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ODOT Contact Information

Ohio Department of Transportation
Office of Materials Management
Cement & Concrete Section
Attention: Klaire A. Mason
E-mail: Klaire.Mason@dot.state.oh.us
Telephone: (614) 275-1326
Fax:(614) 351-5559

Supplier Information

Date of Request

Name

Company

Telephone

Fax

E-mail

JMF Checklist

For State General (Standard Weight) Mixes, Send this information, only.

Class of Concrete: ODOT

ODOT Project Number

Coarse Aggregate Name and Location

Fine Aggregate Name and Location
For All Other Mixes, Send Complete Checklist & Supplier Information. See Mix Design Form.

Size and Type of Coarse Aggregate

Type of Fine Aggregate

Coarse Aggregate SSD Specific Gravity

Fine Aggregate SSD Specific Gravity

Coarse Aggregate Absorption

Fine Aggregate Absorption

Coarse Aggregate Weight

Fine Aggregate Weight

Cementitious Material Types, Grades or Classes

Cementitious Material Manufacturing Locations

Cementitious Material Weights

Cementitious Material Specific Gravities

Water: Cementitious Material Ratio

Total Weight of Water in lbs/cy

Total Weight of Concrete in lbs/cy

Total Volume in ft³/cy
Test Data, As Required by Applicable Specification (i.e. SS898, SS888) or Plan Note

Mix Design Form  Click Here

The mix design form is provided  to assist ready mix suppliers to request and receive PCC JMF numbers with greater ease and efficiency. Note that the proposed format may not be useful when a series of JMF numbers are being requested. Refer to the checklist provided above to send the appropriate information. An example of a completed form has been provided.

Instructions

Insert the required information. Print and fax or save and email the worksheet as a file attachment. If you experience any problems, please contact Klaire Mason of the Office of Materials Management.