Materials Source List

middleweightscourgeUrban and Civil

Nov 29, 2013 (3 years and 9 months ago)

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Printed
11/29/2013

Page
1

of
7


D5 PI0315

(Rev 7/16/09)


Materials Source List


Pre
-
Con Date








C
ontractor

N
ame

and

A
ddress
:

Contract













County













Section













Route








Job No.








District








Listed below are the proposed

Producers or Suppliers of materials for the above section
. If any of the following
items do not apply to this contract, please write NA under the Producer/Suppli
er. If there is any additional material to be
included in this contract, please write in the provided space below.


M
aterial

E
vidence of Inspection

As taken from the Project Procedure Guide

at website

http://www.dot.state.il.us/materials/projectproceduresguide.html

P
roducer
/

S
upplie
r

A
dhesives




B
onding epoxy

C
ert

or M
ark








Chemical adhesive (Dowel &

Tiebar)

L
ist








Glass Capsule for Anchor

Bolts

L
ist







A
ggregate




For Mixtures & Granular Use

L
ist

+ T
ick.








Lightweight, for P. C. Concrete

Cert








Riprap, Concrete

L
ist

+ T
ick.








Riprap, Stone

L
ist

+ T
ick.







B
ridge

B
earing

P
ads




Elastomeric (Whole Pad)

C
ert

or LA 15 or (*
BMPR
)








Fabric

LA 15 or T
est








Pot, Floating Bearings

BMPR







B
ituminous Materials




PG Asphalt Binder

(L
ist

or T
est
) + B
ill

of

L
ading








Road Oil & Cutback Asphalt

(L
ist

or T
est
) + B
ill

of

L
ading








Emulsified Asphalt

(L
ist

or T
est
) + B
ill

of

L
ading







Hot Mix Asphalt




Hot Mix Asphalt

(
QC/QA
)

D
aily

P
lant

R
eport

+ T
ick.

+ T
est







Block/Brick




Clay or Shale Building Brick

T
est








Clay or Shale Paving Brick

T
est








Concrete Building Brick

L
ist








Concrete Paver

List








Precast Block Revetment Mat

List








Precast Articulated Block

Revetment
Mat

List








Segmental Concrete Block Walls

(Retaining Wall)

List







Printed
11/29/2013

Page
2

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7


D5 PI0315

(Rev 7/16/09)


Concrete Masonry Units for

Buildings/Catch

Basin/Manhole/Inlet/Valve Vault

List







Bridge Rail





Railing





-
Structural Steel

BMPR or LA 15 or Test









-
Aluminum, Steel, Stainless Steel

Cert or LA 15








Post, Anchoring Device

Cert or LA 15







C
ementitious

M
aterials




Cement




-

Calcium Aluminate

Test








-


Portland or Blended

(List or Test) + Bill of Lading








-

Rapid Hardening

List








F
inely Divided Minerals
-

Fly

A
sh,

Ground Granulated Blast Furnace
Slag, Microsilica, High
-
Reactivity
Metakaolin

L
ist

or T
est







C
hemicals
/A
dmixtures




HMA
-
Anti
-
strip Additive for

Bituminous
Mixtures

L
ist








HMA
-

Asphalt
Truck Release Agent

L
ist








Calcium Chloride (Dry, Liquid)




-


Dust Palliative

Test








-


PCC


Calcium Chloride
Accelerator

Cert








CLSM
-

Air Entraining Admixture

L
ist








PCC
-
Corrosion Inhibitor

L
ist








PCC
-
Latex Emulsion

C
ert








PCC
-
Air
-
Entraining Admixture

L
ist








PCC
-
Type A
-
G Admixtures

L
ist








PCC

Rheology Modifying Admixture

List








PCC

Viscosity Controlling Admixture

List








PCC
-
Membrane Curing


Compound

LA 15 or IL OK or T
est








PCC
-
Membrane Curing

C
ompound/Linseed Oil Emulsion

LA 15 or IL OK or T
est








Concrete

Seat Sealer

L
ist








Protective Coat (Linseed Oil/Petroleum
Spirits)

LA 15 or IL OK or T
est








Rock Salt, Sodium Chloride

T
est








Water, for concrete, mortar, or curing

Potable Source or Test








Weed Killer

Mark or Vis







C
oncrete




Polymer Concrete

L
ist








Portland Cement Concrete
-

other than
QC/QA

D
aily

P
lant

R
eport

+ T
ick.

(T
ick.

not req’d for
volumetric mixer) +

T
est








Portland Cement Concrete


Daily Plant Report + Tick. (Tick. not req’d for
volumetric mixer) + Test








CAM

II
-

Cement Aggregate Mixture

Daily Plant Report + Tick. (Tick. not req’d for
volumetric mixer)








CLSM
-
Controlled Low

Strength

Material

Daily Plant Report + Tick. (Tick. not req’d for
volumetric mixer) + Test







Printed
11/29/2013

Page
3

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7


D5 PI0315

(Rev 7/16/09)


Non
-
Shrink Grout

L
ist








Shotcrete, High Performance

L
ist

+ Test








Thin Polymer Overlay System for

Bridge Decks

L
ist








PCC


Curing Blanket


Burlap,

Burlap/Poly, Waterproof Paper, White

Poly, Cotton Mat

V
is.

E
xam







C
oncrete, Precast




Architectural Products

L
ist








Bridge Beams

L
ist

+ M
ark








Bridge Slabs

L
ist

+ Mark








Bridge


Three Sided Structure

List + Mark








Drainage Products

List + Mark








Noise Abatement Wall

List








MSE Retaining Wall

List








Modular Retaining Wall

List



Traffic Barrier

List

+ Mark








R.O.W., Drainage, Section, and
Permanent Survey Markers

List








Headwall

List








Bumper Blocks

(Wheel Stops for Cars)

List








Picnic Table, Trash Receptacle,
Planter

List








Splash Blocks

List







C
oncrete
, P
recast

& P
restressed

(Except Piling)




Prestressed Products

IL OK







C
oncrete Repair




M
ortar, Polymer Modified Portland

C
ement

L
ist








Rapid Hardening Cementitious
Material

L
ist







E
lectrical




Cable, unit duct

Mark or LA15








Conduit




-


Aluminum, plastic

Mark or Cert or LA 15








-


Steel

LA 15 or (Cert + Mark)








Detector Loop

LA 15 or M
ark









Fiber Optic Cable

Mark or Cert or LA 15








Ground Rod

LA 15 or C
ert.








Wire, Span or Tether

LA 15 or T
est







F
encing




Fabric, Post, Wire

Cert or LA 15








Glare Guard, Slats

Vis







G
uard Rail




Cable for Road Guard

LA 15 or IL OK or T
est








Fasteners

(M
ark

+ C
ert.
) or T
est








Steel Plate

& Accessories

L
ist

+ Cert








Steel Post

C
ert.

or LA 15







Printed
11/29/2013

Page
4

of
7


D5 PI0315

(Rev 7/16/09)


Traffic Barrier Terminal End Section

NCHRP 350 Pdts.= (List + Cert)or LA 15; Pdts. Not
covered by NCHRP 350 = Cert or LA 15








Wood Posts, Plank

M
ark

or C
ert.

or LA 15








High Tension Cable Median Barrier

(List + Cert) or LA 15







Joint Fillers & Sealers




Mastic for Precast Concrete Pipe

Cert or LA 15








Cold
-

Poured Sealer

LA 15 or IL OK








Hot
-

Poured Sealer

LA 15 or IL OK








Polysulfide Sealer

M
ark

(if it contains spec. info)

or C
ert.

or LA 15








Asphalt Fillers




-

PAF

LA 15 or IL OK or Test








-

Fiber


Modified (Pavement
Preserv.)

Cert








Preformed
-

Bituminous, cork, foam,
fiber
, plastic

LA 15

or IL Ok

or T
est








Preformed Elastomeric Compression

LA 15 or
IL Ok or
T
est








Preformed Neoprene, EPDM

LA 15 or

IL OK or

T
est








PCC
-

Silicone

Cert or Mark (if it contains spec. info.) or LA 15








Water Seal, PVC

LA 15 or T
est







L
andscaping




Agricultural Lime (Dept of Ag. Prog.)

L
ist

+ T
ick.








E
xcelsior Blanket

C
ert

or LA15








Fiber Mat

M
ark

or C
ert








Fertilizer

C
ert

(bulk) or Mark (bags)








Mulch




-


Straw

Vis








-


Paper, Wood cellulose

Mark or Cert








Asphalt coated straw




-


Emulsified Asphalt

(List or Test) + Bill of
Lading








-


Straw

Vis








Compost

Cert








Peat Moss

C
ert.

or IL OK or LA15








Seed, Sod

C
ert.

or IL OK or LA15








Trees, Shrubs, Plants

Vis







L
ighting

& S
ignals




Controllers & Cabinets

V
is.

C
ompared to
A
pproved
S
ubmittals

+ Cert








Lamps, Luminaries & Ballast

V
is.

C
ompared to
A
pproved
S
ubmittals

+ Cert








Traffic Signal Components

V
is.

C
ompared to
A
pproved
S
ubmittals

+ Cert








Break
-
A
way Support

V
is.

C
ompared to
A
pproved
S
ubmittals

+ Cert








Poles




-


Steel, Aluminum

Cert or IL OK








-


Wood

Mark








Mast Arm Assemblies

C
ert.








Composite

Handholes and Gulfbox

Cert







L
umber/Timber




Treated

or Untreated

Lumber

C
ert.

or M
ark







M
etal

P
roducts
, M
isc.




Aluminum Drains

C
ert.

or
Mark or
LA 15







Printed
11/29/2013

Page
5

of
7


D5 PI0315

(Rev 7/16/09)


Copper Water Pipe

M
ark








Name Plate

LA 15 or V
is.








Rodent Shield

V
is.








Survey Markers

LA 15 or V
is.







M
iscellaneous




Manhole Step, Plastic

Cert or LA 15








Geotextile Fabric


French Drain,
Ground Stabiliza
tion, Pipe Underdrain,
Rip Rap,
Silt

Filter Fence & Weed
Barrier

M
ark

or
Cert

or LA15








Concrete Revetment Mat Fabric

L
ist







P
aint




Bridge
P
aint

& Primer

T
est

(
Approved Lot
)








Pavement
M
arking
P
aint

LA 15








Epoxy Pavement Marking L
n.

LA 15 or T
est








Preform Plastic Pav. Marking L
n.

LA 15 or T
est







P
avement
M
arking




Glass Beads

LA 15 or
IL OK








Raised
Pavement
Marker

L
ist









Temporary Pavement Tape

LA 15 or
(
IL OK

+ Batch/Lot Number)








Thermo Letters

& Symbols

C
ert.

or LA 15








Thermoplastic
-
Granular Block

LA 15
or IL OK








Thermoplastic Tape

LA 15 or
IL OK







P
iling




Metal Shell, Steel H, or Steel Sheet

or
Steel Soldier

C
ert.

or LA 15 or IL OK








Precast Concrete

L
ist








Precast, Prestressed Concrete

IL OK








Timber

C
ert.

or M
ark

or LA 15







P
ipe
, C
ulvert

& D
rain




Cast or Ductile Iron Pipe

C
ert.

or LA 15








Clay Pipe & Drain Tile

LA 15 or IL OK or T
est








Metal Corrugated & Components

C
ert.

or IL OK or LA 15








Pipe
-
Plastic, PVC, HDPE
-
water/sewer

IL OK or LA 15 or T
est








Pipe Fittings


PE, PVC

Vis








Pipe Liner, PE
, PVC

IL OK or LA 15 or Test








Pipe Underdrain

IL OK or
LA 15 or T
est








Plastic Deck Drain

C
ert








Precast Concrete Pipe or Box Culvert

L
ist

+ M
ark








Underdrain Mat, Wall Drain

LA 15
or

T
est







S
igning





Completed Sign Panels & Standard






-

Reflective Sheeting

LA 15 or Test










-


Aluminum Sheeting

LA 15 or T
est








Post, Break
-
A
way

Cert.

or IL OK or LA 15








Posts,
M
etal & Hardware

C
ert

or LA 15
.








Post, Tubular (round, rectangle)

LA 15 or IL OK or Test








Posts, Steel Delineator

C
ert

or LA 15








Post
, Wood

M
ark

or C
ert

or LA 15







Printed
11/29/2013

Page
6

of
7


D5 PI0315

(Rev 7/16/09)


Reflector
, Delineator, Terminal

C
ert

or LA 15








Reflector
, Prism

C
ert

or LA 15








Sign Structure, Overhead

BBS 59 + C
ert.








Structural Fasteners

BMPR or
LA 15 or IL OK







Soil/Modification/Stabilization




CAM



Cement Aggregate Mixture

T
est








Topsoil

T
est








For IBR





-


Fine
-

Grained Soil

T
est









-


Coarse
-

Grained Soil

T
est








For Moisture Density





-

Fine
-

Grained Soil

T
est









-

Coarse
-

Grained Soil

T
est








Pozzolanic Stabilized Subbase or Base
Course

T
est








Cement (Portland

or Blended
)

(L
ist

or

T
est
) + B
ill of Lading








Fly Ash

L
ist

or
T
est








Lime

C
ert.

& M
anufacturers
’ T
est

R
esults

r
epresent
ing

m
at’l

d
elivered

to be provided prior to or with 1
st

load








Modified Soil with Lime, Portland
Cement, Portland

Blast
-
Furnace
Cement, or Fly Ash

T
est








Lime Stabilized Subb
ase or Base
Course

T
est








Soil
-
Cement Base Course

T
est







S
teel

& C
asting




Cast Frames & Grates/Lids

C
ert

or LA 15








Cast Manhole

Steps

Cert or LA 15








Deck Drains

C
ert

or LA 15








Gabions, Slope Mattress

C
ert

or LA 15








Pipe Casing

LA 15

or IL OK or Test








Steel Frame & Grates

C
ert

or LA 15







Steel, Miscellaneous




Anchor Bolts

BMPR or LA 15 or IL OK







S
teel
, R
einforcing




Dowel Bars


black or epoxy coated

L
ist

+
Cert








Dowel Bar Assembly

(Only)

List +
C
ert








Pavement Fabric & Wire Mesh

L
ist

+
Cert








Prestressing Strand

BMPR








Reinforcing Bar



black or epoxy
coated

L
ist
+

Cert +
M
ark








Rebar
Splicers


black or epoxy coated

L
ist

+ C
ert;

Test if > 100








S
teel
, S
tructural




Fasteners

BMPR or LA 15 or IL OK








Structural Steel

BBS 59
+
C
ert









Stud Sheer Connectors

(
M
ark

+ Cert) or

LA 15







T
emporary Items



Printed
11/29/2013

Page
7

of
7


D5 PI0315

(Rev 7/16/09)


See Sections 100, 500

Vis. Exam








Except

Reflective Material

See Paint, Pavement Marking & Signing requirements


W
aterproofing Materials




Asphalt Emulsion (Art. 1060
.08
)

(L
ist

or T
est
) + B
ill of Lading








Membrane System (Art. 1061)





-

Coal
-
Tar Pitch Emulsion &
Primer

LA 15 or Test









-

Fabric, Glass

LA 15 or Test








Reflective Crack Control (Art. 1062)





-

Reinforcing Fabric

M
ark

or
Cert or
LA 15








Fiberglas
R
epair
S
ystem (Art. 1063)





-


Fiberglas
F
abric

LA 15 or Test









-


Bit
. Adhesive

LA 15 or Test








The material from the producers or suppliers is approved contingent upon appropriate Evidence of Inspection as outlined
above and in accordance with the Department’s Project Procedures Guide at website
http://www.dot.state.il.us/materials/projectproceduresguide.html
.


Under no condition are materials to be incorporated into a contract without appropriate Evidence of Inspection.


Award Date:







Execution Date:







Starting Date








R.E.









Contact Person for Material Discrepancies







Phone








Location:










District Materials Engineer