo(s) Yes No

Project Visitors Photo(s) Yes No

Remarks Photo(s) Yes No

Include condition of traffic control and roadway; important discussions with contractors regarding rejected work or materials and reasons; delays, difficulties, accidents, utility damage and other unusual conditions and events; arrivals and departures of major equipment, visitors.

3734-3474-d_test (06-2016)

Work DateProject Name (Section)


PHOTOGRAPHS

Insert photo in this box. (Click in box and upload photo from computer or source.)

Photo #

Brief Description

X Insert photo in this box. (Click in box and upload photo from computer or source.)

Photo #

Brief Description

X


Photo #

Brief Description


Photo #

Brief Description

X


Photo #

Brief Description


Photo #

Brief Description

X

MILEPOST

CONTRACT NO STRUCTURE NAME AND NO.

PROJECT NAME (SECTION)

PROJECT MANAGER CONTRACTOR

COUNTY PILE DRIVING SUBCONTRACTOR (Piles Driven By):

TYPE OF LEADS:

OTHER (Provide Description):

LEAD DIMENSIONS Depth Width

MANUFACTURER MODEL TYPE

SERIAL NO. OWNER:

@ LENGTH OF STROKE RAM WT.

(KN-m)MODIFICATIONS

MATERIAL THICKNESS AREA

MATERIALS

TOTAL THICKNESS AREA

MODULUS OF ELASTICITY (E):

(MPa)COEFFICIENT OF RESTITUTION (e)

WEIGHT MODIFICATIONS

CUSHION MATERIALS AREA

NO OF LAYERS THICKNESS (EACH) TOTAL THICKNESS

MODULUS OF ELASTICITY (E): COEFFICIENT OF RESTITUTION (e)

(MPa)

PILE TYPE & SIZE Weight

LENGTH IN LEADS

WALL THICKNESS TAPER

NOMINAL PILE RESISTANCE ACCEPTANCE BY WAVE EQUATION

DESCRIPTION OF SPLICE

TIP TREATMENT DESCRIPTION (TYPE, MANUFACTURER, MODEL NO., ETC.)

SUBMITTED BY: DATE

(KN)

(mm)

(mm.) (mm2)

NOTE: If mandrel is used to drive the pile, attach separate manufacturer's detail sheet(s) including weight and dimensions.

ALLCOMPONENTS `

(mm2)

PILE AND DRIVING EQUIPMENT DATA

HIGHWAY

(m)

(KN/m)

(mm.) (mm.)

(KN)RATED ENERGY

(m)

(KN)

(mm.)

(mm2)

Yes No

Fixed Semi-Fixed Swinging

734-2608 (8-2009)

MICROPILE INSTALLATION LOG

Project Name Contract No.

Bridge No. Bent No. Pile No. Design Load (kips) Installation Date:

Micropile Type (A, B, C, or D) Start of Drilling (date & time)

Drill Rig/Drill Method End Drilling

Flushing Media (air/water) Start of Grouting

Drill Rig #, Operator Pile Completion

Grout Plant#, Operator Total Duration

Drill Bit Type and Size Cement Type*

Casing Dia./Wall Thickness w/c ratio

Casing (tempofafy/permafient) . . ... . .

GtourStrehgtH (psi)

Pile Inclination Reinforcement Size/Grade/Length aescnoe any grout aam1xtures oelow m grout comments

Pile Length Above B.O.F. Tremie Grout Quantity (bags)

Upper Cased Length Pressure Grout Quantity (bags)

Casing Plunge Length Grouting After Plunge (bags)

Bond Length Below Casing Total Grout Quantity (bags)

Total Pile Length Grout Ratio (bags/ft. bond)

COMMENTS • PILE DRIVING

Depth from B.O.F. Soil / Rock Flush Description Comments (ft) Description

COMMENTS· PILE GROUTING

uepth from B.O.F. Pressure Range Max/Average Comments (ft) (psi)

B.O.F. = Bottom of Footing

Was a load test performed? D Yes D NoIf load test was performed attach load test results.

Did micropile pass load test? D Yes D No D N/A

734-2644 (112007)

PROJECT BRIDGE NO. CONTRACT NO

BENT STATION SHAFT NO. SHAFT DIAMETER

DRILLED SHAFT CONTRACTOR INSPECTED BY CERT. NO. DATE

REFERENCE ELEVATION SHAFT TOP ELEVATION AT START AT FINISH

DEPTH TO WATER OR SLURRY SHAFT BOTTOM ELEVATION REBAR DESIGN ELEV.

TOP OF ROCK ELEVATION SHAFT LENGTH

SHAFT CONCRETE INFORMATION

Placement Method Volume in Lines Begin Pour: Date: Time:

Free Fall # ID Length Volume End Pour: Date: Time:

Tremie cy Shaft Completion Time:

De-Airing Method cy (including casing removal)

Tremie Plug cy Total Concrete Volume Delivered (TVD)

Tremie Cap Total Volume in Lines (VL) cy Total Concrete Volume In Shaft; cy

Relief Valve cy(=TVD-VL-VW)

Total Concrete Volume Delivered (TVD)

INSPECTOR SIGNATURE DATE

NOTES:

CASING REMOVALOD Finish

Truck No.

Concrete Volume

Arrival Time

Start Time

SlumpDepth To Concrete

NOTES(delays, additives, breaching, casing removal)

Finish TimeTremie Depth

Permanent Casing

Top Elev. Bot. Elev. Start

DRILLED SHAFT CONCRETE PLACEMENT LOG

REBAR CAGE TOP ELEVATION:

WITHIN SPEC?

Estimated Waste Concrete (VW)

REBAR CAGE CENTERED WITHIN SPEC?

YES NO

YES NO

734-2597 (11-2011)

PROJECT BRIDGE NO. CONTRACT NO

BENT STATION SHAFT NO. SHAFT DIAMETER

DRILLED SHAFT CONTRACTOR INSPECTED BY CERT. NO. DATE

CONCRETING CURVE

Shaft Top

Shaft BottomCONCRETE VOLUME PLACED (cubic yards)

Volume Delivered TVD cy Notes/Comments:

Volume in Lines VL cy

Wastage VW cy

Volume Placed VP cy(= TVD-VL-VW)

Theoretical Volume VT cy(π(D2/4)(Shaft Length,ft)/27)

OP cy

DRILLED SHAFT CONCRETE VOLUMES

Prior to pouring concrete, a plot should be made showing the theoretical concrete surface (by depth or elev.) vs. concrete volume placed. During concrete placement the actual concrete surface vs. the actual concrete volume placed is then plotted.

DE

PT

H/E

LEV

AT

ION

(F

eet

Overpour (VP-VT)

VOLUME CALCULATIONS

734-2603 (4-2005)

PROJECT CONTRACT NO

BENT STATION SHAFT DIAMETER

DRILLED SHAFT CONTRACTOR CERTIFICATION NO. DATE

Slurry Type & Manufacturer :

Soil Shaft Length

Water Table Elev. Slurry Meets Specifications? Y NTop Shaft Elev. Rock Socket Length

Construc. Shaft Length Bucket Airlift PumpOther:

Visual Tape/Probe

Record 5 depths to the bottom of finished shaft:

Casing (Temp / Perm) Casing (Temp / Perm) Casing (Temp / Perm) 1 3

Type Type Type

OD (in.) OD (in.) OD (in.) 4Thickness Thickness Thickness

Top Elev. Top Elev. Top Elev.

Length: Length: Length: 2 5

Ave. Shaft Bottom Elev.:

Meet Cleanout Specification? Y NMeet Alignment Specifications? Y N

START LOG


NOTES:

TYPE OF CONSTRUCTION

DRILLING SLURRYDIMENSIONSSoil Auger Dia.

DATE/TIME EXCAVATED

START

Grd. Surface Elev.

DEPTH ELEVATION

Record and describe all materials encountered during drilled shaft excavation, water table information, depths of seepage and seepage rates, obstructions encountered, equipment used and equip. breakdowns (use additional sheets if necessary).

FINISH SOIL OR ROCK MATERIAL DESCRIPTION AND NOTES

Msd Avg. Shaft Bot Elev.

CLEANOUT METHOD

INSPECTED BY

FINISH:

Msd Top Rock Elev.

Reference Elev.

ELEVATIONS

Rock Auger Dia.

CASING INFORMATION (if applicable)

BOTTOM INSPECTION

BRIDGE NO.

SHAFT NO.

DRILLED SHAFT EXCAVATION LOG

DRY WET

734-2604 (4-2005)

BRIDGE NAME PROJECT: CONTRACT NO.:

BRIDGE NO. BENT STATION SHAFT NO. SHAFT DIAMETER INSPECTED BY CERTIFICATION NO. DATE

DRILLED SHAFT CONTRACTOR PRIME CONTRACTOR

Time Excavation Started:

Date/Time Bottom Inspected:

Date Concreting Started:

Plan "As-Built"Measurements Measurements

ReinforcementElev. Before Conc.

Shaft Diameter Ref. Elev. Elev. After Conc.

Shaft Length* Ground Surface or

*Was longer shaft approved for payment? Mudline Elev. OUTER (Perm/Temp)

Concrete Volume (cy) Diameter

Concrete Mix Design Groundwater Top Elev.

Concrete Placement MethodElev.: Length

Concrete Slump @ time or pour MIDDLE

Water Inflow Rate gal/min (est.) Diameter

Bottom of Shaft Cleanliness Meets Specification? Top Elev.

Proper reinforcement and CSL tubes installed: Length

Description of bottom of shaft: INNER

Diameter

COMMENTS (Obstructions Encountered, etc.): Top Elev.

Length

CSL Test Performed:

CSL Test Results Approved: *If not approved, describe results and resolution

Shaft Approved by:


734-2598 (8-2009)

As-built location within tolerances?

Mark Deviation from Plan

Note: Forward completed reports to ODOT Bridge Section.

STOPPED

Rock Socket Diameter (if appl.)

Top Elevation

Bottom Elevation

DRILLED SHAFT INSPECTION REPORT

STOPPED BOTTOMTOP

Casing

Bottom of ShaftElevation

Top of RockElevation

N

Yes No

Tremie Free Fall

NoYes

Yes No

No*Yes

TUR

N-O

F-N

UT

MET

HO

D (L

ON

G B

OLT

S)

PRO

CES

SES

PUR

POSE

1.R

otat

iona

l Cap

acity

Tes

tC

heck

s bo

lts fo

r pro

per l

ubric

atio

n &

for d

amag

e du

ring

stor

age

or tr

ansi

t 2.

Ver

ifica

tion

Test

Dem

onst

rate

s th

at C

ontra

ctor

's p

erso

nnel

, equ

ipm

ent &

pro

cedu

re w

ill tig

hten

bol

ts to

pro

per t

ensi

on

3.In

spec

tion

Torq

ueD

eter

min

es to

rque

val

ue to

be

used

in th

e ra

ndom

fiel

d in

spec

tion

4.R

ando

m F

ield

Insp

ectio

nC

heck

s bo

lt in

stal

latio

n on

stru

ctur

e us

ing

the

Insp

ectio

n To

rque

PRO

CES

SES

PRO

CED

UR

E

1.R

otat

iona

l Cap

acity

Tes

t1.

Sam

ple

2 bo

lt, w

ashe

r & n

ut a

ssem

blie

s

(02

560.

60 (a

))2.

Ass

embl

e fa

sten

er w

ith 3

-5 th

read

s w

ithin

the

grip

3.S

nug

tight

(10%

of R

equi

red

Fast

ener

Ten

sion

in T

able

560

-1);

Tole

ranc

e= -0

kip

s, +

2 ki

ps4.

Mar

k th

e bo

lt, n

ut &

pla

te5.

Tigh

ten

to R

equi

red

Fast

ener

Ten

sion

& re

cord

torq

ue (t

orqu

e m

ust n

ot e

xcee

d T=

0.25

PD

) (P

in lb

s, D

in ft

)6.

Turn

nut

to tw

ice

the

rota

tion

in T

able

560

-3 (t

ensi

on m

ust e

xcee

d 11

5% o

f Req

uire

d Fa

sten

er T

ensi

on)

7.R

emov

e nu

t and

che

ck th

read

s

2.Ve

rific

atio

n Te

st1.

Sam

ple

3 bo

lt, w

ashe

r & n

ut a

ssem

blie

s

(00

560.

29 (c

)(1 &

5))

2.S

nug

tight

(Plie

s of

join

t in

firm

con

tact

, ful

l effo

rt on

12"

spu

d w

renc

h; 1

0% o

f RFT

< Te

nsio

n <

50%

of R

FT)

3.M

ark

the

bolt,

nut

& p

late

4.T i

ghte

n nu

t to

the

rota

tion

in T

able

560

-3 (m

ax. o

f 10

seco

nds

with

impa

ct w

renc

h)5.

Ver

ify te

nsio

n is

5%

gre

ater

than

Req

uire

d Fa

sten

er T

ensi

on

3.In

spec

tion

Torq

ue1.

Sam

ple

3 bo

lt, w

ashe

r & n

ut a

ssem

blie

s

(00

560.

29 (d

))2.

Pla

ce in

Ski

dmor

e &

tigh

ten

to R

equi

red

Fast

ener

Ten

sion

in T

able

560

-13.

Mea

sure

torq

ue re

quire

d to

turn

the

nut 5

deg

rees

(1" @

12"

radi

us)

4.A

vera

ge th

e 3

test

s to

det

erm

ine

the

Insp

ectio

n To

rque

4.R

ando

m F

ield

Insp

ectio

n1.

Sel

ect a

t ran

dom

10%

of t

he te

nsio

ned

bolts

in e

ach

conn

ectio

n (2

min

imum

)

(00

560.

29 (d

))2.

App

ly In

spec

tion

Torq

ue.

If no

ne tu

rn, t

he c

onne

ctio

n pa

sses

.3.

If on

e or

mor

e fa

sten

ers

turn

, app

ly in

spec

tion

torq

ue to

all

fast

ener

s in

the

conn

ectio

n.4.

Re-

tens

ion

& in

spec

t all

fast

ener

s th

at tu

rned

whe

n ap

plyi

ng th

e In

spec

tion

Torq

ue.

734-

2629

Sum

mar

y (1

2-20

11)

HIG

H S

TREN

GTH

BO

LTIN

G S

UM

MA

RY

TU

RN

-OF

-NU

T M

ET

HO

D (

SH

OR

T B

OL

TS

)

PR

OC

ES

SE

SP

UR

PO

SE

1.R

otat

iona

l Cap

acity

Tes

tC

heck

s bo

lts fo

r pr

oper

lubr

icat

ion

& fo

r da

mag

e du

ring

stor

age

or tr

ansi

t 2.

Ver

ifica

tion

Tes

tD

emon

stra

tes

that

Con

trac

tor's

per

sonn

el, e

quip

men

t & p

roce

dure

will

tigh

ten

bolts

to p

rope

r te

nsio

n3.

Insp

ectio

n T

orqu

eD

eter

min

es to

rque

val

ue to

be

used

in th

e ra

ndom

fiel

d in

spec

tion

4.R

ando

m F

ield

Insp

ectio

nC

heck

s bo

lt in

stal

latio

n on

str

uctu

re u

sing

the

Insp

ectio

n T

orqu

e

PR

OC

ES

SE

SP

RO

CE

DU

RE

1.R

ota

tio

nal

Cap

acit

y T

est

1.S

ampl

e 2

bolt,

was

her

& n

ut a

ssem

blie

s

(

0256

0.60

(a)

)2.

Ass

embl

e fa

sten

er w

ith 3

-5 th

read

s w

ithin

the

grip

3.S

nug

tight

(10

% o

f max

allo

wab

le to

rque

< T

orqu

e <

20%

of M

AT

, MA

T=

1.15

(0.2

5PD

)) (

P in

lbs,

D in

ft)

4.M

ark

sock

et5.

Tig

hten

nut

to r

otat

ion

in T

able

560-

3 &

rec

ord

torq

ue (

torq

ue m

ust n

ot e

xcee

d T

=1.

15(0

.25P

D)

6.T

urn

nut t

o tw

ice

the

rota

tion

in T

able

560

-37.

Rem

ove

nut a

nd c

heck

thre

ads

2.V

erif

icat

ion

Tes

t1.

Sam

ple

3 bo

lt, w

ashe

r &

nut

ass

embl

ies

(

0056

0.29

(c)

(1 &

5))

2.S

nug

tight

(Jo

int p

lies

in fi

rm c

onta

ct, f

ull e

ffort

on

spud

wre

nch;

10%

of M

AT

< T

orqu

e <

50%

of M

AT

3.M

ark

the

bolt,

nut

& p

late

4.T

ight

en n

ut to

the

rota

tion

in T

able

560

-35.

Ver

ify to

rque

is 5

% g

reat

er th

an a

vera

ge o

f the

rec

orde

d to

rque

s @

turn

req

uire

men

t in

the

RoC

ap T

est

3.In

spec

tio

n T

orq

ue

1.S

ampl

e 3

bolt,

was

her

& n

ut a

ssem

blie

s

(

0056

0.29

(d)

)2.

Snu

g tig

ht (

10%

of m

ax a

llow

able

torq

ue <

Tor

que

< 2

0% o

f MA

T, M

AT

=1.

15(0

.25P

D))

(P

in lb

s, D

in ft

)3.

Mar

k th

e bo

lt, n

ut &

pla

te4.

Tig

hten

nut

to th

e ro

tatio

n in

Tab

le 5

60-3

3.M

easu

re to

rque

req

uire

d to

turn

the

nut 5

deg

rees

(1"

@ 1

2" r

adiu

s)4.

Ave

rage

the

3 te

sts

to d

eter

min

e th

e In

spec

tion

Tor

que

4.R

and

om

Fie

ld In

spec

tio

n1.

Sel

ect a

t ran

dom

10%

of t

he te

nsio

ned

bolts

in e

ach

conn

ectio

n (2

min

imum

)

(

0056

0.29

(d)

)2.

App

ly In

spec

tion

Tor

que.

If n

one

turn

, the

con

nect

ion

pass

es.

3.If

one

or m

ore

fast

ener

s tu

rn, a

pply

insp

ectio

n to

rque

to a

ll fa

sten

ers

in th

e co

nnec

tion.

4.R

e-te

nsio

n &

insp

ect a

ll fa

sten

ers

that

turn

ed w

hen

appl

ying

the

Insp

ectio

n T

orqu

e.

734-

2630

Sum

mar

y (

12-2

011)

HIG

H S

TR

EN

GT

H B

OL

TIN

G S

UM

MA

RY

Project Contract No.

Company Test No.

RCT-Torque Wrench Serial No. Calibration Due Date

Skidmore Serial No. Calibration Due Date

Bolt Diameter Bolt Length Quantity

Bolt Mfg. Lot No. Heat No.

Nut Mfg. Lot No. Heat No.

Washer Mfg. Lot No. Heat No.

Ro-Cap Sample 1: Required Fastener Tension = Lbs. (Table 00560-1)Snug Tight Tension = Lbs. (0.10 x Req. Fastener Tension): Tol. = -0 kips + 2 kipsMeasured Torque = Maximum Allowable Torque = Ft.-Lbs. (T < 0.25PD); (P in Lbs., D in Ft.)Measured Tension = Lbs. @ Turn (2x Rotation In Table 00560-3)Minimum Tension Required = Lbs. (1.15 X Required Fastener Tension)

Sample 1 Results:Ro-Cap Sample 2: Required Fastener Tension = Lbs. (Table 00560-1)Snug Tight Tension = Lbs. (0.10 x Req. Fastener Tension): Tol. = -0 kips + 2 kipsMeasured Torque = Maximum Allowable Torque = Ft.-Lbs. (T < 0.25PD); (P in Lbs., D in Ft.)Measured Tension = Lbs. @ Turn (2x Rotation In Table 00560-3)Minimum Tension Required = Lbs. (1.15 X Required Fastener Tension)

Sample 2 Results:

Rotational Capacity Test Results:Inspection Torque Sample 1:Required Fastener Tension = Lbs. (Table 00560-1)Measured Torque = Ft.-Lbs. @ Additional 5 Degrees (Apprx. 1" @ 12" Radius)

Inspection Torque Sample 2:Required Fastener Tension = Lbs. (Table 00560-1)Measured Torque = Ft.-Lbs. @ Additional 5 Degrees (Apprx. 1" @ 12" Radius)

Inspection Torque Sample 3:Required Fastener Tension = Lbs. (Table 00560-1)Measured Torque = Ft.-Lbs. @ Additional 5 Degrees (Apprx. 1" @ 12" Radius)

Inspection Torque = Ft.-Lbs. (Average of the 3 Inspection Torque Samples)

Comments:

Inspector Cert No. Title

Contractor's Representative Date

734-2629 (3-2012)

0

#N/A#N/A

Ft.-Lbs. @ Required Fastener Tension (Go to Insp. Torque)

Ft.-Lbs. @ Required Fastener Tension (Go to Insp. Torque)

#N/A

0

HIGH STRENGTH BOLTSROTATIONAL CAPACITY TEST & INSPECTION TORQUE

(LONG BOLTS)

0

#N/A

#N/A

0

#DIV/0!

0

0

Pass Fail

Accept Reject

Pass Fail

Turn of Nut MethodTurn of Nut Method Direct Tension IndicatorDirect Tension Indicator Tension Control FastenerTension Control Fastener


Company Test No.

Torque Wrench Serial No. Calibration Due Date






Ro-Cap Sample 1: Required Fastener Tension = Lbs. (Table 00560-1)Snug Tight Torque = Ft.-Lbs.; T = 0.1(1.15)(0.25PD); (P in Lbs., D in Ft.)Measured Torque = Ft.-Lbs. @ Maximum Allowable Torque = Ft.-Lbs; T = 1.15(0.25PD): P in Lbs., D in Ft.)2 x Rotation = Turn (2x Rotation in Table 00560-3)

Sample 1 Results:Ro-Cap Sample 2: Required Fastener Tension = Lbs. (Table 00560-1)Snug Tight Torque = Ft.-Lbs.; T = 0.1(1.15)(0.25PD); (P in Lbs., D in Ft.)Measured Torque = Ft.-Lbs. @ Maximum Allowable Torque = Ft.-Lbs; T = 1.15(0.25PD): P in Lbs., D in Ft.)2 x Rotation = Turn (2x Rotation in Table 00560-3)

Sample 2 Results:

Rotational Capacity Test Results:Inspection Torque Sample 1:Measured Torque = Ft.-Lbs. @ Turn (Turn Rotation in Table 00560-3)Sample Inspection Torque = Ft.-Lbs. @ Additional 5 Degrees (Apprx. 1" @ 12" Radius)

Inspection Torque Sample 2:Measured Torque = Ft.-Lbs. @ Turn (Turn Rotation in Table 00560-3)Sample Inspection Torque = Ft.-Lbs. @ Additional 5 Degrees (Apprx. 1" @ 12" Radius)

Inspection Torque Sample 3:Measured Torque = Ft.-Lbs. @ Turn (Turn Rotation in Table 00560-3)Sample Inspection Torque = Ft.-Lbs. @ Additional 5 Degrees (Apprx. 1" @ 12" Radius)

Inspection Torque = Ft.-Lbs. (Average of the 3 Inspection Torque Samples)

Comments:



734-2630 (3-2012)

Turn (Table 00560-3) (Go to Insp. Torque)

Turn (Table 00560-3) (Go to Insp. Torque)

#DIV/0!

#N/A

#N/A

#N/A

#N/A

0

HIGH STRENGTH BOLTSROTATIONAL CAPACITY TEST & INSPECTION TORQUE

(SHORT BOLTS)

RCT-

0

Pass Fail

Accept Reject

Pass Fail



Company Test No.







Verification Sample 1: Required Fastener Tension = Lbs. (Table 00560-1)Meas'd Tension @ Snug Tight = Lbs.(Joint Plies in Firm Contact, Full Effort on Spud Wrench)

(10% Req'd Fastener Tension < Snug Tight < 50% RFT)Measured Time = Seconds (From Snug Tight to Turn Rotation in Table 00560-3)Maximum Allowable Time = Seconds (From Snug Tight to Turn Rotation in Table 00560-3)Measured Tension = Lbs. @ Turn (Turn Rotation In Table 00560-3)Minimum Tension Required = Lbs. (1.05 X Required Fastener Tension)

Sample 1 Results:Verification Sample 2: Required Fastener Tension = Lbs. (Table 00560-1)Meas'd Tension @ Snug Tight = Lbs.(Joint Plies in Firm Contact, Full Effort on Spud Wrench)


Sample 2 Results:Verification Sample 3: Required Fastener Tension = Lbs. (Table 00560-1)Meas'd Tension @ Snug Tight = Lbs.(Joint Plies in Firm Contact, Full Effort on Spud Wrench)


Sample 2 Results:Verification Test Results:Comments:



734-2747 (3-2012)

VT-

HIGH STRENGTH BOLTSVERIFICATION TEST (LONG BOLTS)

10

#N/A

#N/A

#N/A

#N/A

#N/A

10

10

#N/A


Pass Fail

Accept Reject

Pass Fail

FailPass


Company Test No.







Required Fastener Tension = lbs. (Table 00560-1)Verification Sample 1: Maximum Allowable Torque = Ft.-Lbs.; MAT = 1.15(0.25PD), (P in Lbs., D in Ft.)Meas'd Torque @ Snug Tight = Ft.-Lbs.(Joint Plies in Firm Contact, Full Effort on Spud Wrench)

(10% MAT < Snug Tight < 50% MATMeasured Time = Seconds (From Snug Tight to Turn Rotation in Table 00560-3)Maximum Allowable Time = Seconds (From Snug Tight to Turn Rotation in Table 00560-3)Measured Torque = Ft.-Lbs. @ Turn (Turn Rotation In Table 00560-3)Minimum Torque Required = Ft.-Lbs. (1.05 X Avg. RoCap Torque @ Rotation in Table 00560-3)

Sample 1 Results:Verification Sample 2: Maximum Allowable Torque = Ft.-Lbs.; MAT = 1.15(0.25PD), (P in Lbs., D in Ft.)Meas'd Torque @ Snug Tight = Ft.-Lbs.(Joint Plies in Firm Contact, Full Effort on Spud Wrench)


Sample 2 Results:Verification Sample 3: Maximum Allowable Torque = Ft.-Lbs.; MAT = 1.15(0.25PD), (P in Lbs., D in Ft.)Meas'd Torque @ Snug Tight = Ft.-Lbs.(Joint Plies in Firm Contact, Full Effort on Spud Wrench)


Sample 2 Results:Verification Test Results:Comments:



734-2748 (3-2012)

#N/A

10

10

10

VT-

#N/A

#N/A

HIGH STRENGTH BOLTSVERIFICATION TEST (SHORT BOLTS)

#N/A


Pass Fail

Accept Reject

Pass Fail

FailPass

734-

2697

(1

1-17

-201

5)1

of 1

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tor

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l Bat

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734-

2696

(06

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Jack

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For

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Mea

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Mea

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engt

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%

Gau

ge

(in.)

Cal

c.

100%

E

long

. (in

.)

(B -

A)

=M

easu

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80%

E

long

. (in

.)

Cal

c. 8

0%

Elo

ng.

(in.)

% E

long

. P

er

Ten

don

Sea

ted

Tai

l Le

ngth

(in

.)

Jack

E

long

(in

.)

Pla

n A

ncho

r S

et

(in.)

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

0.25

R:

Rec

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from

Sho

p D

raw

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Fm

: F

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Mea

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alue

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F

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Cal

cula

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734-

2594

(12

-201

1)

No

te:

% E

long

. Per

Ten

don

(F)

= C

olum

n (D

) of

the

tend

on d

ivid

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y co

lum

n (E

) of

the

tend

on x

100

No

te:

% E

long

. Per

Ten

don

shal

l be

betw

een

95%

min

imum

and

105

% m

axim

um.

If M

easu

red

Anc

hor

Set

is >

Pla

n A

ncho

r S

et, c

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Jack

Lo

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For

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(Kip

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pe

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Pla

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(in.)

0.25

0.25

#DIV

/0!

0.25

0.25

#DIV

/0!

0.25

0.25

#DIV

/0!

0.25

0.25

#DIV

/0!

0.25

0.25

#DIV

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#DIV

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R:

Rec

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Mea

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734-

2594

a (1

0-20

09)

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sum

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end

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tend

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100

No

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long

. Per

Ten

don

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l be

betw

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95%

min

imum

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105

% m

axim

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If M

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Pla

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d.

734-2596 (06-2013) 1 of 4

Contract No.

Deck Placement Conference Outline (00540.02(a)(b))

Project Name (Section) Contract No.

Highway County Date

Contractor Project ManagerEstimated Date Estimated Quantity/Day

Mix Design

Approved? Yes No

Mix Design No.

List types of admixtures to be used (Superset extender required to extend initial set by 90 min. 02001.30(e). Extra for travel, time or struct. type.)

Slump Range W/C Air Content

Concrete Mix

Supplier Name

Supplier notified well in advance.

Supplier aware of specification on truck mixer equipment. 02001.40, ASTM C94

Communication between batch plant and project. How? Who?

Continuous delivery assured for cubic yards needed per hour, at what intervals?

Supplier has sufficient material on-hand for quantity required.

Mix temperature of 50°F minimum and 80°F maximum when air temperature is 40°F or higher. Mix temperature of 60°F minimum and 80°F maximum when air temperature is or forecast to be below 40°F during cure period.

Contractor Quality Control

CCT Name Certification No.

QCT Name Certification No.

Individual authorized for acceptance and rejection of materials

Weather Conditions

Precipitation forecast less than 30% during placement window (2 hours before to 2 hours after). 00540.49(b)

Surface evaporation rate of less than 0.10 psf per hour. Fig. 00540-1

Cold weather plan approved if temperature is or forecast to be below 40°F. 00540.49(1-2-a) Yes No N/A

No frost or ice on forms or rebar.

Print Form

734-2596 (06-2013) 2 of 4

Contract No.

Deck Finishing Machine

Type 00540.24Brand Name

Approved working drawings showing location of deck machine rails 00540.24(a).

Deck machine to set up and run over full length of area of placement 00540.24(g).

Experienced operator with good knowledge of machine operation.

Operator Name

Changes in crown or super?

How will changes be handled?

Dry run rebar clearance is +/- ¼" from clearance shown. 00540.48(g)

Method of checking rebar clearance:

Forms

Top mat, tie bar at every intersection if spacing is more than 6", otherwise every other intersection. 00530.41(b)

Bottom mat, tie every other intersection.

At least 3 ties per lap splice.

Monitor falsework, tattletales installed (when needed).

All forming and bulkhead in place prior to start of placement.

Stay-in-place forms are not allowed for bulkheads.

Apply form release to forms.

Cleanliness of bottom and rebar.

How? When?

Edge of forms set to line and grade.

How? When?

Supports for outside edge.

Deck Placement

Saturate the tops of precast beam and formwork 2 hours immediately prior to beginning deck placement.

Minimum rate of placement 20 ft/hr 00540.48(g) third bullet.

Calculated cubic yards to be placed

Method of Placement Backup Method Estimated time to place mix

734-2596 (06-2013) 3 of 4

Contract No.

Deck Placement (continued)

Vibrators 00540.48(c)

Experienced vibrator person

Operator Name

Size of vibrators to be used Meet requirements of 00540.23

Number of vibrators to be used (minimum 2)

Discuss methods of consolidation 00540.48(c)

Power Source: Generators Direct Power BackupType

Placement direction 00540.48(g)

Transverse work bridge (2 minimum)

Emergency bulkheads, how will this be addressed if needed?

12-foot straightedge is on-site prior to start of pour. Check gutters, lane lines, ends of pours and "as directed". 00540.55

Environmental

Where will concrete trucks clean out?

Containment?

Where will deck machine clean out?

Containment?

Steps to assure containment of in forms?

Curing Concrete

Provide pressure washers with fog nozzles.

Provide wind breaks for spray or other approved methods to prevent premature drying during placement operations.

Presoaked wet burlap or dry non-woven polypropene fabric with 4-mil polyethylene film. Color as weather dictates.

Additional soaking to keep the deck moist at all times during the cure period.

Water availability during and after placement

Where?

How?

If above information is not available, who will advise the PM prior to start of placement?

During non-working days, who will be able to add water for cure?

Name Phone No.

Bridge deck cure time is 14 calendar days.

734-2596 (06-2013) 4 of 4

Contract No.

General Information

Check special provisions for additional information.

Construction joint surfaces: Use surface retarder to aid in laitance removal. 00540.43 (a)

Closure pour prep: Sawcut top 1" of deck, may be waived if joint is straight without spalls. Hand rub or brush fresh concrete paste onto the existing surface of vertical joints down to the top mat.

Deck roadway texturing: Cut grooves no sooner than 14 days after deck is cast. 00540.50

Striping forms: 80% of specified strength and 7 days. Table 00540-1

Early removal of forms does not eliminate the curing requirement of 00540.51

Documents

Forms Type (A, B, C, or D) Start of Drilling (date & time) Drill Rig/Drill Method End Drilling Flushing Media (air/water) Start of Grouting Drill Rig #, Operator Pile Completion