test number: 271-2.200 - 905 - 0001 - 2015 lab site: daar ... files/ii...satisfactory wisdot quality...
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DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 1 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
209.0200.S Y
Inspected By ELIZABETH REIS
Product Name FINE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-162-0003-2012
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� Doc Id: 02
NE, NW, S2, T11N, R8E COLUMBIA COUNTY
BLAU (LYCON) PORTAGE PIT
CUBIC YARDS
2Backfill Controlled Low Strength04/29/15
209.0200.S Y
Inspected By ELIZABETH REIS
Product Name TYPE I/II PORTLAND CEMENT
Basis for AcceptanceProduct of WisDOT Approved List
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Doc Id: 10/08/2014
ALPENA, MI
LAFARGE NORTH AMERICA
CUBIC YARDS
2Backfill Controlled Low Strength04/29/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 2 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
209.0200.S Y
Inspected By ELIZABETH REIS
Product Name MASTERAIR AE 90
Basis for AcceptanceProduct on WisDOT Approved List
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Doc Id: 09/15/2014
CLEVELAND, OH
BASF ADMIXTURES, INC.
CUBIC YARDS
2Backfill Controlled Low Strength04/29/15
209.0200.s Y
Inspected By ELIZABETH REIS
Product Name FLOW FILL
Basis for AcceptanceMaterial meets requirements of Contract Special Provisions Article 13.Mix Design on FileSee DT1310 for additional acceptance criteria.
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PORTAGE, WI
LYCON, INC.
CUBIC YARDS
2Backfill Controlled Low Strength04/29/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 3 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
209.0200.s Y
Inspected By ELIZABETH REIS
Product Name CLASS C FLY ASH
Basis for AcceptanceCertification of Compliance on File See Doc ID #Certified Report of Tests on File See Doc ID#
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Doc Id:
Doc Id:
04
05
LOCKPORT, IL
LAFARGE NORTH AMERICA
CUBIC YARDS
2Backfill Controlled Low Strength04/29/15
305.01## Y
Inspected By ELIZABETH REIS
Product Name QC PLAN
Basis for AcceptanceQC Plan submitted 3/27/2015, reviewed and approved on 3/27/2015QMP Summary Report on File See 271-2.200-155-0018-2015Placement Summaries on File
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Doc Id:
Doc Id:
A
271-2.200-155-0018-2015
WAUNAKEE, WI
YAHARA MATERIALS
TON(s)
250Base Aggregate Dense03/27/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 4 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
305.0110 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceHohl QuarryNW, NW S20, T12N, R8EColumbia CountySatisfactory Quality Test 0-225-0084-2014 on FileSatisfactory QC Production Test on FilePlacement Summary on File
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Doc Id:
Doc Id:
Doc Id:
06
B
C
WAUNAKEE, WI
YAHARA MATERIALS
TON(s)
166Base Aggregate Dense 3/4-Inch03/27/15
305.0120 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceHohl QuarryNW, NW S20, T12N, R8EColumbia CountySatisfactory Quality Test 0-225-0084-2014 on FileSatisfactory QC Production Test on FilePlacement Summary on File
Mfg Certification
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Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
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�
�
�
Doc Id:
Doc Id:
Doc Id:
06
D
E
WAUNAKEE, WI
YAHARA MATERIALS
TON(s)
84Base Aggregate Dense 1 1/4-Inch03/27/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 5 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.0610 Y
Inspected By ELIZABETH REIS
Product Name EPOXY APPLICATOR
Basis for AcceptanceManfacturer's Certification of Compliance on File
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Doc Id:
Doc Id:
07
01; 07
MUNCIE, IN
GERDAU
EACH
790Drilled Tie Bars03/18/15
416.0610 Y
Inspected By ELIZABETH REIS
Product Name BAR STEEL
Basis for AcceptanceCertified Report of Tests on FileHeat #5713843502; #5713995402; #5714011703
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Doc Id:
Doc Id:
Doc Id:
08a-e
09; 10; 11
01; 09; 10; 11
KNOXVILLE, TN
GERDAU
EACH
790Drilled Tie Bars03/18/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 6 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.0610 Y
Inspected By ELIZABETH REIS
Product Name GREENBAR 720A009
Basis for AcceptanceManufacturer's Certification of Compliance on FileBatch #3W69015996; #4496016619Product on WisDOT Approved List
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Doc Id:
Doc Id:
12a-d; 13a-b
02/06/2014
CHARLOTTE, NC
VALSPAR
EACH
790Drilled Tie Bars03/18/15
416.0610 Y
Inspected By ELIZABETH REIS
Product Name SCOTCHKOTE 413
Basis for AcceptanceManufacturer's Certification of Compliance on FileBatch #4D07B; #4D07CProduct on WisDOT Approved List
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Doc Id:
Doc Id:
14a-b
02/06/2014
MINNEAPOLIS, MN
3M
EACH
790Drilled Tie Bars03/18/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 7 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1010 Y
Inspected By ELIZABETH REIS
Product Name CONCRETE
Basis for AcceptanceSee Item 416.1715 Concrete Pavement Repair SHES for material acceptanceWelded Steel Wire Fabric installed was free of defects and will perform its intended purpose
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MARSHFIELD, WI
TRIERWEILER
SQUARE YARDS
3Concrete Surface Drains03/10/15
416.1715 Y
Inspected By ELIZABETH REIS
Product Name CONCRETE
Basis for AcceptanceQC Plan submitted, reviewed and approved on 3/10/2015Mix Design approved 3/18/2015Mix Design approved 4/30/2015QC Test Results on FileQMP Summary Report on File 271-2.200-155-0015-2015
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Doc Id:
Doc Id:
Doc Id:
Doc Id:
F
271-2.200-155-0015-2015
G
15a-f; 16a-i
MARSHFIELD, WI
TRIERWEILER
SQUARE YARDS
2218Concrete Pavement Repair SHES03/10/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 8 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1715 Y
Inspected By ELIZABETH REIS
Product Name CEMENT TYPE I/II
Basis for AcceptanceProduct on WisDOT Approved List
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Doc Id: 10/14/2014
CHARLEVIOX, MI
ST MARYS CEMENT
SQUARE YARDS
2218Concrete Pavement Repair SHES03/10/15
416.1715 Y
Inspected By ELIZABETH REIS
Product Name POLYCHEM 400 NC
Basis for AcceptanceProduct on WisDOT Approved List
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Other
Doc Id: 09/15/2014
EAGAN, MN
GENERAL RESOURCE TECHNOLOGY, INC.
SQUARE YARDS
2218Concrete Pavement Repair SHES03/10/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 9 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1715 Y
Inspected By ELIZABETH REIS
Product Name PHOLYCHEM SA
Basis for AcceptanceProduct on WisDOT Approved List
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Doc Id: 09/15/2014
EAGAN, MN
GENERAL RESOURCE TECHNOLOGY, INC.
SQUARE YARDS
2218Concrete Pavement Repair SHES03/10/15
416.1715 Y
Inspected By ELIZABETH REIS
Product Name FINE AGGREGATES FOR CONCRETE
Basis for AcceptanceSatisfactory WisDOT Qualtity Test 0-162-0044-2012
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� Doc Id: 17
NW, SE, S22, T9N, R9E DANE COUNTY
MADISON SAND AND GRAVEL PIT
SQUARE YARDS
2179Concrete Pavement Repair SHES03/10/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 10 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1715 Y
Inspected By ELIZABETH REIS
Product Name COARSE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Qualtity Test 0-225-0256-2012
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� Doc Id: 18
NW, SE, S22, T9N, R9E DANE COUNTY
MADISON SAND AND GRAVEL PIT
SQUARE YARDS
2179Concrete Pavement Repair SHES03/10/15
416.1715 Y
Inspected By ELIZABETH REIS
Product Name DOWFLAKE CALCIUM CHLORIDE
Basis for AcceptanceProduct meets the requirements of Standard Specifications Section 416.2.1(3).1
�
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OtherDoc Id: 19
DALLAS, TX
OXYCHEM
SQUARE YARDS
2218Concrete Pavement Repair SHES03/10/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 11 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1715 Y
Inspected By ELIZABETH REIS
Product Name WHITE WATER RESIN PAMS
Basis for AcceptanceBatch #51313AProduct on WisDOT Approved ListSatisfactory WisDOT Test on File 0-140-0006-2015
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Doc Id: 20
03/18/2015
DEKALB, IL
RIGHT POINTE
SQUARE YARDS
2218Concrete Pavement Repair SHES03/10/15
416.1715 Y
Inspected By ELIZABETH REIS
Product Name WATER FOR CONCRETE
Basis for AcceptanceSatisfactory WisDOT Test 0-131-0007-2015
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� Doc Id: 21
DEFOREST, WI
MADISON SAND AND GRAVEL
SQUARE YARDS
2179Concrete Pavement Repair SHES03/10/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 12 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1715 Y
Inspected By ELIZABETH REIS
Product Name FINE AGGREGATES FOR CONCRETE
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-162-0036-2013
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� Doc Id: 22
NE, SE, S10, T8N, R6E DANE COUNTY
SCHADLER PIT
SQUARE YARDS
39Concrete Pavement Repair SHES05/01/15
416.1715 Y
Inspected By ELIZABETH REIS
Product Name COARSE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-225-0006-2013
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
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QMP Plan
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Other
� Doc Id: 23
S35, T8N, R8E DANE COUNTY
MEINHOLZ QUARRY
SQUARE YARDS
39Concrete Pavement Repair SHES05/01/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 13 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
416.1715 Y
Inspected By ELIZABETH REIS
Product Name WATER FOR CONCRETE
Basis for AcceptanceMunicipal Source
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MIDDLETON, WI
TRIERWIELER
SQUARE YARDS
39Concrete Pavement Repair SHES05/01/15
502.0717.S Y
Inspected By ELIZABETH REIS
Product Name TK-9030 POLYUREA CRACK REPAIR
Basis for AcceptanceProduct on WisDOT Approved List
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Doc Id: 04/06/2009
MINNETONKA, MN
TK PRODUCTS
LINEAL FEET
193Crack Sealing Epoxy03/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 14 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
502.3200 Y
Inspected By ELIZABETH REIS
Product Name TK-590-90
Basis for AcceptanceProduct on WisDOT Approved List
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Doc Id: 06/10/2014
MINNETONKA, MN
TK PRODUCTS
SQUARE YARDS
169Protective Surface Treatment04/01/15
509.1500 Y
Inspected By ELIZABETH REIS
Product Name PERMA PATCH VO
Basis for AcceptanceProduct approved by WisDOT on 3/17/15 via phone call with Scott Syron. Product is only approved for use on the underside and sides of structure
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OtherDoc Id: 24a-c
MIAMISBURG, OH
DAYTON SUPERIOR
SQUARE FEET
222Concrete Surface Repair03/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 15 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
509.1500 Y
Inspected By ELIZABETH REIS
Product Name CONCRETE CLASS E
Basis for AcceptanceSee Item of SPV.0035.01 Concrete Masonry Overlay Deck Patching Concrete for material acceptance.
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PORTAGE, WI
LYCON, INC.
SQUARE YARDS
222Concrete Surface Repair03/17/15
509.9020.S Y
Inspected By ELIZABETH REIS
Product Name SIKADUR CRACK WELD
Basis for AcceptanceProduct was approved for use per the Contract Special Provisions Article 19.
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OtherDoc Id: 25
LYNDHURST, NJ
SIKA CORPORATION
LINEAL FEET
121Epoxy Crack Sealing03/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 16 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
603.8000 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceProduct on WisDOT Approved List
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Doc Id: 03/29/2012
PORTAGE, WI/MAIDEN ROCK, WI
WEISER CONCRETE PRODUCTS, INC.
LINEAL FEET
1384Concrete Barrier Temp Precast Delivered03/30/15
606.0200 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-225-0103-2015
Mfg Certification
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� Doc Id: 26
WILLIAMS QUARRY (SE, NE, S19, T12N, R8E COLUMBIA CO)
KRAEMER COMPANY
CUBIC YARDS
10Riprap Medium05/01/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 17 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
606.0200 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-225-0073-2015
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
� Doc Id: 27
HWY 51 QUARRY (SW, NE, S17, T8N, R10E DANE COUNTY)
YAHARA MATERIALS
CUBIC YARDS
14Riprap Medium05/01/15
614.0905 Y
Inspected By ELIZABETH REIS
Product Name TAU II
Basis for AcceptanceProduct on WisDOT Approved ListShop Drawings on FileCertifications of Installation on File
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Mfg Certification
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QC Test
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Doc Id:
Doc Id: 28a-g; 29a-d
06/24/2013
VACAVILLE, CA
BARRIER SYSTEMS
EACH
4Crash Cushions Temporary03/27/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 18 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
614.0920 Y
Inspected By ELIZABETH REIS
Product Name SALVAGED RAIL
Basis for AcceptanceRail was removed and stacked within the Project Limits. Columbia County picked up all materials on the day of removal
Mfg Certification
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QC Test
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DEFOREST, WI
WESTLAND RESTORATION
LINEAL FEET
601Salvaged Rail03/23/15
614.0925 Y
Inspected By ELIZABETH REIS
Product Name END TREATMENTS
Basis for AcceptanceEnd Treatments were removed and stacked within the Project Limits. Columbia County picked up all materials day of removal
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DEFOREST, WI
WESTLAND RESTORATION
EACH
2Salvaged Guardrail End Treatments03/23/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 19 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
614.2300 Y
Inspected By DERRICK BALLWEG
Product Name STEEL BEAMS, POSTS & BLOCKS
Basis for AcceptanceInstaller's Certification of Compliance is on FileManufacturer is on WisDOT Approved ListSatisfactory WisDOT Verification Test See 271-2.200-155-0013-2015
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�
� Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
�
Doc Id:
Doc Id:
Doc Id:
Doc Id: 271-2.200-155-0013-2015
30
01; 31a-h
12/08/2014
LIMA, OH
TRINITY HIGHWAY PRODUCTS
LINEAL FEET
994MGS Guardrail 304/08/15
614.2300 Y
Inspected By DERRICK BALLWEG
Product Name MONROEVILLE 12-INCH MSG COMPOSITE BLOCK
Basis for AcceptanceInstaller's Certification of Compliance is on FileManufacturer is on WisDOT Approved List
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Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
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QC Test
Other
Doc Id:
Doc Id:
30
05/17/2012
NORWALK, OH
MONROEVILLE INDUSTRIAL MOULDINGS
LINEAL FEET
994MGS Guardrail 304/08/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 20 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
614.2500 Y
Inspected By DERRICK BALLWEG
Product Name STEEL BEAMS, POSTS & BLOCKS
Basis for AcceptanceInstaller's Certification of Compliance is on FileManufacturer is on WisDOT Approved List
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�
� Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
Doc Id:
Doc Id:
Doc Id:
30
01; 31a-h
12/08/2014
LIMA, OH
TRINITY HIGHWAY PRODUCTS, INC.
LINEAL FEET
198MGS Thrie Beam Transition04/08/15
614.2610 Y
Inspected By DERRICK BALLWEG
Product Name SKT-350
Basis for AcceptanceInstaller's Certification of Compliance is on FileManufacturer is on WisDOT Approved ListMarkings: HS M180 A2
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�
� Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
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Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id:
Doc Id:
Doc Id:
30
01; 32a-g
10/28/2014
BIG SPRINGS, TX
ROAD SYSTEMS, INC.
EACH
4MGS Guardrail Terminal EAT04/08/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 21 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
628.1504 Y
Inspected By ELIZABETH REIS
Product Name PP WOVEN SILT FENCE FABRIC
Basis for AcceptanceMaterial meets requirements of Standard Specifications Section 628.2.6.Manufacturer's Certification of Complaince on File
� Mfg Certification
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WISDOT Test
QC Test
Other
Doc Id: 33
CARSON, CA
ESSEN POLYMERS, INC.
LINEAL FEET
684Silt Fence03/24/15
628.7570 Y
Inspected By ELIZABETH REIS
Product Name SEDIMENT CONTROL FILTER BAG
Basis for AcceptanceMeets requirements of Standard Specifications Section 628.2.13.Manufacturer's Certification of Compliance on File
� Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id: 34
ANTIGO, WI
VOLM COMPANIES
EACH
36Rock Bags03/26/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 22 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
628.7570 Y
Inspected By ELIZABETH REIS
Product Name #2 STONE
Basis for AcceptanceMeets requirements of Standard Specifications Section 628.2.13.QC Gradation on File
Mfg Certification
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WISDOT Test
QC Test
Other� Doc Id: 35
DEFOREST, WI
MADISON SAND & GRAVEL, INC
EACH
36Rock Bags03/26/15
643.0100 Y
Inspected By ELIZABETH REIS
Product Name TRAFFIC CONTROL
Basis for AcceptanceAll traffic control devices meet the requirements of Section 643 of the Standard Specifications and Contract Special Provisions, as well as, conform tothe MUTCD and meet criteria for acceptable devices according to the ATSSA publization Quality Guidelines for Temporary Traffic Control Devices.
Mfg Certification
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Product Data Sheets
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Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
MADISON, WI
MEGA RENTALS, INC.
LUMP SUM
1Traffic Control (project)03/16/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 23 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
645.0130 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceWaiting on response frrom contractor; did not know exact product and manufacturer during installation. Multple emails and phones made to obtaininformation...still waiting.
Meets requirements of Standard Specifications Section 645.2
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Other
TBD
TBD
SQUARE YARDS
37Geotextile Fabric Type R04/15/15
646.0106 Y
Inspected By ELIZABETH REIS
Product Name EPOPLEX LS60 WHITE & YELLOW
Basis for AcceptanceProduct on WisDOT Approved Products ListManufacturer's Certification of Compliance on File
�
� Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
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Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id:
Doc Id:
36a-b
03/20/2015
MAPLE SHADE, NJ
EPOPLEX
LINEAL FEET
12201Pavement Marking Epoxy 4-Inch05/18/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 24 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
646.0106 Y
Inspected By ELIZABETH REIS
Product Name GLASS SPHERES
Basis for AcceptanceProduct on WisDOT Approved Products ListManufacturer's Certification of Compliance on FileSatisfactory Verification Test on File
�
� Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
�
Doc Id:
Doc Id:
Doc Id: 38
37
10/292014
MUSCATINE, IA
POTTERS INDUSTRIES
LINEAL FEET
12201Pavement Marking Epoxy 4-Inch05/18/15
649.0300 Y
Inspected By ELIZABETH REIS
Product Name 3M STAMARK WET REFLECTIVE REMOVABLE TAPE 710
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
Doc Id: 02/08/2011
ST PAUL, MN
3M
LINEAL FEET
36360Temp Pvt Marking Reflective Tape 4-In03/16/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 25 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
649.0300 Y
Inspected By ELIZABETH REIS
Product Name 3M STAMARK WET REFLECTIVE REMOVABLE TAPE 711
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
Doc Id: 02/08/2011
ST PAUL, MN
3M
LINEAL FEET
36360Temp Pvt Marking Reflective Tape 4-In03/16/15
649.0600 Y
Inspected By ELIZABETH REIS
Product Name 3M STAMARK MASK TAPE REMOVABLE 715
Basis for AcceptanceProduct on WisDOT Approved Products List
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id: 09/10/2012
ST PAUL, MN
3M
LINEAL FEET
175Temp Pvmt Marking Removable Tape 6-Inch03/16/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 26 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
649.2100 Y
Inspected By ELIZABETH REIS
Product Name 3M 290
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
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Other
Doc Id: 2015
ST PAUL, MN
3M
EACH
279Temporary Raised Pavement Markers03/16/15
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name CONCRETE
Basis for AcceptanceMix Design on File approved 3/19/2015Satisfactory Verification Test 1-130-0027-2015
Mfg Certification
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Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
�
�
Doc Id:
Doc Id:
1-130-0027-2015
39a-e
PORTAGE, WI
LYCON, INC.
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 27 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name TYPE I/II PORTLAND CEMENT
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
Buy America
Product Data Sheets
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Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id: 10/08/2014
ALPENA, MI
LAFARGE NORTH AMERICA
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name MASTERAIR AE 90
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
Doc Id: 09/15/2014
CLEVELAND, OH
BASF ADMIXTURES, INC.
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 28 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name MASTERGLENIUM 7511
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
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Product Data Sheets
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Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id: 09/15/2014
CLEVELAND, OH
BASF ADMIXTURES, INC.
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name WATER FOR CONCRETE
Basis for AcceptanceMunicipal Source
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
PORTAGE, WI
CITY OF PORTAGE
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 29 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name FINE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Qualtity Test 0-162-0003-2012 on File
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
� Doc Id: 02
NE, NW, S2, T11N, R8E COLUMBIA COUNTY
BLAU (LYCON) PORTAGE PIT
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name COARSE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Qualtity Test 0-225-0019-2012 on File
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
� Doc Id: 40
NE, NW, S2, T11N, R8E COLUMBIA COUNTY
BLAU (LYCON) PORTAGE PIT
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 30 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name TK-26-CLEAR
Basis for AcceptanceProduct on WisDOT Approved Products ListBatch #S-15306
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Mfg Certification
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Product Data Sheets
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Documents Included in Material Records
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Doc Id: 04/01/2001
MINNETONKA, MN
TK PRODUCTS
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching04/06/15
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name ORGANIZATIONAL CHART
Basis for AcceptanceQC Organizational Chart on File submitted 3/19/2015, reviewed and approved on 3/19/2015QC Test Results on FileQMP Summary Report on File 271-2.200-155-0014-2015
Mfg Certification
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Product Data Sheets
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Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
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�
�
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Doc Id:
Doc Id:
Doc Id:
H
271-2.200-155-0014-2015
I
STEVENS POINT, WI
POB MATERIALS
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching03/19/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 31 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0035.01 Y
Inspected By ELIZABETH REIS
Product Name MASTERSET DELVO
Basis for AcceptanceProduct on WisDOT Approved List
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
Other
Doc Id: 09/15/2014
CLEVELAND, OH
BASF ADMIXTURES, INC.
SQUARE YARDS
57Concrete Masonry Overlay Deck Patching04/09/15
SPV.0090.01 Y
Inspected By ELIZABETH REIS
Product Name ROADSAVER 221
Basis for AcceptanceMaterial meets requirements of Contract Special Provisions Article 26.
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
CHANGLER, AZ
CRAFCO
LINEAL FEET
450Saw, Route and Seal Construction Joints04/24/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 32 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0180.03 Y
Inspected By ELIZABETH REIS
Product Name HD 50
Basis for AcceptanceMaterial meets the requirements of the Contract Special Provisions Article 31.
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
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WISDOT Test
QC Test
OtherDoc Id: 41a-b
MIAMISBURG, OH
DAYTON SUPERIOR
SQUARE YARDS
368Filling Rumble Strips03/11/15
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name
Basis for AcceptanceSatisfactory Mix Design 0-250-0197-2011 on FileQC Test Results on File
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
�
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Doc Id:
Doc Id:
J
42a-b
WAUKESHA, WI
PAYNE & DOLAN, INC.
TON(s)
408Polymer Modified Asphalt Overlay04/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 33 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name FINE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-225-0040-2014 on File
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
� Doc Id: 43
N, SW, S7, T4N, R19E RACINE COUNTY
PRAGER PIT
TON(s)
408Polymer Modified Asphalt Overlay04/17/15
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name COARSE AGGREGATES
Basis for AcceptanceSatisfactory WisDOT Quality Test 0-225-0029-2013 on File
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
� Doc Id: 44
SE, SE, S26, T7N, R19E WAUKESHA COUNTY
WAUKESHA LIME & STONE QUARRY
TON(s)
408Polymer Modified Asphalt Overlay04/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 34 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name PG64-22
Basis for AcceptanceProduct on WisDOT Approved ListVerification Testing was waived due to project quantity under 25 Tons
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Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
Doc Id: 04/25/2012
MILWAUKEE, WI
CONSTRUCTION RESOURCES MANAGEMENT
TON(s)
408Polymer Modified Asphalt Overlay04/17/15
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name ROSPHALT 50-LT
Basis for AcceptanceTechnical Data Sheet on File See Doc IDConstruction Guidelines on File See Doc ID
�
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other�Doc Id: Doc Id: 46a-o45a-b
WESTWOOD, MA
CHASE CONSTRUCTION PRODUCTS
TON(s)
408Polymer Modified Asphalt Overlay04/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS
DAAR Engineering, IncSite 3151 E.Cook St.Portage, WI 53901
Lab Site:
Materials Laboratory Testing System Tests On:
Materials Diary Inspection
1011-03-78Main Project ID:
271-2.200 - 905 - 0001 - 2015Test Number:
MATERIALS DIARY
03/17/15 By: ELIZABETH REIS
Category:
Date Entered:
Page 35 of 35
Bid Item SatisfactoryQuantityLocation
Manufacturer NameDescription
Bid ItemDateInspection
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name CSS1H
Basis for AcceptanceMeets requirements of Contract Special Provisions Article 32.B
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
PORTAGE, WI
HENRY G. MEIGS, LLC
GALLONS
408Polymer Modified Asphalt Overlay04/17/15
SPV.0195.01 Y
Inspected By ELIZABETH REIS
Product Name ROYSTON 120-29 EDGE SEALER LVOC
Basis for AcceptanceMaterial was on list of approved edge sealers for use with Rosphalt 50-LT
Mfg Certification
Buy America
Product Data Sheets
PAL / Approved List
Certified Test of Report
Documents Included in Material Records
QMP Plan
WISDOT Test
QC Test
Other
WESTWOOD, MA
CHASE CONSTRUCTION PRODUCTS
TON(s)
408Polymer Modified Asphalt Overlay04/17/15
Date Verified: 07/20/2015 Verified By: ELIZABETH REIS