Form 367-TF4 "Core Density Testing of Hma Report" - Rhode Island

What Is Form 367-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 367-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 367-TF4 "Core Density Testing of Hma Report" - Rhode Island

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RHODE ISLAND DEPARTMENT OF TRANSPORTATION
Office
MATERIALS MANAGEMENT
Resident:
CORE DENSITY TESTING OF HMA REPORT
_______________
Item No:
RI Contract No:
PTSID:
Date Paved:
Project:
Date Cored:
P. Engineering
Acceptance
Independent
Info Only
Pavement Details / Notes:
Design Lift Thickness (in.):
Pavement Type:
Plant:
3
A
Plant Lab Density (lbs/ft
):
Core Numbers:
Lot Details / Notes:
Lot Begin (station):
Lot End (station):
Total Length of Lot (ft):
Minimum No. Tests:
Core Number
B
Sublot Begin (station):
C
Length of Sublot (ft):
D
Random # 1 (0.0001 – 1.0000):
E
Random Length (ft):
[C x D]
F
Random Station:
[B+E]
G
Width @ Location E (ft):
H
Random # 2 (0.0001 – 1.0000):
I
Random Offset (ft):
[G x H]
3
J
Field Nuclear Density # 1 (lbs/ft
):
K
3
Field Nuclear Density # 2 (lbs/ft
):
3
L
Average Density (lbs/ft
):
[(J+K)÷2]
M
% of Plant Lab Density:
(L÷A)x100
Specification
Remarks:
Field Technician
Date
(Sign/Print)
Lab Bulk Specific Gravity
Lab No:
Mass of the Dry Specimen in air (g):
Mass of the Specimen in Water (g):
Mass of the SSD Specimen in air (g):
Bulk Specific Gravity:
Average Thickness of Core (in):
Meets Spec
Does Not Meet Spec
Info Only
_____________________________________
____________________________________
Technician
Date
Reviewed By
Date
(Sign/Print)
(Sign/Print)
ID# TF4 - 367
REV. 4/25/19
RHODE ISLAND DEPARTMENT OF TRANSPORTATION
Office
MATERIALS MANAGEMENT
Resident:
CORE DENSITY TESTING OF HMA REPORT
_______________
Item No:
RI Contract No:
PTSID:
Date Paved:
Project:
Date Cored:
P. Engineering
Acceptance
Independent
Info Only
Pavement Details / Notes:
Design Lift Thickness (in.):
Pavement Type:
Plant:
3
A
Plant Lab Density (lbs/ft
):
Core Numbers:
Lot Details / Notes:
Lot Begin (station):
Lot End (station):
Total Length of Lot (ft):
Minimum No. Tests:
Core Number
B
Sublot Begin (station):
C
Length of Sublot (ft):
D
Random # 1 (0.0001 – 1.0000):
E
Random Length (ft):
[C x D]
F
Random Station:
[B+E]
G
Width @ Location E (ft):
H
Random # 2 (0.0001 – 1.0000):
I
Random Offset (ft):
[G x H]
3
J
Field Nuclear Density # 1 (lbs/ft
):
K
3
Field Nuclear Density # 2 (lbs/ft
):
3
L
Average Density (lbs/ft
):
[(J+K)÷2]
M
% of Plant Lab Density:
(L÷A)x100
Specification
Remarks:
Field Technician
Date
(Sign/Print)
Lab Bulk Specific Gravity
Lab No:
Mass of the Dry Specimen in air (g):
Mass of the Specimen in Water (g):
Mass of the SSD Specimen in air (g):
Bulk Specific Gravity:
Average Thickness of Core (in):
Meets Spec
Does Not Meet Spec
Info Only
_____________________________________
____________________________________
Technician
Date
Reviewed By
Date
(Sign/Print)
(Sign/Print)
ID# TF4 - 367
REV. 4/25/19