Form 410-TF4 "Pavement Surface Test Report" - Rhode Island

What Is Form 410-TF4?

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

Form Details:

  • Released on April 25, 2019;
  • The latest edition provided by the Rhode Island 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 Form 410-TF4 by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Transportation.

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Download Form 410-TF4 "Pavement Surface Test Report" - Rhode Island

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RHODE ISLAND DEPARTMENT OF TRANSPORTATION
Office
MATERIALS MANAGEMENT
Resident:
PAVEMENT SURFACE TEST REPORT (ASTM E965)
_______________
Item No:
Date:
RI Contract No:
PTSID:
F.A.P. No:
Project:
Location:
Acceptance
Independent
Info Only
Lot Begin (station):
Lot End (station):
Total Length of Lot (ft):
Total Width of Lot (ft):
Test Number
1
2
3
4
A
Sublot Begin (station):
Length of Sublot (1500 ft or
B
less):
C
Random # 1 (0.0001 – 1.0000):
Random Length:
D
[B x C]
Random Station:
E
[A+D]
F
Width @ Location E:
G
Random # 2 (0.0001 – 1.0000):
Random Offset:
H
[F x G]
I
Time 1
J
Time 2
K
Time 3
L
Time 4
Remarks:
Meets Spec
Does Not Meet Spec
Info Only
_____________________________________
____________________________________
Inspector
Date
Reviewed By
Date
(Print / Sign)
(Print / Sign)
ID# TF4 – 410
REV. 4/25/19
RHODE ISLAND DEPARTMENT OF TRANSPORTATION
Office
MATERIALS MANAGEMENT
Resident:
PAVEMENT SURFACE TEST REPORT (ASTM E965)
_______________
Item No:
Date:
RI Contract No:
PTSID:
F.A.P. No:
Project:
Location:
Acceptance
Independent
Info Only
Lot Begin (station):
Lot End (station):
Total Length of Lot (ft):
Total Width of Lot (ft):
Test Number
1
2
3
4
A
Sublot Begin (station):
Length of Sublot (1500 ft or
B
less):
C
Random # 1 (0.0001 – 1.0000):
Random Length:
D
[B x C]
Random Station:
E
[A+D]
F
Width @ Location E:
G
Random # 2 (0.0001 – 1.0000):
Random Offset:
H
[F x G]
I
Time 1
J
Time 2
K
Time 3
L
Time 4
Remarks:
Meets Spec
Does Not Meet Spec
Info Only
_____________________________________
____________________________________
Inspector
Date
Reviewed By
Date
(Print / Sign)
(Print / Sign)
ID# TF4 – 410
REV. 4/25/19