SEGREGATION WORKSHEET
CONTRACT NO. PROJECT NO. CONTRACTOR SHEET_____ of ______ CONSULTANT
INSPECTION(1.During Construction or 2.Following Construction(Two Week)
PROJECT FROM MAT 6 - 95/02 DATE INSPECTED STATION LOCATION LANE MAT
PROJECT TO
SEGREGATED AREAS
SLIGHT MODERATE SEVERE
Centre of Paver Length(m)
OBVIOUS DEFECT
COMMENTS
1. During Construction Inspection to include all moderate and severe segregation, moderate and severe centre-of-paver segregation and obvious defects. 2. Following Construction (Two Week) Inspection to include all additional segregation not previously rated. OBVIOUS DEFECT CODES SG EA SL MJ CR CH Segregation(<.1 sq.m) Excess Asphalt Sample Location Imp. Matching Joint Cracking Imp. Rep. Core Holes RM TM TR HC AP OH INSPECTED BY: RECEIVED BY: Roller Mark *** Contractor's Representative Tire Mark Roller Tears DATE RECEIVED TIME Hairline Cracking *** Signature indicates receipt of data on the date and time indicated Approach Seg. Other___________________________