Field Assistant

DWR

Contractor Information

*Contractor:

Contractors Selected	ID	Action

Crew
Equipment
Remarks

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*Contractor:
*Crew No.:

*Personnel type:
*Qty:

Select	Contractor	Crew	Personnel Type	Qty	ID	Action

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*Contractor:
*Equipment:

*Crew No.:
*Qty:		*Qty Used:

Select	Contractor	Crew	Equipment	Qty	Qty Used	ID	Action

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*Select a Remark Type:

Number of characters allowed:

Select	Remark Type	Text	ID	Action

Project

Select a Project:

Pay Items

PLN	CLN	Item Code	Item Desc	Item Unit	Bid Qty	Remaining Qty	Daily Qty	contractKey	projectKey	dwrKey	dwrProjectKey	hma	ContractSource	MaterialSetList	MaterialSetIsExempt	AgencyViewId

Random Ton:
Override Reason:

Contract:		Contractor:
Project Number:		Material Code:
CLN:		Producer/Supplier:
		DMF:

Select a Contractor:
Select a Material Code:
Select Producer/Supplier:
Select a DMF:
Initial Course Width (ft.):		Planned Quantity (lb/yd²):

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Lot:

Sublot:

Date:

Ticket Count:

Ticket Type:	Lift:		Tons:
Start:	Start Paving Width:	ft.
End:	End Paving Width:	ft.

Route / Direction / Lane / Location:

HMA

HMA Accumulated Tons:

Daily Tons:

Lot	Sublot	Sample Desc	Start Ton	Random Ton	Sampled Lot Ton	Daily Tons To Sample	Offset Loc	Sample Station	Override	HmaIndex	SublotNum

PlacedQuantity:

Theoretical Quantity:

Lot	Sublot	Date	Lift	Type	Start Station	Paving Width Start	Ton	Accum. Ton	End Station	Paving Width End	Location Info	Ticket_Id

Description:

Material Sets:

#	Shape	Calculation Entries	Stationing	Area	Action

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Sample ID:
	YEAR	DISTRICT	SUBMITTER	SEQUENCE

Sampled By:

Contract:

Material Code:

Item Unit:

Total Rep Qty:

*Sample Date:

*Sample Size:

Mix ID:

*Sample Type:

*Acceptance Method:

Sampled From:

Sampled At:

Lot:

Sublot:

Requested By:

*P/S-Mnfctr:

Buy America Link:

Brand:

*Project Number:
*Line Item:
*Material Set:
*Rep Qty:

Project Items:

Project	Line Item	Material Set	Quantity	Remove

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*yd ³ Batched(0.01) Yd
*Cement	(lbs.)	lb/cyd
*Pozzolan	(lbs.)	lb/cyd	*Pozzolan 2	lb/cyd
*Fine Aggregate	(lbs.)	lb/cyd
*Coarse Aggregate	(lbs.)	lb/cyd
*Water (gallons or lbs)	(gal.)	lb/cyd
Gallons lbs

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Reference Specification Condition

*Test Method
*Weight of Container	M_m	(0.01 lbs.)	lbs
*Weight of Container & Concrete	M_c	(0.01 lbs.)	lbs
Net Wt. Concrete = M _c-M _m	N	(0.01 lbs.)	lbs
*Container Factor = 1 / Volume	C_f	(0.001)	lbs/cft
Unit Weight = N x C _f	A	(0.1 lbs / ft³)	lbs/cft
Relative Yield = B / (A x 27)	Y_f	(0.001)
Cement Content = C / Y _f		(1 lbs / ft³)	lbs/cft
*Test Results	Pass Fail Adjust

Material 1yd³ Batch Wts.	(1 lb / yd³)
Cement		(lbs.)	lbs/cyd
Pozzolan		(lbs.)	lbs/cyd	Pozzolan 2	lbs/cyd
Fine Aggregate		(lbs.)	lbs/cyd
Coarse Aggregate		(lbs.)	lbs/cyd
Water		(lbs.)	lbs/cyd
Total Batch Weights B		(lbs.)	lbs/cyd
% Fine Aggregate (0.1%)

Unit Weight and Relative Yield Test Methods:

Test Result	Test Method	M_c	M_m	N	C_f	A	Y_f	C/Y_f	% Fine Agg	Remove	RefSpecCond
No Tests Found

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Reference Specification Condition

Test Method

*Percent Air Gross	A₁		(0.1%)	%
*Aggregate Correction	G		(0.1%)	%
Air Content A₁-G	A_s		(0.1%)	%
*Test Results		Pass Fail

Air Test Methods:

Test Result	Test Method	A₁	G	A_s	Remove	RefSpecCond
No Tests Found

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Reference Specification Condition
*Test Method
*Formed, Slipformed or Cast-In-Place?	Formed Slipformed Cast-In-Place
*Method Type:	Portland Cemment Concrete Latex Modified Concrete
*Slump (0.25 in.)
*Water Meter Reading(For Latex Modified Concrete Only)
*Test Results	Pass Fail Info

Slump Test Methods:

Test Result	Test Method	Form, Slip or Cast	Slump	Remove	RefSpecCond
No Tests Found

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Reference Specification Condition

*Test Method	Was 2 Coarse Aggregate Used? No Yes
	Coarse Aggregate		Coarse Aggregate #2		Fine Aggregate
*Mass of Container	M_c	lbs	M_c2	lbs	M_f	lbs
*Wet Mass of Sample & Container	W_c	lbs	W_c2	lbs	W_f	lbs
*Dry Mass of Sample & Container	D_c	lbs	D_c2	lbs	D_f	lbs
Moisture % [MP=((W-D)/(D-M))*100]	Mp_c	%	Mp_c2	%	Mp_f	%
	From Concrete Mix Design
*Percent Absorption	P_c	%	P_c2	%	P_f	%
	Batch Information
Batch Mass	B_c	lbs	B_c2	lbs	B_f	lbs
Dry Batch Mass [Db=(B/(1+(Mp/100)))]	Db_c	lbs	Db_c2	lbs	Db_f	lbs
Water in Aggregate [A=B-Db]	A_c	lbs	A_c2	lbs	A_f	lbs
Total Water in Aggregate [Wa=Ac+Af]	Wa lbs
Add Water at Mixer	Wm lbs
Total Free Water in Mix [((Wa+Wm)-((Dbc(Pc/100))+(Dbf(Pf/100))))]	Wt lbs
Total Wt. of Cement in Batch	C lbs
Total Wt. Pozzolans in Batch	P lbs
Total Wt. Cementitous in Batch [Ct=C+P]	Ct lbs
Water Cementitious Ratio [R=Wt/Ct]	R
*Final Test Results	Pass Fail Info

Water Cementitious Ratio Test Methods:

Test Result	Test Method	M_c	M_f	W_c	W_f	D_c	D_f	Mp_c	Mp_f	P_c	P_f	B_c	B_f	Db_c	Db_f	A_c	A_f	Wa	Wm	Wt	C	P	Ct	R	Remove	RefSpecCond
No Tests Found

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Reference Specification Condition
*Mass of Pan	Mp		lbs.
*Mass of Pan and Wet Soil	Mp_w		lbs.
Mass of Wet Soil [Mp_w-Mp]	M_w		lbs.
*Mass of Pan and Dry Soil	Mp_d		lbs.
Mass of Dry Soil [Mp_d-Mp]	M_d		lbs.
Moisture Percent [(((M_w-M_d)/M_d)*100)]	MC_t		%
*Final Test Results		Pass Fail Info

Test 255 Methods:

Test Results	M_w	M_d	MC_t	Remove	Mp	Mpw	Mpd	RefSpecCond
No Tests Found

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Reference Specification Condition
*Soil Dry Method
Optimum Moisture Content			%
*Mass of Pan	Mp		lbs.
*Mass of Pan and Wet Soil	Mp_w		lbs.
You have not met the minimum amount required for testing.
*Mass of Pan and Dry Soil	Mp_d		lbs.
Moisture Content [(((Mp_w-Mp_d)/(Mp_d-Mp))*100)]	MC_t		%
*Final Test Results		Pass Fail Info
Difference			%

Test 506 Methods:

Test Result	Dry Method	MC_t	Remove	Mp	Mpw	Mpd	D	Pr1	Pr2	Pr3	Avg	RefSpecCond
No Tests Found

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Reference Specification Condition
*Stationing
*Lift Number	Ln
*Test Number	Tn
*Test Area	Ta
*Chemical Modifiers		Lime Cement
*Maximum Allowable Deflection	MAD
*Test 1	T1
*Test 2	T2
*Test 3	T3
Average of Tests [(T1+T2+T3)/3]	Avg
*Stove Drying	Sd	%
*Final Test Results		Pass Fail
Comments:

LWD Test Methods:

Test Result	Ln	Test Area	Modifier	MAD	T1	T2	T3	Avg	Sd	Remove	Stationing	TestNumber	Comments	RefSpecCond
No Tests Found

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Reference Specification Condition
*Stationing
*Lift Number	Ln
*Method of Compaction	COM
*# of Passes with Compaction Equipment	Pce
*Test Area (Specific Operation)
*Subgrade Treatment Depth		14 Inch Lift 8 Inch Lift
*Textual Classification
*Site Manager Sample Id (Proctor)	Si
*Site Manager Sample Id (Proctor)	Enter
*Dry Density (Proctor)	DD		lbs./f³
*Optimum Moisture Content	OMC		%
*Textural Classification	TC
*Topsize of B-Borrow or A-1 Soil
6/12 inch Penetration Blow Count
*Location 1	L1		Blows
*Location 2	L2		Blows
*Location 3	L3		Blows
Average [(L1+L2+L3)/3]	Avg		Blows

Blow count for top 8 inch Interval
*Location₂ 1	L₂1		Blows
*Location₂ 2	L₂2		Blows
*Location₂ 3	L₂3		Blows
Average [(L₂1+L₂2+L₂3)/3]	Avg₂		Blows
*Blow count for top 6 inch Interval	BC6		Blows
*Blow count for 12 inch Penetration	BC12		Blows
	Percent Moisture ITM506 at Time of Mixing
*Target Blow Count	TBC		Blows
*Percent Moisture	MCt	%
Moisture Difference [Mct-OMC]	Md		%
30 Inch Penetration
*Blow count for 0 - 6 inch Interval	BC6		Blows
*Blow count for 6 - 12 inch Interval	BC12		Blows
*Blow count for 12 - 18 inch Interval	BC18		Blows
*Blow count for 18 - 24 inch Interval	BC18		Blows
*Blow count for 24 - 30 inch Interval	BC24		Blows
*Final Test Results		Pass Fail Info

DCP IT509 Test Methods:

Test Result	Ln	Test Area	Classification/ Treatment Depth	OMC	TBC	MCt	Md	Remove	Stationing	COM	Pce	Si	DD	TC	L1	L2	L3	Avg	Topsize	L21	L22	L23	Avg2	Treatment	Bc6	Bc12	Bc18	Bc24	Bc30	RefSpecCond
No Tests Found

Sample ID:
	YEAR	DISTRICT	SUBMITTER	SEQUENCE

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Sample ID:
	YEAR	DISTRICT	SUBMITTER	SEQUENCE

Test	Result	Dry Method	MC_t

Sample ID:
	YEAR	DISTRICT	SUBMITTER	SEQUENCE

Sample ID:
	YEAR	DISTRICT	SUBMITTER	SEQUENCE

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Summary Grid

DWR

Contractor Information

Project

Pay Items

HMA

HMA Accumulated Tons:

Daily Tons:

Lot / Sublot:

Additional Loop or Run Length

Lane/Intersection Information

Sample Material