Appendix G

STATE OF OHIO

DEPARTMENT OF TRANSPORTATION

Certification of Temporary Materials for

Construction and Roadside Improvement Items

PROJECT NO: ______________________________________________________



COUNTY: ______________________________________________________



ROUTE NO: ______________________________________________________



SECTION NO:______________________________________________________



PID NO: ______________________________________________________



FEDERAL NO:______________________________________________________



CONTRACTOR:______________________________________________________





This letter certify's that all construction and material items reported as "Temporary Items" or incorporated into this project have been approved in accordance with contract requirements and Department regulations and are documented in the project records.



_______________________________________________ ____________

PROJECT ENGINEER / SUPERVISOR DATE





Exceptions to this certification are also documented in the project records.





cc: District Testing Engineer

District Construction Engineer

Project File

Appendix I

Material Testing Forms and Instructions

TE-10 Shipping Tag / Sample Data (Front) - Concrete Cylinder Sample Data (Back)
TE-24 Notice of Shipment of Plant Tested and Approved Materials (See Appendix "E")
TE-30 Generic Field Inspection Form (See Appendix "D" for specific instruction for the technical part-center portion-of the form)
TE-31 Sample Data
TE-37 Bituminous concrete Extraction Work Sheet
TE-45 concrete Inspectors daily Report (Test portion of the form-see Construction Manual of Procedures for Concrete.)
TE-67 Aggregate Gradation Test
TE-125 Bituminous Concrete Plant Report
TE-199 Contractors Quality Control Report for Bituminous Concrete
TE-217 Bituminous Concrete Density Determination
TE-220 Bituminous Concrete Rice Worksheet
TE-221 Bituminous concrete Marshall Specimen