By Earl Matthews,2014-01-20 03:18
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    TP-2163-06 (1/2007) dual

    Minnesota Department of Transportation

     Contact Report Ready Mix 2007

Plant Name: ________________________________ Date:


    Address: __________________________________________________ Phone:




Prior to the production of Agency concrete each construction season, an Agency Representative shall perform a

    thorough on-site inspection of the concrete plant to assure that the plant can produce concrete meeting Mn/DOT


In addition, the Concrete Producer must also provide the following copies of documentation:

     Lab Equipment Calibrations Producer must check and calibrate the sieves prior to starting production.

    The date of calibration should be clearly marked on the equipment using the procedures described in the

    Mn/DOT Lab Manual 2001, 2002, 2008, and 2009.

     Scale and/or Meter Calibrations An approved scale company or the Minnesota Department of Public

    Service must check and calibrate the scales. Thereafter, they are checked and calibrated once each year.

    Additional calibrations are made at three-month intervals using the procedures described in the Mn/DOT

    Concrete Manual 5-694.431- 5-694.435.

     Certificate of Compliance A batch ticket that includes all Mn/DOT Specifications, and the supporting

    oven dried mix design and moisture test results.


     MN/Dot Certified Plant 1 Technician _____________________________________ Cert #


     MN/Dot Certified Plant 1 Technician _____________________________________ Cert #


     MN/Dot Certified Plant 2 Technician _____________________________________ Cert #


    MN/Dot Certified Plant 2 Technician Cell Phone #___________________________



Agency Representative: ________________________________Agency


     Approved Date: _____________________

     Not approved for the following reason/s:






     Re-inspected and approved





    The Concrete Producer agrees to maintain all plant and laboratory equipment within allowable tolerances as set forth in the MN/DOT Specifications, to have all moisture and gradation tests run by a Plant Level I Technician certified by MN/DOT, and to have the Plant Level II Technician certified by MN/DOT on site at all times or available at the plant site in a reasonable time frame when called.

    After completing the Concrete Plant Contact Report, any procedural changes that cause non-compliance with this program will result in de-certification of the plant and cessation of further production of Agency concrete.

Certified by: ______________________________________________

     Plant Representative


    OFFICE AT 651-366-5530


    Type of Mixer:

    Type of Plant: Ready Mix _____ Dry Batch _____

    Batching Equipment: Make: _____________________________________________________

    Model: ____________________________________________________

    Condition: __________________________________________________ Batching Software: Manufacturer: _______________________ Version: ________________

    3Max. mixer batch size _______ yd

Certificate of Compliance:

    NOTE: All of the following items are required (Specification 2461.4D7a) ____1. Name of Plant ____12. Approved Fly Ash Abbreviation

    ____2. Contractor ____13. Pit Number

    ____3. Date ____14. Approved Admix Abbreviation

    ____4. State Project Number ____15. Correct Column Order & Approved Labels

    ____5. Bridge Number ____16. Total Water in lbs

    ____6. Batch Time ____17. Water available to add in gallons, and spaces to record:

    ____7. Truck Number Water added at plant, Water added at jobsite, Total actual


    3____8. Yd/load ____18. Spaces to record: air, temp, conc temp, slump, cylinder


    3____9. Yd/Cum part of structure, time discharged, and signature of Inspector.

    ___10. Mix Designation ____19. Space for Producer’s signature ___11. Approved Cmt Abbr

Aggregate Moisture Meters:

    Meter Plant Automatically Material Equipped with Make Model Sensor Location Adjusts Batch Meter (y/n) Weights (y/n) Sand

     3/4"+ (19mm+)

     3/4"- or (19mm-)

    1/2"- or 3/8"- (12.5mm or 9.5mm) Class A

Scale and Meter Information:

    Material Type Make Capacity Graduation


     Fly Ash



     Water Scale

    Water Meter


Cementitious Materials:

    Delivered To Delivered To Sampled At # of Capacity Delivered By Material Supplier w/Mill (truck, rail, hopper Silo By Hopper By (tons) (truck, rail) Silos valve) (blower, elevator) (gravity, auger)



     Fly Ash



    Total Cementitious Silos at



    Sampled At Type Manufacturer Name of Product (dispensing tubes recommended) A.E.A.

     Water Reducer


     Super Plasticizer

     Calcium Chloride


    Sampled At In-Plant Storage Material Supplier Pit Number Delivered By (batch hopper, belt, (tons) stockpile) Sand

     3/4"+ (19mm+)

     3/4"- (19mm-)

    1/2"- or 3/8"- (12.5mm or 9.5mm) Class A

Are stockpiles separated? (y/n) _____

    Plant is fed by: Drive over hoppers _____ How many compartments? _____

     Field hoppers _____ How many? _____

    Number of bins feeding plant ________

    How many belts feed plant working bins _____ Is turn head used? (y/n) _____

    Belt Splitter (y/n) ___________ Auto Belt Splitter (y/n) ________


    Source: Proportioned by:

     ____ City Water ____ Meter

     ____ Well Water ____ Scale

     ____ Both

    Can water be heated with a boiler? (y/n) _______ Temperature gauge location:

    Lab and Equipment

Additional Requirements:

    Required at Plant Posted at Plant

    ____ Concrete Manual ____ Current Site Map

    ____ Working Fax Machine ____ Tech I & II Names & Cert #

     ____ Tech II Cell Phone #


    Mechanical Shakers, Screens and Sieves

    Box Screens: Must have all screens listed below Calibrated on _____________

     ____ 2" (50mm)* ____ 3/4" (19.0mm) ____ #4 (4.75mm)

     ____ 1-1/2" (37.5mm)* ____ 5/8" (16mm) ____ 1/4” (6.3mm)**

     ____ 1-1/4" (31.5mm)* ____ 1/2" (12.5mm) ____ Bottom Pan

     ____ 1" (25mm) ____ 3/8" (9.5mm) ____ Mechanical Shaker

     *Required when using 3/4”+ (19.0mm) aggregate

     **Plants producing CA-50 with two fractions will need to use a 1/4" (6.3mm) sieve

     as a filler between the 3/8" (9.5mm) and the #4 (4.75mm) sieves.

    Brass Sieves: Must have all sieves listed below Calibrated on _____________

     ____ 3/8" (9.5mm) ____ #30 (600µm) ____ Bottom Pan

     ____ #4 (4.75mm) ____ #50 (300µm) ____ Mechanical Shaker

     ____ #8 (2.36mm) ____ #100 (150µm)

     ____#16 (1.18mm) ____ 2 - #200 (75µm)

     NOTE: Two #200 (75µm) sieves are needed, one is for shaking the

     gradation and the second is for washing the sample during the

    final steps of the gradation process.

Scales and Miscellaneous


     ____ Dairy Scale Calibrated on ____________ MINIMUM 55 lb CAPACITY

     Must have one of the two scales listed below.

     ____ Triple Beam Balance including the needed MINIMUM 2600g CAPACITY

     Hanging Weights (1 - 500g and 2 - 1000g)

     Calibrated on_________________

     ____ Electronic Scale Calibrated on ____________ MINIMUM 2600g CAPACITY


     ____ -200 Wash Bowl

     ____ 2" (50mm) Sample Splitter with 3 Pans

     ____ 3 Burners: Natural Gas or Electric

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