T112 template BardonExt Extraction Extraction Marshall Marshall Mass of Retained on Date by HC12092911525

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									                                            NorthEast Transportation Training & Certification Program
                                                                      Deleterious Materials Test Report (T 112)
                      Date/Time:                                                   Lab/Location:
                        Weather:                                                   Date Rec'd #:                                        Random Sample:       No

                         Project:                                                   Lab Login #:                                                    Lot #:
                      Contract #:                                                    Material ID:                                               Sublot #:
                      Contractor:                                                     Material #:                                       Sample Location:
                   Pay Item #:                                                        Sample #:                                                   Station:
                      Source:                                                   Sample Type:        QC                                             Offset:
                   Plant Type:                                             Sampled By/Cert. #:




                                                         Clay Lumps and Friable Particles in Aggregate (T 112)


                                                        Total Sample Mass:


                                                                                      Size                                 Mass of      Percent of Clay
                                                Size of Particles                   of Sieve               Mass            Particles    Lumps & Friable
                                          Making up Sample, in. (mm)              for Removing            of Test        Retained on     Particles ( P )
                                                                                Particles, in. (mm) Sample ( W )          Sieve ( R )    ((W-R)/W)*100
                                               Over 1 1/2 (37.5)                    #4 (4.75)
                                             3/4 (19) - 1 1/2 (37.5)                #4 (4.75)
                                               3/8 (9.5) - 3/4 (19)                 #4 (4.75)
                                              #4 (4.75) - 3/8 (9.5)                 #8 (2.36)
                                    Fine Aggregate (Retained on #16 (1.18 mm)) #20 (850 µm)




                   Comments:



                      Tested by:                                                                         Reviewed by:
                Certification #:                                                                     Certification #:
                           Date:                                                                                Date:
                  Test Results Within Engineering Limits:                 YES                                       NO




                QC
                A-V
                IA
                DR
                Other

                Yes
                No


Rev. 10/22/09                                                    CT MA ME NH NY RI VT                                                                             T112
                                            NorthEast Transportation Training & Certification Program
                                                                      Deleterious Materials Test Report (T 112)
                      Date/Time:                                                   Lab/Location:
                        Weather:                                                   Date Rec'd #:                                     Random Sample: Yes No
                         Project:                                                   Lab Login #:                                                 Lot #:
                      Contract #:                                                    Material ID:                                            Sublot #:
                      Contractor:                                                     Material #:                                    Sample Location:
                   Pay Item #:                                                        Sample #:                                                Station:
                      Source:                                                   Sample Type: QC A-V IA DR Other                                 Offset:
                   Plant Type:                                             Sampled By/Cert. #:




                                                         Clay Lumps and Friable Particles in Aggregate (T 112)


                                                        Total Sample Mass:


                                                                                      Size                              Mass of      Percent of Clay
                                                Size of Particles                   of Sieve            Mass            Particles    Lumps & Friable
                                          Making up Sample, in. (mm)              for Removing         of Test         Retained on    Particles ( P )
                                                                                Particles, in. (mm) Sample ( W )       Sieve ( R )    ((W-R)/W)*100
                                               Over 1 1/2 (37.5)                    #4 (4.75)
                                             3/4 (19) - 1 1/2 (37.5)                #4 (4.75)
                                               3/8 (9.5) - 3/4 (19)                 #4 (4.75)
                                              #4 (4.75) - 3/8 (9.5)                 #8 (2.36)
                                    Fine Aggregate (Retained on #16 (1.18 mm)) #20 (850 µm)




                   Comments:



                      Tested by:                                                                     Reviewed by:
                Certification #:                                                                    Certification #:
                           Date:                                                                              Date:
                  Test Results Within Engineering Limits:                 YES                                    NO




                QC
                A-V
                IA
                DR
                Other

                Yes
                No


Rev. 10/22/09                                                    CT MA ME NH NY RI VT                                                                        T112

								
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