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Web Based Training for Sample Transmittal (C-22)

CardsFirst and foremost, it should be noted that it is the Inspector’s responsibility to insure that all paper work handed in is completely and properly filled out.

The Project Engineer or his designee should review all turned-in paper work to insure completeness and accuracy prior to input by the Office Engineers.

The C-22 Card

Filling Out the C-22 Card

PROJECT ID: This will be the 11 digit Financial Project Number (FN) found in the Contract & Plans.PAY ITEM NO.: The placement of these numbers, in the spaces provided, is critical and is not always as found on the pay item list in the plans. Inspectors should check the bid item list in the contract, the Job Guide Schedule or get a copy of the Pay Item List by Project from IMS (JCR-PF5).

Filling Out the C-22 Card (continued)

Filling Out the C-22 Card

MATERIAL NO.: This number comes from the Job Guide Schedule and will always be preceded by a letter.SAMPLE NO.: Once a Sample Number is used on a project, it should not be reused on that project with the same Material Number. Sample numbers should always be sequential, regardless of whether or not a different mix design or Pay Item Number is used.

Filling Out the C-22 Card (continued)

SAMPLE NO.: (continued) The sample numbers for asphalt have their own letter designations depending on mix. All others will usually be preceded by a letter “A”. The asphalt letter designations can be found in the Instructions for Completion of the Daily Report of Asphalt Plant & Paving Inspector.

Filling Out the C-22 Card (continued)

Examples of Sample numbers (Asphalt)

Type of Mix Correct Numbering Sequence

ABC-1 B1001, B1002, B1003, B1999

ABC-2 B2001, B2002, B2003, B2999

ABC-3 B3001, B3002, B3003, B3999

FC-2 F2001, F2002, F2003, F2999

FC-3 F3001, F3002, F3003, F3999

FC-5 F5001, F5002, F5003, F5999

S-1 S1001, S1002, S1003, S1999

S-2 S2001, S2002, S2003, S2999

S-3 S3001, S3002, S3003, S3999

SAHM L1001, L1002, L1003, L1999

SP-9.5 mm P1001, P1002, P1003, P1999

SP-12.5 mm P2001, P2002, P2003, P2999

SP-19.0 mm P3001, P3002, P3003, P3999

Type II L2001, L2002, L2003, L2999

Type III L3001, L3002, L3003, L3999

Miscellaneous M0001, M0002, M0003, M0999

Filling Out the C-22 Card

DATE SAMPLED: This will be the date that the sample was taken.STATION FROM: This will be the BEGINNING STATION of the area represented by this sample. STATION TO: This will be the ENDING STATION of the area represented by this sample.

Filling Out the C-22 Card

SAMPLE FROM: Enter the station number of the sampling location if available otherwise use “truck” ,“plant”, “jobsite” or “roadway”, etc.ROADWAY SIDE: Enter R for right, L for left or C for center in relation to the roadway.OFFSET DISTANCE: This will be the distance from the reference line to the sample point.OFFSET DIRECTION: Indicates the direction of the sampling point in relation to the reference line used. Enter R for right, L for left or C for center.

Filling Out the C-22 Card (continued)

Direction of Stationing

RT

LT

Filling Out the C-22 Card

MAINLINE: Enter Y if the sample is referenced to the mainline roadway and enter N if it is not.REFERENCE LINE: Enter the line on the plans used as the reference for determining sample location. Examples include Survey BL, Const. CL, Ramp B1 Survey BL, etc. PLANT OR PIT NO.: This information can be obtained from the Materials Office Infonet page or the pit approval correspondence.

Filling Out the C-22 Card

QUANTITY REPRESENTED: Enter this in units of area, volume, mass, or length. Identify either a particular quantity, such as with asphalt tonnage, for each type of mix or the entire project quantity for items such as earthwork.INTENDED USE OR PART OF STRUCTURE PLACED: This defines how the material represented by the sample is to be used. eg: shoulder, leveling, overbuild, box culvert extension, etc.

Filling Out the C-22 Card

ROAD NO.: This can be found on the Index sheet of the plans.

DISTRICT NO.: The FDOT District number.

COUNTY: This can be found in the Plans and the Contract. The county # is also the first 2 digits of the old Project Number.

SECTION: This number is the next three digits of the old Project Number.

Filling Out the C-22 Card

CONTRACT: This number can be found in the Contract documents.

SAMPLED BY: This will be the first nine (9) digits (including the letter) of the sampling Inspector’s driver’s license number in addition to their name.

MATERIAL DESCRIPTION: This should be as detailed as possible in order to distinguish different samples.

Filling Out the C-22 Card

MANUFACTURER OR PRODUCER (NOT JOBBER): This can be a company name or a pit name or number.

SOURCE: This will be either the plant #, pit #, manufacturer, etc.

GRADE: This will be the FDOT’s classification with regards to type or grade of material required

Filling Out the C-22 Card

BATCH NO.: If applicable, This refers to the manufacturer’s material batch number which can be found on the material container. If not applicable, this should be marked “N/A”LOT NO.: If applicable, this also is a manufacturer’s designated number and is usually identified either on the material container or in the accompanying paperwork. If not applicable, this should be marked “N/A”LAB NO.: N/A

Filling Out the C-22 Card

DESIGN MIX NO.: This will be the FDOT’s designated mix design number found either in the project records under approved concrete mix designs or on the FDOT Materials Dept. infonet site for asphalt or on the accompanying load tickets as with both asphalt and concrete.

Filling Out the C-22 Card

Filling Out the C-22 Card

SLUMP: For concrete sampling, this will be the measured distance, in inches or millimeters, that the slump sample “falls” from it’s original position after the slump cone is removed.

% AIR: This will be the percent of air entrainment, read to the nearest 0.1 percent, found after testing a sample with the Roll-A-Meter.

Filling Out the C-22 Card (continued)

Filling Out the C-22 Card

PRODUCERS CMT.: This will be the producers brand of cement used in the mix.

F.A.: This will be the pit number of the fine aggregate used in the mix.

C.A.: This will be the pit number of the course aggregate used in the mix.

Filling Out the C-22 Card

Filling Out the C-22 Card

RETARDANT: If applicable, this will be the brand of retardant (i.e.: WRDA 79) used by the producer in the mix. If not applicable, mark “N/A”

FLY ASH: If applicable, this will be the brand of fly ash (i.e.:Monex Resources) used by the producer in the mix. If not applicable, mark “N/A”.

Filling Out the C-22 Card

REMARKS: This is important to fill-in when sampling items such as glass beads for traffic paint. All project pay items which utilize the glass beads, such as: Solid (White/Black/Yellow), Skip (White/Black/Yellow), Pavement Messages, Directional Arrows, Guide Lines, etc. should be listed here with an “* See Below” in the Pay Item line on the C-22 card.

Example of a Completed Card

The Multi-Sample C-22 Card

This card will be filled out the same way as the regular C-22 card except that for materials that require multiple samples such as Finish Soil Layer, there are spaces for up to 12 samples per card, The Sample No., Sta. To, Sta. From, and Sample From have been moved and are to be filled out for each sample.

The Multi-Sample C-22 Card

Example of a Multi-Sample C-22 Card

Last But Not Least

All of the data fields must be filled in correctly for a sample to register in the project data bank. All data entries must be legible. The person responsible for taking the sample must include the first 9 digits (this includes the beginning letter) of their drivers license number. This enables the lab or other Dept. personnel to contact the responsible party if additional information is required.

FDOT Internet Address Information

To obtain additional information concerning the C-22 Card, go to:

Ordering:http://www.dot.state.fl.us/statematerialsoffice/quality/construction/materialcertification/documents/c22order.pdf

General Instructions:http://www.dot.state.fl.us/statematerialsoffice/quality/construction/materialcertification/documents/sampletransmittalcard.pdf