OCTO 03-22-0753Page 1 of 61 2/94

LOUISIANA DEPARTMENT OF TRANSPORTATION AND DEVELOPMENT

BASE COURSE CENTRAL MIX PLANT CERTIFICATION REPORT

District: ..Name Nllmber

Plant:..-~Name Matt Plant Code

0 oM k -.a e Model/Serial No.

Meiling Address

Plant Type: 0 Batch D Continuous Capacity:Yd3/Hr Tons/Hr

Date:

Remarks:

Inspected By: Date:Signature

Approved By: Date:District Labolatory Engineer

MATERIAL STORAGE AND HANDLING

SOILS, AGGREGATES, OR SOIL/AGGREGATES

0 Loader 0 Dragline Other:Describe

Remarks:

MatE!rial: Material:

0 yes 0 no 0 yes D noApproved Source: Approved Source:

D no 0 yes 0 noSatisfactory Drainage: Satisfactory Drainage:0 yes

Separation: 0 spacing 0 partitions Separation: 0 spacing 0 partitions

0 yes 0 no Dyes D noContamination: Contamination:

D no 0 noSegregation: Segregation:0 yes 0 yes

D no 0 noUniform:Uniform: Dyes 0 yes

DOTD 03-22-0753Pegs 2 of 6, 2/94SOILS. A,GGREGATES. OR SOIL/AGGREGATES (Continued)

Material: ~ Material:

0 noApproved Source: 0 yes 0 no0 yes Approved Source:

Dyes 0 noSatisfactory Drainage: 0 yes D noSatisfactory Drainage:

Separation: D spacing D partitions Separation: 0 spacing 0 IJartitions

Dyes 0 noContamination: 0 yes 0 noContamination:

0 yes D noSegregation: 0 noSegregation: 0 yes

Dyes 0 noUniform: 0 yes D noUniform:

Remarks:

CEMENT

0 yes 0 noApproved Source:

Number of Storage Silos: 0 noAdequate: 0 yes

0 yes D noCements in Same Silo from Same Source:

0 yes D noCements From More Than One Source In Storage:

Remarks:

LIME

0 SlurryType: D Hydrated D Pelletized Quicklime

0 yes D no DyesApproved Source: D noApproved Blending Process:

Remarks:

Other Additives: Type:

0 yes 0 yes D noApproved Source: Approved Blending Process:D noRemarks:

WATER

0 yes 0 no 0 yes 0 noPotable: Approved Source:

Remarks:

OCTO 03-22-0753Pegs 3 of 61 2/94STORAGE EQUIPMENT

BINS: Loading Method:

Other:

Number of Bins:

0 belt convey'or0 dragline D loader

0 N/A

0 N/A

Partitions Extend 1 Ft Above Bins:Individual Bin For Each Material:Number of Bins Adequate for Production:Designed for Efficient Discharge:No Material Accumulation In Corners:Free of Holes:Load Without Segregation:

Discharge Without Segregation:Vibrators Working:Bins Leak Free:Automatic Cutoff for Material Flow Interruption:

Type of Discharge Gate:

(overhead storage bins)

Individual Cold Feed Gates:

0 yes0 yes0 yes0 yes0 yes0 yes0 yes0 yes0 yes0 yes0 yes

0 clam shell

000000000000

uescrlDe Utner

0 yes0 yes0 yes

0 no0 no0 no

Rectangular:Positive Mechanized Adjustment:Locks in Position:

Proportioning by Cold Feed: 0 Applicable 0 Not ApplicableDetermined by: 0 Belt Speed 0 Gate OpeningCalibration Curve/Each Bin per Material Type Used: Dyes

Automatic Shut-off on Each Bin: 0 yesAdjusted & Operating Correctly: 0 yes

Platforms and ladders Safe and Adequate: 0 yes

000D

Remarks:

SILOS: Number of Silos: Capacity of Each:Itonsl

Dyes D noDyes D noDyes 0 noDyes 0 noDyes 0 noDyes D noDyes D noDyes 0 noDyes 0 no0 yes D noDyes 0 no

Weatherproof:Holes:

Individual Silo For Each Material:

Number of Silos Adequate for Production:

Designed for Efficient Discharge:

Vibrators:

Air:Feed Controlled to Proper Percentage:

leaks:Excessive Dusting:

Platforms and ladders Safe and Adequate:

Remarks:

nonononononononononono

other

nononono

DOTD 03-22-0753Page 4 of 6, 2/94

CONVEYOR SYSTEMS

0 yes0 yes0 yes0 yes0 yes0 yes

000000

Adequately Transport Materials:

Spillage:Holes or Tears in Belts:

Platforms & Ladders -Meet Safety Standards:

-Cover Inspection Points:

Material Diversion System (each component):

Remarks:

MEASURING DEVICES.

Dr.JDDDDDD

Protected: DyesClean: DyesZero: DyesVisible to Operator: DyesCertification Report for Scales & Meters on File: DyesWater Measuring Device Accurate to 1 % of Measured Quantity: DyesWater Meter -Maximum Graduation is 1 gal: DyesAdditives measured to 3% of required weight: Dyes

Remarks:

* Volumetric Calibrations will be documented in a field book.

PLATFORM SCALES

Make Capacity:(tons)

Maximum Error, %:Date Calibrated:

Type Panel Indicated:

DyesDyesDyesDyes

D noD noD noD no

Sufficient Length to Weigh Entire Unit at One Time:

Prints Tare Weight:Prints Total Weight of Mixture:Prints Total Weight of Mixture & Unit:

Remarks

nononononono

nononononononono

DOTD 03-22-0753Pegs 5 of 61 2/94

PUG MILL

D Continous0 BatchType:

cu yd/hrRated Capacity:

Number of Shafts:

Mixing Time (Batch): raw

w/limewi cementMixing Time (Batch):

00000

0 yes0 yes0 yes0 yes0 yes

Paddles All In Place:

Paddles In Good Condition:

Liner In Good Condition:

Spray Bar Operating:

Uniform Moisture/Cement Blend:

DyesDyesDyesDyesDyes

DDDDD

Mixes Without Segregation:

Platforms and Ladders Safe and Adequate:

No Gate Leaks: (Batch Plant Only)

Positive Gate Lock During Mixing: (Batch Plant Only)

Soil/Aggregate Feeder Interlocked with Cement, Additives & Water Feed:

Remarks:

SAMPLING PLATFORM

DDDD

DDDD

Sturdy:Acceptable Location:

Safe:

Satisfactory:

Remarks:

PLANT LABORATORY

sq ftft AreaWidthLength ftSize:

No. of Windows:Number of Doors:

nonononono

no

nono

nono

no

no

no

no

yes

yes

yes

yes

DOTD 03-22-0753Page 6 of 6'2/94

PLANT LABORATORY (Continued)

00000000000000

00000000000000

Acceptable Location:

Proper Construction:

Dedicated to Testing Personnel/DOTD & Contractor:

Air Conditioned:

Heated:

Weatherproof:

Adequate Power Outlets:

Adequate Electric Lights:

Fume Hood With Exhaust Fan Suitably Located:

Running Water:

Desks, Work Benches, Chairs, File Cabinets:

Approved Sanitary Facilities (toilet & basin):

Quality Control Equipment:

Suitable Locks With Keys:

Remarks:

TESTING EQUIPMENT

All contractor's testing equipment calibrated and approved in accordance with current DClTD requirements:

0 yes D no

0 yes 0 noAll equipment in-place and approved prior to production:

PERFORMANCE

0 yes 0 noPlant produces mixture that meets specifications:

Remarks:

yesyesyes

yes

yes

yes

yes

yes

yes

yes

yes

yes

yes

yes

no

no

no

no

no

no

no

no

no

no

no

no

no

no