Materials Requiring A Certificate Of Compliance Per .

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Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsExhibit 16-T1 Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (1 of 7)Material/ProductAsphaltAsphaltic emulsionRemarks (Including Requirements for Additional Back-Up InformationRequired with Certificate of Compliance)Certificate of compliance must include the following:1. Shipment number and shipment date.2. Source refinery, consignee, and destination.3. Type and description of material with specific gravity and quantity.4. Contract or purchase order number.5. Signature by the manufacturer of the material and a statement that thematerial complies with the contract.Asbestos cement pipeAsbestos sheet packingAsphalt modifierAsphalt rubber joint sealantBacker rodsTest results required with each truck load.A certified test report of the results for the required tests performed within 12months before the proposed use.Must include manufacturer’s statement of compatibility with the joint sealant to beused.Barbed WireBlast cleaning materialBonding MaterialBrickCable-type restrainersLock nutsCertificate of compliance must be submitted with a copy of each required testreport.Cast iron pipeCast iron manhole rings and coversChemical adhesive for bonding tiebars and dowel bars in concretepavementChemical adhesive for structuresConcreteAdmixtureConcrete CementitiousmaterialConcreteCuring compoundConcrete MinorconcreteCeramic tileChain link fencing and railingCertificate of compliance must state compliance with ICBO AC 58 andCaltrans. Augmentation/Revisions to ICBO AC 58.Certificate of compliance from the manufacturer must certify that theadmixture furnished is the same as that previously authorized or theauthorized materials list.Certificate of compliance must include the source name and location.If the cementitious material is delivered directly to the job site, the certificate ofcompliance must be signed by the cementitious material supplier.If the cementitious material is used in ready-mixed concrete, the certificate ofcompliance must be signed by the concrete manufacturer.If blended cement is used, the certificate of compliance must include astatement signed by the blended cement supplier that shows the actualpercentage of SCM, by weight, in the blend.Certificate of compliance must include:1. Test results for the tests specified in Section 90-1.01D(6) [90-7.01B] of theStandard Specifications.2. Certification that the material was tested within 12 months before use.Before placing minor concrete from a source not previously used on thecontract, a certificate of compliance stating that the minor concrete to befurnished complies with the contract requirements, including the specifiedminimum cementitious material content.Certificate required for protective coating system.Concrete anchorage devicesPage 1 of 7January 2020

Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (2 of 7)Material/ProductConcrete pipeCircular reinforced direct designmethodRemarks (Including Requirements for Additional Back-UpInformation Required with Certificate of Compliance)Certificate of compliance must:1. Be signed by the manufacturer's quality control representative.2. State that all materials and workmanship comply with thespecifications and authorized shop drawings.Copper pipeCorrugated metal pipeCrack sealantCrash cushionsCrumb rubber modifierCertificate of compliance must include:1. Manufacturer's name2. Production location3. Product brand or trade name4. Product designation5. Batch or lot number6. Crack treatment material type7. Contractor or subcontractor name8. Contract number9. Lot size10. Shipment date11. Manufacturer's signatureTest results required with each truck load.Culvert markersDelineatorsCertificate of compliance required for:1. Metal target plates2. Enamel coating3. Retroreflective sheetingDowel bar basketsDrop inlet grates and framesDrain tileDrip irrigation lineElastomeric Bearing PadsPlainElastomeric Bearing PadsSteel-reinforcedElectricalBattery back-up systemCertified test results for the elastomer.Certified test results.Certificates of compliance is required for: External cabinet BatteriesElectricalConductorElectricalConduit (galvanized and plastic)ElectricalEquipmentElectricalPull boxes (concrete and plastic)Electrical ServicecabinetsPage 2 of 7January 2020

Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (3 of 7)Material/ProductErosion controlEpoxyEpoxy powder coating for dowel barsand tie barsExpansion joint fillerFiberglass pipeRemarks (Including Requirements for Additional Back-UpInformation Required with Certificate of Compliance)Certificate of compliance is required for: Straw Fiber RECP FastenersCertificate of compliance with attachments are required for: Tackifier Bonded fiber matrix Polymer-stabilized fiber matrixCertificates of compliance attachments include:1. Material Safety Data Sheet.2. Product label.3. List of applicable nonvisible pollutant indicators for soil amendmentand stabilization products as shown in the table titled "PollutantTesting Guidance Table" in the Caltrans Construction Site MonitoringProgram Guidance Manual.4. Report of acute and chronic toxicity tests on aquatic organismsconforming to EPA methods.5. List of ingredients, including chemical formulation.6. Properties of polyacrylamide in tackifier including (1) percent purity byweight, (2) percent active content, (3) average molecular weight, and(4) charge density.Certificate of compliance must be submitted with laboratory test results.GabionsIf PVC coating is shown, a suitable UV resistance additive must be blendedwith the PVC and the additive must be shown on the certificate ofcompliance.Geocomposite drainCertificate of compliance must certify that the drain produces the specifiedflow rate. The certificate must be accompanied by a flow capability graph forthe geocomposite drain showing flow rates and the externally appliedpressures and hydraulic gradients. Verification must be by an authorizedlaboratory for the flow capability graph.GeosyntheticsTest sample representing each lot and minimum average roll value.Glass beadsGlue laminated timbers and deckingGuide markersIrrigation hoseIrrigation pipeJoint filler materialJoint seals (Type A and AL)Certificate of compliance required for: Polyethylene pipe. Plastic pipe supply line for pipe with wall thickness of the bell less thanthe specified minimum wall thickness of the pipe.Certified test report for each batch of sealant.Page 3 of 7January 2020

Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (4 of 7)Material/ProductJoint seal (Type B)Joint seal assemblies with a movementrating of 4 inches or lessJoint seal assemblies with amovement rating over 4 inchesLimeMachine spiral wound PVCpipelinersMarkersMasonry blockRemarks (Including Requirements for Additional Back-UpInformation Required with Certificate of Compliance)Certificate of compliance required for: Elastomeric joint seal Lubricant-adhesiveCertificate of compliance must be submitted with certified test report for eachlot of elastomeric joint seal and lubricant-adhesive. Test reports must includethe seal movement rating, the manufacturer's minimum uncompressed width,and test results.For alternative joint seal assemblies, a certificate of compliance must besubmitted for each shipment of joint seal materials. The certificate must statethat the materials and fabrication involved comply with the specifications and thedata submitted in obtaining the authorization for the alternative joint sealassembly.Certificate of compliance must include a statement certifying the limefurnished is the same as on the authorized material source list.Certificate of compliance for each reel of PVC strip must include:1. Name of manufacturer2. Plant location3. Date of manufacture and shift4. Cell classification5. Unit mass6. Average pipeliner stiffness and profile typeCertificate of compliance required for:1. Metal target plates2. Enamel coating3. Retroreflective sheetingCertificate of compliance required for:1. Concrete masonry units2. Aggregate for grout3. GroutMicro surfacing emulsionMulchOpen steel flooring and gratingOverside drainsCertificate of compliance based on steel materials, aluminum materials orplastic materials.Parking area seal materialPavement markersPavement marking Paintor thermoplasticPlastic lumberLaboratory test report.Plastic traffic drumsPlastic pipe for drainageCertificate of compliance must include average pipe stiffness, resinmaterial cell classification, and date of manufacture.For corrugated polyethylene pipe, manufacturer’s copy of plant auditsand test results from the National Transportation Products Evaluation Programfor the current cycle of testing for each pipe diameter furnished.Portable changeable message signPrecast concrete Cementitiousmaterial used in precast concreteproductsCertificate of compliance must be signed by the precast concrete productmanufacturer.Page 4 of 7January 2020

Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (5 of 7)Material/ProductPrecast concreteBox culvertsPrecast raised traffic barsPreformed compression seal forconcrete pavementPreformed membrane sheetRapid strength forcementEpoxy-coated ng patching materialsRemarks (Including Requirements for Additional Back-UpInformation Required with Certificate of Compliance)Certificate of compliance must be signed by the manufacturer's QCrepresentative for each shipment.Must include type of sheet and the conditioner or primer application rates.Certificate of compliance is required for each delivery of aggregate,cementitious material, and admixtures used for calibration tests.The certificate of compliance must state that the source of the materials usedfor the calibration tests is the same source as to be used for the planned work.You may request that the contractor submits with certificate ofcompliance:1. Copy of the certified mill test report for each heat and size ofreinforcing steel showing physical and chemical analysis.2. Two copies of a list of all reinforcement before starting reinforcementplacement.Certificate of compliance for each shipment of epoxy-coatedreinforcement must be submitted with:1. Certification that the coated reinforcement complies with ASTM A 775/A775M for bar reinforcement or ASTM A 884/A 884M, Class A, Type 1, forwire reinforcement2. All certifications specified in ASTM A 775/A 775M for barreinforcement or ASTM A 884/A 884M for wire reinforcement.Certificate of compliance for each shipment of epoxy-coated prefabricatedreinforcement must be submitted with:1. Certification that the coated reinforcement complies with ASTM A 934/A934M for bar reinforcement or ASTM A 884/A 884M Class A, Type 2 forwire reinforcement.2. All certifications specified in ASTM A 934/A 934M for barreinforcement or ASTM A 884/A 884M for wire reinforcement.Certificate of compliance for the patching material must includecertification that the patching material is compatible with the epoxypowder to be used.ReinforcementHeaded barCertificate of compliance for each shipment of headed bar reinforcement mustbe submitted with:1. Mill test reports for the:1.1. Bar reinforcement1.2. Head material2. Production test reports3. Daily production logsReinforcementSplicingCertificate of compliance for each shipment of splice material must besubmitted with:1. Type or series identification of the splice material, including trackinginformation for traceability.2. Grade and size number of reinforcement to be spliced.3. Statement that the splice material complies with the type ofmechanical splice on the authorized material list.4. For resistance-butt-welded material:4.1. Heat number4.2. Lot number4.3. Mill certificatesPage 5 of 7January 2020

Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (6 of 7)Material/ProductSheet metalRemarks (Including Requirements for Additional Back-Up InformationRequired with Certificate of Compliance)Sign panelsCertificates of compliance required for:1. Aluminum sheeting2. Retroreflective sheeting3. Screened-process colors4. Nonreflective, opaque, black film5. Protective-overlay filmSilicone joint sealantA certified test report of the results for the required tests performed within 12months before the proposed use.Slotted edge drainSnow polesSnow plow deflectors polyethylenematerialSoil amendmentSteel crib wallSheet metalSign panelsCertificates of compliance required for:1. Aluminum sheeting2. Retroreflective sheeting3. Screened-process colors4. Nonreflective, opaque, black film5. Protective-overlay filmSilicone joint sealantA certified test report of the results for the required tests performed within 12months before the proposed use.Slotted edge drainSnow polesSnow plow deflectors polyethylenematerialSoil amendmentSteel crib wallSteel pipe pilesThe certificate of compliance must be signed by the plant's QC representative.The QC representative must be on record with the Department's Office ofStructural Materials. certificate of compliance must include:1. Statement that all materials and workmanship incorporated in the work and allrequired tests and inspections of this work have been performed as described.2. Certified mill test reports for each heat number of steel pipe piles beingfurnished.3, Test reports for tensile, chemical, and any specified non-destructive test(NDT).4. Test reports must be based on test samples taken from the base metal, steel,coil or from the manufactured or fabricated piles.5. Calculated carbon equivalent. The carbon equivalent may be shown on themill test report.Steel sheet pilingStructural plate culvertsCertificate of compliance required for:1. Structural metal plate pipe2. Arches3. Pipe arches4. Metal liner plate pipePage 6 of 7January 2020

Local Assistance Procedures ManualExhibit 16-T1Materials Requiring a Certificate of Compliance per Caltrans Standard SpecificationsTable 6-2.3 Materials Accepted by Certificate of Compliance (7 of 7)Material/ProductStructural shape steel pilesStructural composite lumber used infalseworkStructural steel thermal spray coatWire feedstockStyrofoam fillerRemarks (Including Requirements for Additional Back-Up InformationRequired with Certificate of Compliance)Certificate of compliance must include:1. Test reports for tensile, chemical, and any specified NDT. Test samples mustbe taken from the base metal, steel, or from the manufactured or fabricatedpile.2. A statement that all materials and workmanship incorporated in the workand all required tests and inspections of this work have been performedas described.Subsurface drainTemporary concrete washoutTemporary fence (Type ESA)Temporary linear sediment barrierCertificate of compliance required for: Gravel-filled bag Plastic linerCertificate of compliance required for: High visibility fabric Safety caps for metal postsCertificate of compliance required for: Fiber roll Safety cap for metal posts Silt fence fabric Sediment filter bag Foam barrier Gravel-filled bag fabricTemporary railing (Type K)ThermoplasticTie barsTie bar basketsTimber products (treated anduntreated)Certificate of compliance for timber and lumber must state the species of thematerial to be shipped and include a certified grading report. If treated, certifiedtreating report.Threaded tie bar splice couplersTraffic stripePaint or thermoplasticTurf sodUnderdrainsWaterproofing fabricWaterstopCertificate of compliance required for: Type of pipe Tubing FittingCertificate of compliance for waterstop material must state compliance withparagraph 6 of Army Corps of Engineers CRD-C 572.Welded wire fabricWire mesh fencingPage 7 of 7January 2020

Local Assistance Procedures Manual Exhibit 16-T1 Materials Requiring a Certificate of Compliance per Caltrans Standard Specifications Exhibit 16-T1 Materials Requiring a Certificate of Compliance per Caltrans Standard Specifications Table 6-2.3 Materials Accepted by Certificate of Compliance (1 of 7)

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