"Daily Report on Portland Cement Concrete Pavement - Roadway Inspector's Report" - North Carolina

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NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
DAILY REPORT ON PORTLAND CEMENT CONCRETE PAVEMENT
ROADWAY INSPECTOR’S REPORT
CONTRACT NO.:
COUNTY:
DATE:
WEATHER:
TEMPERATURE– HIGH:
DIVISION:
CONTRACTOR (PRIME):
LOW:
REPORT NO.
CONCRETE MIX DESIGN:
PAVING CONTRACTOR:
RE OFFICE:
STAKING
METHOD OF BAR
VIBRATOR
PINS
NO. OF TRUCKS:
TINING / CURING:
INSTALLATION:
FREQUENCY: (VPM)
CORRECTLY
(BASKET, DBI)
INSTALLED:
MIXER:
TYPE OF CURING:
AGITATOR:
BEGIN:
TOTAL AREA:
NON-AGITATOR:
MIDDAY:
GALLONS USED:
END:
AVERAGE
ROUNDTRIP:
RATE OF APPLICATION:
PLAN
SIZE OF
FROM
LINEAR
WIDTH
SQUARE
CUBIC
LANE/
NO. OF
TO
DEPTH
BATCHES
STATION:
STATION:
FEET:
(FEET)
YARDS:
YARDS:
SHOULDER:
BATCHES:
(FEET):
(CU. YDS.)
TODAY’S
TOTALS:
NOTE: WHEN MORE THAN ONE DEPTH OF CONCRETE IS PLACED, SHOW THE NUMBER OF SQUARE YARDS, AND DEPTH USED FOR EACH
DIFFERENT DEPTH. SHOW EQUALITIES AND OTHER DEDUCTIONS OR ADDITIONS TO THE NEAREST LINEAR FOOT.
Method -
Time of
No. of Joints
Batch Ticket
Concrete
Discharge
Protect
Avg. Depth of
Air Content:
Slump:
Station:
Initial
Checked
Time:
Temperature:
Time:
Existing
Saw Cut:
Cut:
(20% min)
Joints
Tining
Curing
Joints
Are locations for
Is curing Full
Jt.s clearly
Depth:
Coverage
marked:
What is the
Are Jt.s aligned
Spacing:
Appli.Rate:
with Adj. Jts.:
What was the
Are Jt. Cuts
Width:
Time of Appli.
Raveling:
Has Curing been
Uniform Appearance:
reapplied:
Microtexture (burlap,
etc.:
*Technician Signature: __________________________________
* PCCP Certification Number:______________________________________
*By providing this data under my signature and/or HiCAMS certification number, I attest to the accuracy and
validity of the data contained on this form and certify that no deliberate misrepresentation of this data in any
manner has occurred.
Distribution: Materials and Tests Unit, Pavement Construction Section, Division Engineer, Resident Engineer
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
DAILY REPORT ON PORTLAND CEMENT CONCRETE PAVEMENT
ROADWAY INSPECTOR’S REPORT
CONTRACT NO.:
COUNTY:
DATE:
WEATHER:
TEMPERATURE– HIGH:
DIVISION:
CONTRACTOR (PRIME):
LOW:
REPORT NO.
CONCRETE MIX DESIGN:
PAVING CONTRACTOR:
RE OFFICE:
STAKING
METHOD OF BAR
VIBRATOR
PINS
NO. OF TRUCKS:
TINING / CURING:
INSTALLATION:
FREQUENCY: (VPM)
CORRECTLY
(BASKET, DBI)
INSTALLED:
MIXER:
TYPE OF CURING:
AGITATOR:
BEGIN:
TOTAL AREA:
NON-AGITATOR:
MIDDAY:
GALLONS USED:
END:
AVERAGE
ROUNDTRIP:
RATE OF APPLICATION:
PLAN
SIZE OF
FROM
LINEAR
WIDTH
SQUARE
CUBIC
LANE/
NO. OF
TO
DEPTH
BATCHES
STATION:
STATION:
FEET:
(FEET)
YARDS:
YARDS:
SHOULDER:
BATCHES:
(FEET):
(CU. YDS.)
TODAY’S
TOTALS:
NOTE: WHEN MORE THAN ONE DEPTH OF CONCRETE IS PLACED, SHOW THE NUMBER OF SQUARE YARDS, AND DEPTH USED FOR EACH
DIFFERENT DEPTH. SHOW EQUALITIES AND OTHER DEDUCTIONS OR ADDITIONS TO THE NEAREST LINEAR FOOT.
Method -
Time of
No. of Joints
Batch Ticket
Concrete
Discharge
Protect
Avg. Depth of
Air Content:
Slump:
Station:
Initial
Checked
Time:
Temperature:
Time:
Existing
Saw Cut:
Cut:
(20% min)
Joints
Tining
Curing
Joints
Are locations for
Is curing Full
Jt.s clearly
Depth:
Coverage
marked:
What is the
Are Jt.s aligned
Spacing:
Appli.Rate:
with Adj. Jts.:
What was the
Are Jt. Cuts
Width:
Time of Appli.
Raveling:
Has Curing been
Uniform Appearance:
reapplied:
Microtexture (burlap,
etc.:
*Technician Signature: __________________________________
* PCCP Certification Number:______________________________________
*By providing this data under my signature and/or HiCAMS certification number, I attest to the accuracy and
validity of the data contained on this form and certify that no deliberate misrepresentation of this data in any
manner has occurred.
Distribution: Materials and Tests Unit, Pavement Construction Section, Division Engineer, Resident Engineer
Report No. ____________
M & T Form 253L
Date: __________
North Carolina Department of Transportation
DAILY REPORT ON PORTLAND CEMENT CONCRETE PAVEMENT
Field Lab Inspector’s Report
RECORD OF BEAMS TESTED
Specimen No.
Date Made
Date Tested
Age
Station No.
Depth
Width
Load (lbs.)
PSI
RECORD OF TEMPERATURES
TIME
Water
Water Bath
Water Bath
Water Bath
Water Bath
Water Bath
AIR TEMPERATURE
Bath 1
2
3
4
5
6
OUTSIDE
INSIDE
MAXIMUM
MINIMUM
Note: Curing temperatures should be obtained from automatically controlled recording thermometers whenever possible.
Technician Signature
PCCP Certification Number
By providing this data under my signature and/or HiCAMS certification number, I attest to the accuracy and
validity of the data contained on this form and certify that no deliberate misrepresentation of this data in any
manner has occurred.
M & T Form 253P
Report No. ____________
Date : __________
North Carolina Department of Transportation
DAILY REPORT ON PORTLAND CEMENT CONCRETE PAVEMENT
PLANT INSPECTOR’S REPORT
(1)
Fine Aggregate – Moisture Probe
Time
% Moisture
(2)
Drying Method for Fine and Coarse Aggregate
Wet Wt.
Minus Dry Wt.
=
X 100 =
% Total Moisture
Dry Wt.
Total Moisture
Minus Absorbed Moisture
=
% Free Moisture
X 100 =
Wet Wt.
Minus Dry Wt.
=
% Total Moisture
Dry Wt.
Total Moisture
Minus Absorbed Moisture
=
% Free Moisture
X 100 =
Wet Wt.
Minus Dry Wt.
=
% Total Moisture
Dry Wt.
Total Moisture
Minus Absorbed Moisture
=
% Free Moisture
Mix Design Proportions (SSD)
Cement
lbs.
Coarse Aggregate
lbs.
Water
gals.
Pozzolan
lbs.
Fine Aggregate
lbs.
Water
lbs.
Percent
Percent
Additional
Additional
Gallons
Gallons
Water
Free
Free
F. A.
Batched
C. A.
Batched
Total
of Water
of Water
Added
(Pounds)
F.A. Wt.
(Pounds)
C.A. Wt.
Water
Moisture
Moisture
in F. A.
in C. A.
at Mixer
in F. A.
in C. A.
NOTE: Show ACTUAL amounts of water used (not theoretical amounts)
Remarks:
*Technician Signature
* Batch Certification Number
________________________________________________________
*By providing this data under my signature and/or HiCAMS certification number, I attest to the accuracy and
validity of the data contained on this form and certify that no deliberate misrepresentation of this data in any
manner has occurred.
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