CDOT Form 46 "Concrete Truck Mixer Inspection Certification" - Colorado

What Is CDOT Form 46?

This is a legal form that was released by the Colorado Department of Transportation - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2014;
  • The latest edition provided by the Colorado Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of CDOT Form 46 by clicking the link below or browse more documents and templates provided by the Colorado Department of Transportation.

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Download CDOT Form 46 "Concrete Truck Mixer Inspection Certification" - Colorado

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Date Submitted
Contract ID
COLORADO DEPARTMENT OF TRANSPORTATION
CONCRETE TRUCK MIXER
Project No.
INSPECTION CERTIFICATION
Project location
Concrete company
Unit number
Rated mixing
capacity (1)
Blade wear (2)
Free of
Hardened concrete (3)
Revolution counter
Water gauges
Meets operating
speed requirements
Date inspected
INSPECTED BY
(company employee)
(1)
Rated mixing capacity cannot exceed 63% of gross volume of drum
(2)
Blade wear cannot exceed more than 25 mm (one inch) of the original height. For typical blade
configurations see “x” dimensions below.
Mixer blade types:
“L”
“Straight”
“T”
(3)
The drum cannot have an appreciable accumulation of hardened concrete inside.
I certify the truck mixers listed above were inspected and met the requirements for conformance with
the AASHTO M157 specifications.
I DECLARE UNDER PENALTY OF PERJURY IN THE SECOND DEGREE, AND ANY OTHER APPLI-
CABLE STATE OR FEDERAL LAWS, THAT THE STATEMENTS MADE ON THIS DOCUMENT ARE TRUE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
Concrete company’s principal executive, signature and title
Completed and checked by CDOT personnel
Batch plant scale certification (Certifiers name and date)
Batch plant water meter certification date
Print name
Signed
Title
Remarks:
Previous editions are obsolete and may not be used.
Distribution:
original - Region Materials Engineer
CDOT Form #46
3/14
1st copy - Resident/Project Engineer
2nd copy - Concrete company
Date Submitted
Contract ID
COLORADO DEPARTMENT OF TRANSPORTATION
CONCRETE TRUCK MIXER
Project No.
INSPECTION CERTIFICATION
Project location
Concrete company
Unit number
Rated mixing
capacity (1)
Blade wear (2)
Free of
Hardened concrete (3)
Revolution counter
Water gauges
Meets operating
speed requirements
Date inspected
INSPECTED BY
(company employee)
(1)
Rated mixing capacity cannot exceed 63% of gross volume of drum
(2)
Blade wear cannot exceed more than 25 mm (one inch) of the original height. For typical blade
configurations see “x” dimensions below.
Mixer blade types:
“L”
“Straight”
“T”
(3)
The drum cannot have an appreciable accumulation of hardened concrete inside.
I certify the truck mixers listed above were inspected and met the requirements for conformance with
the AASHTO M157 specifications.
I DECLARE UNDER PENALTY OF PERJURY IN THE SECOND DEGREE, AND ANY OTHER APPLI-
CABLE STATE OR FEDERAL LAWS, THAT THE STATEMENTS MADE ON THIS DOCUMENT ARE TRUE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
Concrete company’s principal executive, signature and title
Completed and checked by CDOT personnel
Batch plant scale certification (Certifiers name and date)
Batch plant water meter certification date
Print name
Signed
Title
Remarks:
Previous editions are obsolete and may not be used.
Distribution:
original - Region Materials Engineer
CDOT Form #46
3/14
1st copy - Resident/Project Engineer
2nd copy - Concrete company