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Home My WebLink AboutReel_0012E BARTELLS MATERIALS MANAGEMENT. INC. - SAFETY MANUAL - Section: Asbestos Handling Procedure Snbject: Index Section Page ---1- June 1 , 1986 ~ r. A. Asbestos Handling Procedure 1. ASR-106 General Instructions & Guidelines 2. ASR-107 Respirator Program for Employees 3. OSHA Standards B. Asbestos Removal Procedure c. Asbestos Encapsulation Procedure D. Asbestos Enclosure Procedure E. Asbestos Clean Up Procedure F. Respirator Procedure 1. Respirator Procedure 2. ASR-109 Respirator Fitting Test G. Air Monitoring Procedure 1. ASR-UO Dust Monitoring Record H. Notice of Intent to Demolish or Renovate 1. ASR-U3 Method of Asbestos Removal II Asbestos Records 1. ASR-100 Asbestos Records Procedures 2. ASR-101 Daily Asbestos Worker's Log 3. ASR-102 Employee Certification 4. ASR-I03 Employee Record 5. ASR-104 Asbestos Disposal ASR-I05 Medical Examination Request 7. ASR-108 MedIcal Examination Referral 8. ASR-1I1 Employee Notification 9. ASR-112 Insurance Notification ~ 5/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/ .1/86 5/ 1/86 5/ 1/86 5/ 1/86 6/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 5/ 1/86 BARTELLS MATERIALS MANAGEMENT, ING. - SAFETY MANUAL - See tion: Asbestos Handling Procedure Section B. I Page ---1- Subject: Asbestos Removal Procedure May I. 1986 1.0 PURPOSE & SCOPE 1.1 This document defines and outlines the procedure for the control and removal of asbestos-bearing materials. This is a general procedure designed to cover most removal situations. Specific job requirements will be defined and incorporated by amendment to this procedure. 2.0 REFERENCES 2.1 NAVSEA 009-09 dated 12 SEP 80 2.2 NAVSEA 009-10 dated I AFR 81 2.3 NAVSEA 009-1I dated 12 SEP 80 2.4 OSHA 29 CRF 1910 Sect 1910.1001 2.5 NIOSH P&CAM 239 2.6 NIOSH. 7400 3.0 INDOCTRINATION 3.1 Each employee will be certified according to the lews and regulations of the State in which the work will be performed. 3.2 Each individual will be informed of any additional job safety rules imposed by;the general contractor. 3.3 Each individual will be made aware of the requirements of this procedure and will be expected to comply with same. 3.4 Failure to comply will result in termination or reassignment. 3.5 A copy of this procedure will be in the possession of the job foreman during the performance of the work. 4.0 PREPARATION 4. I Work Areas: 4.1.1 Shut down electric power. Provide temporary power and lighting and ensure safe ins tallation of temporary power sources and equipment per applicable electrical code requirements and provide 24 V safety lighting and ground-fault interrupter circuits as power source for electrical equipment. 4.1.2 Shut down and isolate heating, cooling, ventilating air systems to prevent contamination and fiber dispersal to other. areas of the structure. During the work, vents within the work area shall be sealed with tape and plastic sheeting. ~tii. . Section: Asbes tos Handling Procedure May I, 1986 Subject: Asbestos Records ASR-112 Insurance Notification BARTELLS MATERIALS MANAGEMENT. INC. - SAFETY MANUAL _ Sec tion I I.9 Page -L Form ASR-l!2 shall be filled out and sent to Bartells Materials Management's insurance company prior to starting the project. Allow sufficient time for the insurance company to send a copy of the insurance certificate to your office for the Customer and your job file. 1 ~ Named Insured: Address Telephone: Contacc: Policy Numbel:': BARTELLS MATERIALS MANAGEMENT I INC. JOB SUBMISSION UNDERWRITING INFORMATION SHEET Bartells Materials Mana~emellt, Inc. 2. Name of Owner of Project: 60159912 3. Name of General Contractor of. project: 4. Name of Project: 5. T.acacion: 6. Contact Person: Telephone: 7. Approximate Length of Job: Start Finish B. Total Cose of Contract: 9. Asbestos Abatement POrtion: 10. Ancl.llary Work. Portion: II. Description: ASR-112 (4/B6) I ~... ..... I ~. -, , . -, '. , ", . . . ' . . " . " ' . ' . -~ r r ~. . ,~.: '~i'~~:', ~ i ' ~ ~ , -"_ _ c:.,,--~ ~ _ \ . , " . . . .' ." ~ . ' , . ,- I, , . . , .. ' ' <.;.J , ' . . r ~ ~ ,\ --'- r-' I \ , '. r I l ~ . . RECYCLING AGENT SPECIFICATIONS JDecember 27,~ If a recycling agent is used on this contract, it shall meet following specification for the grade designated: WSDOT SPECIFICATION FOR HOT MIX RECYCLING AGENTSl Test Oriqinal test Viscosity @ 140oP, cs Flashpoint COC, 'F Saturates, Wt. % Specific Gravity Astm Test Method RA 5 Min. Max. RA 25 Min. Max~ Residue Test from RTFC Viscosity Ratio3 Weight Change D 2170 or D 2171 D 92 D 2007 D 70 or D 1298 D28722 200 800 1000 4000 400 425 Report 30 Report 3 4 3 3 The final .acceptance of recycling agents meeting this specification is subject to the compliance of the reconstituted asphalt blends with current asphalt specifications. 2 The Use of ASTM D 1754 has not been studied in. the context of this specifications; however, it may be applicable. In cases of dispute, the reference method shall be ASTM D 2872. ~I[g_Yi~~2~i~Y~~~_11Q:_[L_~~ Viscosity Ratio = Original Viscosity at 140' F, cs 3 WSDOT SPECIFICATION FOR HOT MIX RECYCLING AGENTSl Astm Test RA 75 RA 250 RA 500 Test Method Min. Max. Min. l1ax. Min. Max. OriqTi1al test Viscosity ~ 140'F, D 2170 5000 10000 15000 35000 40000 60000 cs or D 2171 Flashpoint COC, 'F D 92 450 450 450 Saturates, Wt. % D D 2007 30 30 30 Specific Gravity D 70 or Report Report Report D 1298 Residue Test from RTFC D28722 Viscosity Ratio3 3 3 3 Weight Change 2 2 2 The final acceptance of recycling agents meeting this specification is subject to.the compliance of the reconstituted asphalt blends with current asphalt specifications. 53 . . As specified under PAVEMENT REPAIR EXCAVATION INCLUDING HAUL elsewhere in these' 'Special Provisions I asphalt concrete class B utilized as backfill material shall be placed and compacted within the same day's working shift as the excavation. Measurement and ~nent Measurement and payment for "Asphalt Concrete for Pavement Repair Class S, Including Paving Asphalt" will be specified elsewhere in the Special Provisions ASPHALT CONCRETE PAVEMENT. PAVING COUNTY ROAD INTERSECTIONS In addition to reconstructing Ness' Corner intersection as shown in the plans, the Contractor shall pave to match existing approach grades all other Rhody Drive intersections with county roads and private approaches within the construction limits of this project regardless of location, length, width or design, as shown in the plans, to the radius points, or to the satisfaction of the Engineer. Coun tLB9~.1.D tersec t ion Con'?.trust io!!...Bequi re'!!.!,n ts Asphal t concrete pavement Class S, Including Paving Asphalt Shall be constructed to a compacted depth of 0.17 ft. on the following. county road intersections with Rhody Drive, in accordance with the requirements of section 5-04 of the standard specifications: Sta. 135+45 Lt Sta. 177+30 Lt. Sta. 148+96 Lt. Sta. 184+11 Rt. Sta. 151+77 Rt. Sta. 192+54 Rt. Sta. 162+51 Rt. Sta. 195+46 Lt. Sta. 174+31 Lt. Sta. 198+82 Rt. The road intersections shall he'paved to their respective radius points or to the limits staked by the Engineer. Private Road Approach Construction Requirements Asphalt concrete pavement Class S, Including Paving Asphalt shall be constructed to a compacted depth of 0.17 ft. of varying w.idths, not to exceed 8.0' from existing paved shoulder on private road intersections wi th Rhody Drive, in accordance with the Plans and requirements of section 5-04 of the standard specifications. Measurement and Pavment ~Ieasurement and Payment for "Asphalt Concrete Pavement for Road Approach Class S, Including Paving Asphalt" will be as specified elsewhere in the Special Provisions ASPHALT CONCRETE PAVEMENT. 55 . . S-1 3/29/82 C-6 12/04/85 H-5a. 6/28/85 B-la. 3/20/81 C-6 8/27/85 H-5b. 6/28/85 S-lb. 11/26/85 C-6a. 1/21185 H-5c. 7/17/81 B-lc. 3/20/81 C-6b. 1/21/85 H-6 7/17/81 S-2 9/19/83 C-6c. 11/26/85 H-7 5/07/85 B-2a. 12/12/83 C-6d. 12/06/85 H-7a. 11/28/83 S-2b. 3/19184 C-7 . 11/26/85 H-8 11/26/79 B-4 1/25/80 C-8 1/21/85 H-9 2/22/82 S-4a. 1/25/80 C-8a. 1/21/85 H-l0. 10/26/84 B-4b. 9/07184 C-8b. 8/15/85 H-l1. 9/19/83 S-4c. 9/07/84 C-8c. 6/04/85 S-4f. 9/19/83 I-I 11/26/79 S-4g. 9/19/83 D-2d. 2/13/81 I-la. 11/26/79 B-4h. 7/12/84 D-2e. 2/13/81 I-2 2/04/82 S-5 11/26/79 D-2f. 2/13/81 B-5a. 11/26/79 D-2g. 2/13/81 J-l 2/13/81 S-6 11/26/79 D-3 1/25180 J-la. 2/13/81 B-6a. 11/26/79 D-4 5/23/83 J-1b. 10/31/75 S-6b. 11/26/79 D-5 8/24/79 J-lc. S-7 3/19/84 D-5a. 12/21/84 J-le. 5/10/82 S-7a. 3/29/82 D-6 10/19/79 J-lf . 7/17/81 B-8 12/19/75 D-6a. 10/19/79 J-3 11/07/75 S-8a. 3/29/82 D-6b. 10/19/79 J-3b. 11/07/75 S-9 2/22/82 D-7 1/04/80 J-3e. 2/04/82 S-10. 1/25/80 D-7a. 1/04/80 J-5a. 7/17/81 S-11. 1/25/80 D-8 1/04/80 J-6c. 2/22/82 S-12. 1/25/80 J-6f. 2/22/82 S-13a 12/02/85 E-l 1/04/80 J-6g. 2/22/82 S-13b 12/02/85 E-2 9/19/80 J-6h. 2/22/82 S-13c 12/02/85 E-3 11/26/79 J-7a. 2/22/82 S-13d 12/02/~5 E-4 9/19/80 J-7c. 2/22/82 B-14. 12/02/85 E-4a. 9/19180 J-7d. 10/05/84 S-15. 10/19/79 E-5 1/25/80 J-8 2/13/81 S.,,17. 11/26/79 J-8a. 5/23/83 S-18. 3/19/84 F-l 11/26/79 J-9a. 7/17/81 B-18a .9/06/83 F-2 11/26/79 J-I0. B-18b 10/03/83 F-2a. 11/26/79 J-11a 7/19/85 S-18c .1/28/85 F-2b. 11/26/79 S-19. 10103/83 F-4 11/26/79 K-l 7/17/81 S-20. 9/19/83 F-5 11/26/79 K-2 7/17/81 S-20a .9/19/83 F-6 1/28/85 K-3 7/17/81 S-20b .9/06/83 K-4 7/17/81 S-20c .9/06/83 G-l 10/17/83 K-5 7/17/81 S-20d .9/19/83 G-2 9/06/83 K-6 7/17/81 S-20e .9/26/83 G-2 9/06/83 K-7 7/17/81 S-21. 12/04/85 G-2a. 12/21/73 K-8 7/17/81 S-22. 9/19/83 G-2b. 12/19/75 K-9 7/17/81 S'-23a 11/08/85 G-3 11/26/79 K-I0. 7/17/81 B-23b 11/08/85 G-3a. 11/26/79 K-ll. 7/17/81 S~23c 11/08/85 G-4a. 7/17181 K-12. 7/17/81 S-23d 11/08/85 G-5 11/07/75 Ke13. 7/17/81 B-24 11/08/85 G-6 10/24/75 K-14 . 7/17/81 G-6a. 8/31/73 K-15. 7/17/81 C-l . 11/26/85 G-7 2/04182 K-16. 4/26/82 C-la. 11/26/85 G-8 1/28/85 C-lb. 1/21/85 G-8 1/28/85 L-l 1/21/85 66 .. . 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";'Pl.o.++,'III.<j bla".(.k q\f'L.C. 1-1 R~~ J Number and Classification of Contractor's Hen and Equipment Status (In use and/or deadlined for maintenance, etc.) /-I-"/~A "'-- ;J . Lq 6.,~, J /- rI....../ !-vt,,:..,!' 7'r..l J -P-{o,'j jU' \ /- <I""""" f./...c..J ,/.. v .y Or, iN , f 1- d.......,r> r-'4ui W";1. /- #,vJI,./ ro /<;" c:!... Diary (Report of day's operations, orders given and received.. discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, reoOlrrnend- ations and statement for monthly estimate) &\.....l.. J;'" rI,/r,'UU f"J... t?t..o.L1 rI'//v~ Mr-..J.. u It~ Tn"" Mo fp. 1/ (J. 71.~ ~ /a.,! r-'~o"t:J.I+- n", "H-.... Dr;l~ wt...'c..L '1i""I__ M...1"~ 1IC) (')u+ rt~'t w"";./ 'Ii",,. c.,J:rL '" i+ySh-...... ~(S L af- ~;oo 4.~ IakG:>,j< C,j''''' , ~ 1 'ell!" J d f- J....c.J ,0 rev,' tJ~j /'7 'AoOft. ,'J- 6., o.~ tfJ .J. , Po:;'.J.i..1 11 "I'"....r .z:- l!..~rcJ'r..J 0./1 5/7", <; ()o",r-f"t..-c..h', a._J. T~'_IP,,/a~~ ,.--:.."".1 t,' II e.. d. o wi- r_ ri ~;I'I 5;"'...... 101 ..... ::r.: _Slate ~1I_oI_ INSPECTOR'S DAILY REPORT Book ~ Page ----LL- Contraot No. C!.J?o 7.70 Highway 'iq",,,? Date /d-'"''''_'6"1 P.E. ;7;... /1'1d""//" Section (Title) ,n',h./,. /),-, 'v", DI/U-/c..'c Day 7<...rSo!c,: Weather A. N. 5", "''''7' P. N. 5'~ ~")' Contractor's Representative(s) and Title ;)"-~e.s LJ:" d,,. r. .. Location and Type of Work ?lhdv Dr,'", I' ()/; '" ~ ~I".r/<ed C1:",,,, CI.,-l {-jll ft.e,~ ,"- /l-ep f!...i.~ /'/ev ,;' "..s I" Luh'l... Number and Classification of Contractor's Nen and Equipment Status (In use and/or deadlined for maintenance, etc.) /- lol'<.~ ~_ '] -I. .<,,~ rJ J- n,. '^^f +0<. <. k5 "'1' - 7" l?'ir "/ Or, itcf"J >- -; /.. <], . ~.> 1- n',lVIed'''' ('~ f 0 I~ Co. 'jf2- r-lSO t.",,<. f<tDe..... 1- J~<-KL."k..\<-..~.r 1- ('0 I Grc-tle.r Diary (Report of day's operations, orders given and received, discussions with con- tractor, visitors from Headquarters, District or FHWA, unusual conditions, . recormJend- ations and statement for monthly estimate) z:- Cl/'/'//<! .1 0.+ ?: 00 (),...... 10/'< /1'111/(;.//"; 7J,e /a /4S;de.... .)-0, r!. i9. I"? u+ C'dl'()..J v/.. .'d. P(~'J;I')~sfv l/lA.o..rlc.e...d hV.. 10.... 14 L 5'~a II rl>< .L I- /';1 e) 4c..p (! f.. t3 vHt {""9"-~ (~~-e"" " VI.J.. LJ,'.J{, q.....1. t\A- e.-r- ~ ,(0. J had {\An r,.(1 () -H.. -'!. ~ l~ ..c <2hpc../~d '51 9 I~ , o.V\ ct -P-,.!/,..,.J o lA+- cJ""'y .5 h; '1 La,'? . ~ Lake! ;d", (' r~_w ,,~d(" "- +-k d"y &\1- 4~M (Signed) ft;J/i{ "Z c"L)" ~~ ..... ~1I='::r"_ INSPECTOR'S DAILY REPORT . Contract No. CXo Section (Title) Weather A. M, 730 Highway ~ Date 10-6-77 1'IhJ, dr'-v<- oJe,I<, S",,,,"y P.M. Book ~_ Page ...Ql...... P.E. To.. "'10'-..110 Day 7c.eJ ./"; Contractor's Representative(s) and Title ::r:~ Location and Type of Work s!'-ud", C.o/e W:a..cl.""-a... s...~t 7)/~'9"/4 c!t"OJ,i1,',,; P,Pe.. -far. J" 4F1r_:%"j6 1'1: ,'nd I"rJHt..fr.-I 12. tt ,.~" 6< ,:. 5 T./hJ Number and Classification of Contractor's Men and Equipment Status (In use and/or dead lined for maintenance, etc.) /_ j',y('"",~ 1- I~"+~C~; 5/.0'''"' /. No ",,- ~ ~I"'i~~d 1-loyJ 1)1A1'\Pffll';/(?(J~7' /ljJ.-(;1,uf] ~ L4bor~rJ 1- I!-.+ '16 c. -!-rOw} ",./ /0'.1,;- Diary (Report of day's operations, orders given and received, discussions with con- tractor,' visitors from Headquarters, District or FHWA, unusual conditions, recolmlend- ations and statement for monthly estimate) J Clr,.,'JlJd 0.7- ;;(;00 II M c....J rl.~ Lt./{I!:>,'J(!. ~/()W W<U ?k:{)t:.."'~5 -1-1> '/,(;. (":, do ;j, . 50 1/.... fL<~. C 0(.0 Ii . PI.d G^ If ,~ (,........c..'eie P:f/- t- I'll. In M' '1:30 lAe /t;.J&.f!je. c.'eJj 6e',,::;.... .,1;<5: " -tle ~;I/;.L c. l- II,I · 7"1 -lO fl.. le;:+ ar q:JO ,A,r>> It ,A.d. ';-0 ~k ~/,,,, 14/(,.,,:';<- (""/ "''''in. I>r)rlc.r~;'e t!l'a/J\"'.1....' 17/p- 'a is.J 7, 'IfeYJ.:# es-l..- fc.hL k.','A -Iv.Pe';) r..f. Ib/.H /" I"), t!cJll~C..,I t1e Ii- ),.1.1 ...;., ~J?,rI C. f , af -11... -/D .J:~O L~'-' -r-f. c n ~ d 7aA T let.! -de! ;",6 1?10r,> 1/. Sh)u rI -f'l> A.-I ~~ f -t~ d I"a.s 1=t'......:.Pl'b-..( (I.""aefe. . n:p, (. c.'''. d. ^-. 1. . :j/<.~ ...~,~ I "-",,U~lV Pi Or WOoS.. . 0.110 .hTe /9/".. ~ Jh..rt' ~,')vt< -I'LL k. k.l. n/~J'I-Id, : 11,h '-5 LJor}(;" ~ d,:, <t-F 11 ~rftr (") ..... V,=':r"-- INSPECTOR'S DAILY REPORT Contract No. C.Ro 7)0 Highway ~5~oo7 Date IDkln Section (Title) 7?lIod., 'Pr;"e 0"" /" of Weather A.M, 5"",,,, P.M. Book ~ Page -9..L.. P.E. 1M" ,fflor>~, Day PI,,,,, ,I. ;/ 5t.o.V\1"l Ii ~..,- 0 Contractor's Representative(s) and Title ~ " '" W ;e[),^,~" -.> "-PT Location and Type of Work C/<a";'5 ,,~.J :lr~('b;~, J:f\.5fo.iI -!vp.:rr: (!.c..fc.l, b-=..>iV\ SI~{.('fL<."'e r,,,,de #- )(~y Number and Classification of Contractor's Men and Equipment Status (In use and/or deadlined for maintenance, etc.) /_ 1=0",",," l-r""CK Dr,'v,r /, h"i~<t: s;,(}u~ / ullo ",.,- ;) La I-.IJ('~/'" 1- /0'('/ Ov./I-lP trIAc /( 7 oJ 76 /0-1--1 b~.l ~ - .f 1~'35' r , , /- {!",r '1(.,6(' P:",.. -I ~..d 10<,1.. .- Diary (Report of day's operations, orders given and received, discussions with con- tractor, visitors from Headquarters, Distriot or FHWA, unusual conditions, recorrmend- ations and statement for monthly estimate)' .7 I?('(',',)~d f.:t.J. 8:00' ~ r-J.~". 1':..".1 A-,,,./ w,'.;.1. Tt.I.../JJ()/~/ltJ. /1" LaK.-5,'c!e (!.1r.1-'" " I.J-1S ;nr{l' ()4,f1o'lC: h. Sfr,";Ji,." /6/-r$tf 6~4/:~ , (!1"{U"':l~ Q..,.) ""/,? 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AI/tit 0.1 109 pi Ju;11 Al,.(ol...rL/ rJ." .5~'''~;,~''f' Qff'/. j',,//)..... t.." rAc ",,1'< /Je.J. ~ bl\\,'", --, f.h.f .,./. 1"";:1.0 voJ IN- lira /b 1-'11 :" rh ~'!' ) CI..J It~ )Y';~ c.-,,..u',.1f r''''/.f,,..J 1-,.'3"-'- If +tl- ,,,,-I;,. /tI-?;9""7"~1l,'ef-Jo,d n, .,<,h,1 .,';~. J./(l,J ,n ,.,//.-J rt.L al'~J ,.....",. rtc lr.J<.S")~ (In,! ~ hf"';""_ t.ole r::<-ld C',~,,.,r ;.; L ' . ' (11'1 1r' 1(611 l- 0:.t1-c------- DAYS ,;",.; DATE DAV " WEATHER CONDITION Sunday 9/2 '? Monday .....;;-.>'/I'_i~1 ~ t.vI"t-r.?/,'/ tl/z9 Tuesday 'S u.utJ'l 'i/3D Wednesday 5()/,)/)'\1 /01', Thursday Pro CtO()() V- Iol" Friday ://)1')/)'; Saturday WORKABLE UNWORKABLE DAYS DAYS DAYS THIS WEEK NOTE: ~~~~~S:L~ ~~~. TO TH~ DAYS PREVIOUSLY REPORTED TOTAL DAYS TO DATE STATUS o TOT ALAUTHORIZEDTIME OF CONTRACT LESS WORKABLE DA VB CHARGED SUMMARY OF WEEK'S ACTIVITIES ;1.,0 (t)1i/<'K 11,1 (o;/T,VA("/"IX 711-t.: f/Ji'Fl::", , , PROJECT ENGINEER (, (:'"""" , 77!7/Tii7i:;-C;, (,l\.\'\\ y~. --j NOTE' The contractor will be allowed 10 days from date of this report in which to protestinwriting the , correctness of this slatement,olherwise it shall be deemed to have been accepted as correct. '1I!o2.. ..g... 3 DISTRIBUTION: DAYS CONTRACTOfAr:t=S I bf ADDRESS (Sp.~I:Y. S8~I~COde~7Z g CONTR....CT NO. FEDERAL AID PROJECT NO (I/R./J 7~o THE FOllOWING STATEMENT SJJOWS THE NUMBER OF WORKING DAYS CHARGED TO YOUR CONTRACT FOR THE WEEK ENGING: '" DATE DAY WEATHER CONDITION Sunday 10/' Monday ';vf)>J'/ 7'/" ~ I';)'/~ Tuesday 50//11'-/ 72-. 10/7 Wednesday 5arJ'l b8" 10/8 Thursday ,>., 5J'!r)'! 6Ef' /0(1 Friday ~,':,::lL</..i4Y 1..'5 Saturday WORKABLE UNWORKABLE DAYS DAYS RE'ASON FOR 'UNWORKABLi:OA'yS ( I / 1 I DAYS THIS WEEK S DA VS PREVIOUSLY REPORTED q 1'-1 Co NOTE: , ~~~~~S:L; 1'~~ TO THE . APPROVED EXTENSION OF TIME TOTAL AUTHORIZED TIME OF CONTRACT LESS ,WORKABLE. DAYS CHARGED .. WORKING DAYS REMAINING SUMMARY OF WEEK'S ACTIVITIES /0/>- 1('01) /AJfTPf..1 UJ if 2''1'' eOI t', Ptp" /oj..;,....:.,Vt.$ -- U1Srt'llL C/?:> ;-:1";.8'1 eC:JC r';Jp,,,: 10/7 - tOP!') 10/8 - -rriuG /o!9- FRI - (;'1" Plf'l:/ nloo-; (I ;tOS~/'/~ - zV" pIn lE'f/ObY CI!-W;/IV<j . tSHCV-~Ii...'- I t.,IiT'1 j>C: !CLb:1-)f?'I.U (., ..U...."9.".....lot"t.ro"'''..O....'\jfti/lM'. I PROJ<CJ-ENGINEE"Z:: \.\. \ ,\ -{If;)IUY.,? -i, . A~ )',.,\...\j"" NOTE' . The contractor will be allowed 10 days from date of this report in which topr9\est in writing tile ' correctness of. this statement, otherwise it shall be deemed to have been accepted as correct. .lr!1. '..v-"'J DISTRIBUTION: OF DAYS HIQHWAY NO. OR COUNTY CIS 2C-C'( .. DATE'-; .. DAY Sunday 1"//1.- Monday ",JtJlJ'/ &'>'/-o '0/1, Tuesday SU/J;)'! ft,C;" 101"1 Wednesday t; I' OIJHR. ) 1020 IOJ IS Thursday :;U;1)NY h2-o 10//1> Friday ,'9...)I'I/v"/ 10'1" Saturday DAYS THIS WeEK DA vs PAEVIOUSL Y REPORTED WORKABLE UNWORKABLE DAYS' '.. DAYS / / NOTE: ~~~~~S:L~ ~~~. TO THE . APPROVED EXTENSION OF TIME TOTAL AUTHORIZED TIME, OF CONTRACT LESS WORKABLE DA VS CHARGED -.Q-- 3D fer I .. WORKING DAYS REMAINING SUMMARY OF WEEK'S ACTIVITIES /lor ;>/1" OIJ i!.ut.vfd (i<OSSI"7 c..lfA-r< ~ C7/N ~ - !iX(AvP'13 5!IOUl,f)/f"<. !U+n')</AL /fJ'f{//... Cs rC TD ::;;;./C>utoP" S I Ct.Em<rf(jI<'U/j 13U:. Pf}t./... OuT 1::4'1.4-" Cs :rc. '~d>ci",(./I.Il9.Otd<<"wmb"OI/d.I'O'Hlt'dqYlrt'" ~1I~ "1"11110"_ .d.nl.otl flho* ofIIt QII,h,'ill' 11I1"'MII".t'.....'...._oll_..'8fI(lf'.dl I p~~~~GrENG'NEER "".'Gl( tif;!ifWf"f, , Y tCO/ ( ',~ r- -, ", -"-"....-' . " '. . . ".- ..U..".o"h...lol.I'IO'M"o.~tII'llll""" --7. 'NOTE' The contractor will be allowed 1.0 days from date of thisreport in which to protest in writing the , correctness of this statement. otherwise it shall be deemed to have been accepted as correct. .jlS'. '~~J DISTRIBUTION: ';:'f'DATE DAY Sunday 10/1'l Monday (O!Z.O Tuesday ;"!']./ Wednesday 10!2-'2. Thursday lojz"3 Friday Saturday WEATHER .CONDITION SU^JJ'Jy' ~>o SJ/i)/1iC/ 6,:::0 ~(){'j/i"l -:;::, 1/,\,1,1)'/ 5U/,j/',l'i (~::~ : .. - ,~ c,4" DAYS THIS WEEK DAYS PREVIOUSLY REPORTED . APPROVED EXTENSION OF TIME TOTAL AUTHORIZED TIME OF CONTRACT LESS WORKABLE DAYS CHARGED .. WORKING DAYS REMAINING SUMMARY OF WEEK'S ACTlVlTIES I\/\or) 'TvC OF WORKABLE UNWORKABLE DAYS DAYS {)n{~/7 '/ (i:.?r).Sr;/lly5 1,/ 19 NOTE: ~~~~~S:L~. ~~;. TO THE z? 7 Th(, Od1' ~ 1..-E.r:'1 (eM rACf ,5~~()\lLr)€f~S (7)"-/',-, (III( 'REI'.'lAOi: r\:~J(i: k~'1 i(~fl T" ,IV .( I,?O::: ~:/I:(; 7' ~:li u-y, L ~I'~";. ....g..~ DISTRIBUTION: 7h:i{~E\~~,'~L \L~ (( O,;i/{c) ,'.... ~.' ,,-.... ' ' . . ' .11 WalhlnglonSWEiKLyTramTEMENT CONTR^CTOR LA'KES'I)C ADDRESS (Slreet, City, Slate, ZIP Code) CONTRACT NO 1".0, 8'"x 7za FEDERAl AID PROJECT NO, '') '2'T ,/I /dr,,(~-' I; HIGHWAY NO. OR COUNT '1'$2;.007 t.li!o 7 '3D . DATE WEATHER CONDITION WORKABLE UNWORKABLE DAVS DAVS THE FOLLOWING STATEMENT SHOWS THE NUMBER Of WORKING DAYS CHARGED TO YOUR CONTRACT FOR THE WEEK ENDING; DAY Sunday IO(Zk, Monday $l.hJ,JV b'f" I 10(i!? Tuesday {7LI/l'J oj (cOO I 10(28 Wednesday 'P{.f.uNN! GOO ,"(z1 T~ursday 'Pi, SJrIN~1 '38" ( I D/?O Friday 'Pc , SV t'}IJ~1 57' I Saturday DAYS THIS WEEK C DAYS PREVIOUSLY REPORTED z...'<" . APPROVED EXTENSION OF TIME TOTAL' AUTHORIZED TIME OF CONTRACT lESS WORKABLE DAYS CHARGED .. WORKING' DA VS, REMAINING Z- SUMMARY OF WEEK'S ACTIVITIES litO;) -" 1J-4fu1$."r i C5rc. 7Y.(F..t..k,/~leQ Sn,mc),')5. '!3!5-S - 7jfA{(4~ .i C57G, "'31) .c- .5Iva;P tV.ltlfJOIIF ~'-HoLtl"I;;";.) i fJr~:>'= (C";'f/(-"; ;eD o - r(<F-ft;JIf/~ .~ ;,1...lf^"1' '"/t<f"f1.-t,;,mGrl , ~,j~tN"II."Ol""'~umbetor;d.t"QIHoeIGclu"lerl IfItl...--t;JIl~l",gl"".'1I1'"lion (ahQ"OIIt1o~I~..lir.1 .1I1m....lllllllllee.llft1ionolt"".il'.pon.d) ..u........,.ll...loj.!.,O.llO...Q.....~ltollm. NOTE: . ~~~~~S~L~. ~~~. TO THE ,7./:;"Ltz:.ve.. (A"'~ ;t,(..lr-~l..(c(,~" .;15:. '~>3 d '.. NOTE' .The contractor will be allowed 10 days from date of this report in which to protest inwTiting the .i":. ..' .' correctness of this statement, otherwise it shaii be deemed to have been accepted as correct. DISTRIBUTION: OF THE fOLLOWING STATEMENT SHOWS THE NUMBER OF WORKING OAYS CHARGED TO YOUR CONTRACT fOR THE WEEK ENDING: 'DATE:;'".: DAY'; Sunday Monday Tuesday Wednesday Thursday Friday Saturday WEATHER' CONDITION' WORKABLE UNWORKABLE DAYS DAYS' REASON:: 'FOR<:UNWORKABlE :';~A'YS" '<,!J CUY-JD'I 7)0 tlC.uDY >SoJ (~tCt)OY $'$'''' I!.wuo'/ 5S'e> t,.tO'JC;Y 5,/0 DA VS THIS WEEK 5- NOTE: ~~~~~S~L~. ~~~, TO THE DA VS PREVIOUSLY REPORTED ;:::-. 33 -APPROVED EXTENSION' OF TIME TOTAL AUTHORIZED TIME OF CONTRACT LESS WORKABLE DAYS CHARGED ~o 33 -3 1 .. WORKING DAYS REMAINING SUMMARY OF: WEEK'S ACTIVITIES ,~ _ PIII/ti' /II1AI!Jllli€ [l/t', _ f7f'rrje iV!A7,U/llilf -;;f ~ii.^J ;Jilpl<u'{I{r5 VJf1) - I+lfJfliJAtrlfiJ./ CU'~S'" 13 ,4-e.:Plo/AI.'( I ,1:$(>,.;>;< r rf/I/C!<;' ,- frPi"I'f>^( ~r;;;l~/Ar;!, e WI - II? f'Kl){c/K; (C,[,4 SS i3,A;;,f'ffJ'irJ I PRofe!,"WN"R '- ' ,.. ,.' n....---- ,lllrrrN'lA <::. \'\\.(j l0.L)i.0 NOTE'. The contractor will be allowed 10 days from date of this report in which to protest in writing the . correctness of this statement, otherwise it shall be deemed to have been accepted as correct. DISTRIBUTION: DAYS CONTRACTOR :,YOATE", DAY WEATHER CONDITION WORKABLE UNWORKABLE DAYS DAYS REASON'FOA UNWORKABLE DAYS Sunday H//!; Monday f?,+,1J 5"0 0 "11-of Tuesday IZA,tJ 9)" "f2~ Wednesday Pi, Cto,)!)'! "1zL, Thursday "ft7 Fliday Saturday DA VS THIS WeEK leA,,,) rl.A-10 NOTE: ~~~~~sfL~' ~~~ TO THE .. APPROVED EXTENSION OF TIME TOTAL AUTHORIZED TIME OF CONTRACT LESS WORKABLE DAYS,CHARGED 30 -"B -B .. WORKING DAYS REMAINING SUMMARY OF WEE,K'SACTlVITIES 1401) - 1Z"""I(NGO (0(/ ,eN. <X nOli .s(vII~ rvEr - IJo V)ON-/:", l[[;Ay /l"A/I'JV/ - i'C!fill/-1c (Dr<- I1m,C;Hti'i) <Jre TO/;+,/ .lftdoe.t'(h.&~'(lI'd"~II"Ib,"Ofd'l.oIl",c)qulrl'r. Iettl'lII.ftl""OI."....IMti(>ftCshO*Oft/'IOfl!l..hU, .1.,"'".IIl.,II'l<l..,....~olli....I'."fIOrl.dl ..UUM9.'"..,Cl.,..l'OallO..Il"t."Wl'"'...... r, I PRozlla(;1} , /1 --7, NOTE. ,.. The contractor will be allowed 10 days from date of this report in which to protest in writing the ' correctness of this statement, otherwise it shall be deemed to have been accepted as correct. 'Il~:' '~'J DISTRIBUTION: DAYS :OATE " DAV ' WEATHER CONDITION WORKABLE UNWORKABLE REASON DAYS DAYS Sunday Monday 9/n Tuesday ...:;.x,..'.uN ,j-' - .........' Me. ;"7 I 9/23 Wednesday '"Sv.u.(lT~ ..<.JF;.,Z.,l.1 / 9)2'-/ Thursday C.V!?l!(.I'}sr ;.. /"",/1 ) r , 9/2.<; Friday C\I€kCI';}Sr- S/.J.~'''--'''f:-71S 1 Saturday DAYS THIS WEEK '-f o NOTE: ~~~~~S:L~ g~~. TO THE TOTAL DAYS TO DATE WORKING DA VS SPECIFIED IN CONTRACT . APPROVED EXTENSION OF TIME TOTAL AUTHORIZED TIME OF CONTRACT lESS WORKABLE DAYS CHARGED .. WORKING DA VS REMAINING 2& SUMMARY OF, WEEK'S ACTIVITIES Alb <U=/<:., C.";VTI?HCTOTC )./crr C7-1 vk;g '1e:r: -7.. NOTE' . The contractor will be allowed 10 days from date of this report in which to proteslin writing the . correctness of this statement, otherwise it shall be deemed to have been accepted as correct. ,1I~2. '~'J DISTRIBUTION: " \Xl >- 1 C) ~ r ::>'" ~ aJ -1 " c ~ ~ ~~ ~ ~ ~ ~~ , , ~ ~ ~-' z zQ " .... ",0: ~ .., ';{ 0 -" ~ ",z 0 , 8 u C!l "l UI ..i :l ~ Q -'", b'; , '0 ~~ ~ '(' ~ I " ~ 0 ;; ~ ,<> ~ ~ "'!S ~ ~.., ~~ ~ ".. ,,~ J .. 1 i ~ Ii' l:)!:2 "I . <! <;: ~~ a ~~ . ~'" ,~ , Vl t'! ',::;: ~a -, vI'- " '" IV) 1')(1) (Y1 ~ ~ 0 a: ~~ N f~ u; \..1 ~ ~~~ ~.,: f..;l <. '\ o ~ "," " u , ~ ~ -<: :r ~ ~ ~ . '" 'I;': 'i: .., "'" '" ~ 1~ in;, '" .i. ':: ..... ")- ,.... 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" ~ ~ ! ! ,,~ j! ~ ~~ ,~ ~ i ~ ~ ~ S ~ .... " 0 ;: I! .' VI 0 " 0 '" . ....... ~ i;1. \U l'- ~ ~ ~ -.J 0: III ~ ~ ~ " o " . . . COUNTY ROAD ADMINISTRATION BOARD RURAL ARTERIAL PROGRAM VOUCHER NAME Jefferson County Public Works ADMess p, 0, Box 1220 ,"y STATE .. VOl..Iai&R 8U6MITTEO FOR WORK PERFORMED Port Townsend WA 98368 LOCAL NAME OF ARTERIAL FOR Jefferson County Rhod Drive (NAUE Of COUHTY) CRPNUl,4BER PROJECT HUt.I8ER PROGRESS !Q1I YES DNO CR0730 9520001 Bill" 1 IS THIS YOUR FINAL BilLING? FOR PRD-RATA SHARE OF THE RURAL ARTERIAL TRUST ACCOUNT FUNDS FDR COSTS INCURRED UNDER THE ABDVE-MENTIDNED PROJECT AB FOLl.OWS: TOTAl EXPENOITIJR(S lOCATE PRO-RATA PERCENT CLAIMED TOTAl AMOUNT CLAlMEO LESS PREVIOUS PAYWENTS NET ......OUNT CUlMEO CONSTRUCTION NOTE: DOES NOT INCLUDE PRELIMINARY ENGINEERING OR RIGHT OF WAY COSTS: $213.523,41 80% $152.000,00* Amount Authoriz d b work order 1116048872 $152,000,00 I CERTIFY THAT THE WORK COVERED BY THIS VOUCHER HAS BEEN COMPLETED IN ACCORDANCE WITH PLANS AND SPECIFICA lIONS. I certify lhallhe coals shown In thle youcher Ir. true and correct; the net amount claim- ed Is due and payable from the rural artenal 'rust account under the lerms of 8ppllceble lawI, ruin. regulallons and procedurel; no cl.lm he8 baen presented to or payment made for the amounl for which paymentla claImed herein; claim does nol exceed the rural art.rlalll'1lsl account a"'are 01 the coal. Incurred to date of this claIm: and does not exceed approved aUOCIllon for Ihl. project: and I am authorized to sign for claimant. "~~ 1/20/88 DATE Accountant DO NOT WRITE BELOW THIS LINE ACCOUNnNG CLASSlFICAnoN AUTHORIZATION AUTHORIZATION AGREEMENT HO, Flul Pyml. APPLICABLE WORK ORDER DATE HUMBER INYOICE GIlOSS ^""'"" I DlSCOUP<T NET AMOUNT TOTAL RECEIVING VERIFICATION Of< IN BY ATE WARRANT REGlSTER NO. . . . . . ~ ~ ., '" ,.. ;i\ " " "' ., '" " ,. " eo ,', " r. I ~~s~~~~;~~~~~ i: ~t; r:: l ~:(:~ t(~: ~:~ <:"1"'!.i;''; i.i -.of" i'- 0::(00-0 "' '" '-...,"-.., f" r'l 9 ~ I~ + (j:J , t- o III If) -:l"' l\J -.9 ~:x (j '" X .. 0 rOlJ1 CO 0: '" ~~:X I >< >- ~>< X ~ .. ~ C:( N '" ~ \:P N ~I....! N CO i: ;:; r- - <<() I- ~ '$. c() ,', Z 0 :::)< ~ t>< :::IE NX ' ,~ IX: " 2 ~ ~~.L \:0 ! r- - ~ Q) !! c: !f ~ !:: '" - -:l- ctJ 0 ! - - r\ CC - -:l- \!l !!Ix '>< N , !X X -0 ~ N r.\ -:l- c:c LI z " LI ~ - \II - - , c\l IlJ t: IlJ ::; i c:c OJ >- I) 0 !:! - -:l- - ~ , \): ..J , Q. -:r '-:t Cl::l LI :::IE .. _ IlJ ..X >< t - ..>< lX - '" -.9 - - \:() on ~ 00 N ILl . M~ 1:0 ~ I,~ '" ~ co "" N ~ <:0 N") I~ -D< >< ;;; ;:; !:! ~ ~ 1..1: ~ Ii ., .. ... 8 'l' ~ ~ :i II) IJ'l a: :;) 0 w !~ " 2: d 5~ ~ff ~I ::E i ~ a: <l ~ ~ 0 III 0 ..J '" Z :i :;) z ..J '" ., a: ~ W J 0 i:l w 2 C ~ :t: .... I- .. C j a: 0 >- Z ~ Z '" '" I- 9 ... ~ ~~ 0 z ..J '" [;l ~ 5 ;: ~ ;: Q. ~. .. !t :::IE ~ .: .u 0 0 ;:! -' 0 W Q. ... I- u J' . -c12-<J 7jt:) a /lee <J'-''''TI.vG ~,~ FORCE ACCOUNT WORKED DAILY REPORT CONTRACT NO , I OATE /0/ Z<.lfi7 U!.o 730 .TEM~Ei;;'DOESC:RIPf!~, sel'lLIIJ'f.-- PRIME CONTRACTOR LAK.~S/I>~ ::Ji.Il) US 77?Je5 SUl:l.CONTAACTOA TIME WORKED RECORD CODE OR WORKMAN AND lOR eQUIPMENT OCCUPA liON OF WORKMAN OR _I:t.oURS_.w()R,~,~IL RATE AMOUNT CRAFT GROUP WORKING EOUIPMENT SIZE REG. O.T. I /A-.."" , ~III_~ I-TDA/ AAr"lbt~~Jii 1 l'Z-O(b'IO ,ell''''''' c""'" ~- - 31,016 q3,2,'1 1 1/0'<;0 ~ P~1M.. R41<CR. ~ :!! z~,'Ns: 90 S'<' Z2...e~ ~--- . //0')/0 .:ro,.hJ M.W 31-SovEL.. '3 16.€7~ ' \ 100 0 tA-I</W fll4AV^ SNIII~Y .. ~ 74'_ ---=.;a-. '0710 6 110')/0 ........~ -o...~.. ""-,- '3 7/., 7.Z0 --~;,. ~'/'" , 101."0 "'4-J(~ J"A e<!. i7'<J< 7>lv<J<, "'"""'" " i .?;,Q.07o "O."l.l 8 /5<J/50 c..-v MI!1)tit-/ M'....6/Z loVI'j "",,"p """'" 3 2~, 7!QZ. 89, >>2(, , 'I ~I\i\(' .:ref'<'" J::.oNtJ~,4$1t::.1 Fi>~ 3 ...../),P,7Z~ 'lz. ~b7<; 10 .Z:t ....,'\. II 11 \J _!!.. f--. fiUwJP",.",r '__.__ .- 1\ -.------ -- " ..E... --- Ik.,."" ",,,,,--;;:;:;: 3 1~.l3o 50.4-0 " ""...'Md"". " --..- PE-I!l!.;'- IfhJOItG.. ':3-!" SI. zS" - " ......u<. ",,"GV ,l DIn '1",'fr~.N '-' 52,06 IS(,."t-l\ 10 10 Yb ,.., 'I'HP 7l(.VC,l ... </0.1_1 1"2-1. \3'3 11 11 11 -~ ---- -------- ---- .2L -.--- 1I1A7J1R~~_c__ ------ 16 2' .- t.: '77W> 5RAf~ I.]> J-ro"J y&, '3';'.-'8 18 R $P#,4(.'" Pt>fIl T/k'X. 4\Q ;:;;::r-",t~ ~ 1:n\.kiCm '1',.1/ to / t.D " 1I J1 ---- - II " J\ " II M -------,--.- " P{MUI~.S TOTAL $ ID'1~. "2~ ~, n..j..I s-! M ~SIf)E ClUJ T~o . , ' fo (l.(.e A-=VNI ll.{ 2-187 M ~- -r'/PfE> 01' GtA1 \{1eMe ~"'1 J;rA-L ve...,"l \'1-1' 4Vv.1 ..... '(~ MMcMe'Ji" <!.O'f !~ l:\CiW,- e4\IiP~ \ '1M D,'lt ~ '0 ,<P7 ~q,+o {J ''I" '2oi= 6t"', 1(.,,60 ~. W,B~ Zlo ' 'f',oo' ~A-S 1%8 0,(,,$7- 11,78 (<., 'X> f31S oiC.zS- (fa b,/I> I~"~ o,-rQ7 '27.';0 ~ ~ ?.7r; ,,~~ Iq~S- o 85'1 2\3~ 1"3.100 t/o, fo( 9J,rfr' 1I1.$EfL "J ';)~D 'if z.: '([off/!' t/JAA ~ fl frY j-rYi P.1. SMD 3G.,7& << 5/1i ~& '[2Dut/o TO,( 0,/0 J,/~$< -" .",.',i'_.,~t;,i. dJuJ ,.I/dJ~C.' PHONES: POULSBO . BAINBRIDGE GORST HADLOCK MATERIALS.111C. POST OFFICE BOX 6 . POULSBO, WASHINGTON 98370 LAKESIDE INDUSTRIES., '. P.O. 80X.728 ' L~'A/\l I) ./ PORT ANGELES, WA ,98362 PLEASE DETACH AND RETURN WITH YOUR REMlnANCE ~i~~~\'DATI'~;~',;' :. CREDIT 10/01/87 10/01/87 22697 PO $18,:63 10/07/87 22902 152~OQ 4J... /' to/08/87' 22983 ~'1..70,gB / 10/12/87 Cf( 10392 $3840,84- 11)/12/87 DISCOUNT $18,63- 11)/14/87 23173 H71.4B:r 10/12/87 DISCOUNT $74:0:;;/ $23. ,37- e to/l:;;/87 2.3228 ~ 10/12/87 DISCOUNT JI, $6,:;;7- I 10/16/87 23279 $2<;'.... 9"___ (' 10/12/87 DISCOUNT $,3, 00- 10/21/87 23429 ~406,SO ./ .. 10/12/87 DISCOUNT $11.22,-= ~ . '11)/23/87 ' 23532 .. i 10/12/87 DISCOUNT 10/26/87 23596 10/12/87 DISCOUNT 11)/28/87 10/12/87 11)/29/87 ':~ y'--Q..C'....~;, . ,-L C~\)4P ,/J...:,.'-.-G/-' \ \ <-\:: ~'- !-'~ \I ( c ~ '- \\\.C'-'-~t. .,-.:J ~t\ .:~~ C f.\-- ~ \ 1 '~... ~Is~~I~,L;;7~NC, :='c:l~~~~:~ ~,~a . Et..PlOYEA' , BALANCE '$:;"')1')-,-59- 10/30/87 YARDS 0.1)c) 0.00 0.1)1) 0.00 A SERVICE CH,t.RGE OF \'1,'1, PER ~ON'H WILL BE CHARGECI 0'1 ALL ACCOUNTS OVERJl) DAYS. ,',' , " i , , , " . "." ".','. ." .,," " " , ,',,' ' , ,,' .',' ',. , " .. . ,..'", '" , .. .. " ,', .' " , . " ' ':,:,' , ": ,'.' "', :: , " " ',' . :' ".. "",' , ,', ..,,- .. , ,.. .. " : "".", ,', '-';:;'",,.":;.' ';' , ,,', ,,'. ',:,';.,".',', " ,,':.......'...., r:", , .--. .., ,', ':",,:~rLL MATERIALS, INC, . DELIVERY .. . . ,.'" .: ,J: . . , '.. ,', ,', ",' ,':i ' ~'-".':~: .:iOy, 6 . POULSBO, WASH. 98370 E,,~..I OP130rtllnlly EmPloyer ',', .',..," "'" "," ",:' ", ,,~ PHONES; 842-6100 779-4431 / 373.2541 365-4100 INVOICE NO, ..:J ,'" "'~ / --- I ",,' ' ", ;., . . soU) TO l. /J, ':L-~ ,-/ - /~f// 1 n?4J .' ''': . ", . ,> I n ['I,i',? . ,',' . .., :. ADDRESS DATE . " ' //1/--,,'/ ;(,z?, " , ..: ;,:" DEUVER TodJ--?/)'" ". f" ,r-/' 1,( / P,O, # , " ""..< .':" ",' TRUCK . ' / /, 't(( ,I , '" DRIVER, JOB. , . ", , .. " YDS.I MIX ,/) (:/(' i : ' ',', .' :: . I 1// ,-,TOTAL YOS, , ,', ,"...".. ) SACK 7 ;?1/(f'i ' ,:,',," "'., .', ' ;':< ,j ,',,', ';. AGGREGATE SIZE ;/ !jJi' ,.. ;',' " . ,," .~ / !/ .'1:1 i I . LBS. COARSE AGGREGATE I YO. % MOISTUR~ ',; , .,H ,\/ , LBS. FINE AGGREGATE I YO. % MO~STURE ; ':,"'" ,', ".".:. ','.,' ",'. LBS. OF CEMENT / Yo. ,~ 1)\ I r\ , '. " " :,' GALS. WATER OF TO~AL ALLC;f\v~8LE ..', ' " , ' '.' '.., 1\ \r ','. '.'., ': ",' ,', :,' %CALCIUM/YD. . : OZS. pozz. / YO. 7 Y> , f' \ \ ;~UMPATP'tANT i .- ' ,', ,,'" , OZS. A.E.A./ Yo. \ J I \ ,II il' A r l2j.t"~ ' ',,'" ,.", , ",' i '. ", ", ',',.', REVOL.UTIONS L.E~Vl~G\4~4~~ PCANT J'f0 , " CERTIFIED BY: '"Io\~ 'bl , "".,'" ',',; , ( ,,-.. GAL.S. WATER ADDEO TO IN. SL.UMP , '" ',,', ," TI ME LEFT PL.ANT , >, ' ' TIME ARR IVED J08 1\':'/:1,1\ FREE UNLOAD: , ,i> 8 minutes/yd. \" WJ STANDBY: " ',,,, , TIME L.EFT JOB 90; minute . ,',,' ;, . BACK TO PL.ANT tit. \ '; ., ! BY x~tp (,\~bp\~' .. . ,: . RECEI VED I . .. .' "..' . ' ,,' , SlgnalufGof rhl~ IfuCk In~olce will be conlldefed your notlClI 01 our Intent to lien , ..' "':. , .- thll project II nllc6$sftry, , . " , WII ma~" d....1I ~lIfl., I,nslde curb line end on property at customer'a rlak only. and OC'lIplno rll sponslb,hly whOlsoll~lIr from demeall IIIIUl11nll 110m such dllll~ll'y '.''', ,; ~1 .:' , '" '" ;, , , ' ," ,',. ..", , ',' ""',, i. :'; "'::':."": :" ' ".. '.. ,'..:, , -- -- , , .. ,', ,.' ,',"', , ", "., ',' . . '. " . "..' .,' , '. ., ::.,;.. , ' , ' .." , '. ',' " ;: , ",> .,,'. 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','." .', ,:," ", ,,'" '. ,', "'., " , " , '" '. ..., ',:, "." , ,,', ' , , ,.- 1 .: " , ' " , , I , COUNTY ROAD ADMINISTRATION BOARD RURAL ARTERIAL PROGRAM VOUCHER ,JAN 22 1988 ....... Jefferson County Public Works AOOAESS . p, 0, Box 1220 / CITY STATE ... Port Townsend WA 98368 LOC,tJ,NAlolEOF oUITERI,IJ. Rhod" Drive CAP NUr.lBER f'ftOJECTHlJIol8ER PflOQAESS CR0730 9520001 .LL. 1 YOlJC:HER 8U8MlTTED FOR WORK PERFORMED FOR Jefferson Countv ...... OF COUNTY) IS THIS YOUR FINAL BILLING? iQ9 YES FOR PRO-RATA SHARE OF THE RURAL ARTERIAL TllUST ACCOUNT FUNDS FOR COSTS INCURRED UNDER THE ABOW-MENnONED PROJECT AS FOU.OWS: TOTAL EXPI!NDITUAES lOOATE PRO-RATA PEACeNT ClAIoO.D TOTAl. AMOUNT CLIIoIEll LESS PREVIOUS PAVWENT8 CONSTRUCTION NOTE: DOES NOT INCLUDE PRELIMINARY ENGINEERING OR RIGHT OF WAY COSTS: $213,523.41 80% $152,000,00* Amount Authoriz d b work order 1!16048872 $152,OnO:00 I CERTIFY THAT THE WORK COVERED BY THIS VOUCHER HAS BEEN COMPLETED IN ACCORDANCE Willi PLANS AND SPECIFICATIONS. I certify that the coat, shown Inthle youch.r are true and correct; the nat amount claim- ed I, due and payable from thuural arterial truallccounl under the terma of applicable IIWI, Mel, regullUonl and procedure.: no cl.lm h.. been preaenled 10 or payment mad. lor the amount for which payment II claimed herein; claim doe. not exceed the I'\It.1 lr1eriallruat account .hare of the coltllncurred to date of thll claim: and doel not I.Ceed ~~oved "Uocltlon lor tnle project; and 'em authorIzed to algn for claimant. Rt~~ Accountant I-' ill ,. t' l'i LJ'(~ I~~ II " I AUTHORIZA nON AGRUMEHT FIn.1 APflICABlE NO. Pymt. 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"" <ri "w ri '" r- ., ~~ 0 0 co "" S I >!w 16 wu 0 " ~~ ., r6 ,; ;;; '" I w 0- f"/, " ,." 0 0 a> t:;: O:i "''' 0 c Ow ~ "u I 5 ~~ I 0- I. u C ~ "en 0 ~z ~UJu. I~ '0:.. ., ~ o-,~ '" ~<o::~::: i~ ...2.. C ... ~ 0., ,~ C a:OO~~ Ii; Uen .c . ~~, ~Z~ !~ O\u..:JChcn 2 ,..., O-a,.." tD oll ~< ~ !!i"C"':' 0-.... ~ I -' fI VI :5 l""'4!(~)(QI ~ "'uo: ... ... a>g~.l!l~ O_w i~ \0 !: Z~O \0 "U" " ... O~Q= I- Vj~5 " I 2 >! w '" ~~..:.ll w ." .. " gj g'j ;ji - 0 w :lE :t: >! >- !g ~I " 0 " ..I U e .. z :lE " '" il; -:: ... ;: >! r----i 0 0 VI ~ I '1 a: IQ :> , 0 ~ cL :z: ~OO '" \J a: ~~'~ 0 >! ~ ~ -l oD ci j~~ ... \. q.. ",." -'00: w f ,,-'.... ... ~ .e!~ >! 0 0 0, 0 0 q .... >= <6 '" r6 '" 00 Q Q 0 : " .. c) c I'W w " III -' W -' ... :!1'" ? Q U U I ~ ~ " >= " >= '" " " 0 .... 0- 0- l,. > 2 0 ~ 0 2 w 0 ~ .. . w ~ ., w" .~ 0 co: t '" - en " 0 iJ ; t i;l '" t " i;l a: ~ ~! ~ " " " " :: w -r .. '" a: en ~'Q 0 w 0 z ;: u >- ;: en ~'C ci S Q W t;w III V'l W Z W ..I o ,~ " ~ V'l ex ex z w Z ~ ~'~~ -' "c ex ~ ~ a: a: < " ..< '" ex :> Q. 0 ~J~ > t;~ ex ~ ~ Q Q. a: I- 0 ~ '" ..; l- t' z '" ~ ... ..I ..I 0 0 :5 ... z " Q -- Q " ~ " " ~ "'"' " l- I- '" -iri 0 0 ~ a: >! l- I- t:) 0 .,,;,.,. . . APPENDIX 1107-9 ) CONTRACT COMPLIANCE ON-SITE REVIEW EEO AND TRAINING ON SITE CHECKLIST: 'Crillcal Path "Monthly U~~:::tion ~t?e)2. fet '37 "Training Program CONTRACT DATA: Project Number (!.Ito 1'30 Project Name RHoo" Ol4l\JG c:N~ Location c.~tM.~t.U^^ Prime Contractor ~~IDe I ,,",mus.mlE!S EEO Officer TOAA ?e1J'nrJ Review Date Conlract Amounl i\ 1<i?;1"1;G.!' Percent Complete Ljo ,/0 Start Dale "1.\.......-11'11 Estimated Completion np-t:.e.v.twW.... Contractor's Representative lOM -Pe~l\,.J MBE Officer TC^"" ?elJ'nro1 LOCAL AGENCY DATA: Project Engineer -rlJM Mo~ Local Agency EEO Officer "P1o'P'l 1J.~'P;,I1T" Field Inspector kt.. Sc.AtJ::" ) SUBCONTRACTORS BSERVED ON DATE OF REVIEW: U m m n m m ~ ~ m ~ \ \ \ " \ PRIME CONTRACTORS EEO DATA: TABLE A TABLE B BUCIC ,lIllER1CAN ASIANOA WHITE OHTHE fOUL fOUL IHOIAHOR JOB CAUGOR1U EMPLOYEES 1,I1HOAITlU Nolol HISPANIC A~:~~~H PACIFIC Hotol APP"ENTICES '0' HI'o.ft!<Odg... ISLAND!R Hi,puieO,I\lI" TRAINEES _. M , M , M , " , M , M , M , M F M , ~L!-t~~..2.!.._ -.-- ..- . ,.- -- -_. . - . ..--- u t--h --... -., . ...-- .-- -.- ~--- ", ... ", - FOREMEN'WOJolEN -.-- 1--- 1--- t ClERIC..... EOWPJolENT OPERUORS 7 7 2- MECH"'~ICS -" tRVCKOA1VERS t-,I re.. IAONWOAKER$ C"'APE~TERS CE"'(NT ......SONS ElECTRICI"'~S PIP(FITTERS. Pl.UV8EAS I P"'INfERS UBOPERS.SEUlSKll.lEO '1 (" 'I " l"'BORERS. UNSMl.lED --1- - ~.5>''''l.__ ?-l "'.L.., L. _.~. .'" ---- ._u -~;BL! c-- ....-.-. .,- k~_ 4>.J 2- -, .. - -_.. ...PPR(NTICU I I I I I - I I I I I Iz.. O"4MJOem.../SfU I I I I I I I I DOT :?:.'" I,::'~~. ., . APPENDIX 'H.g ') CONTRACT COMPLIANCE ON-SITE REVIEW EEO AND TRAINING ON SITE CHECKLIST: .Critical Path . Monthly Utilization Report Dale: 5ePrEMe.m. 1987 'Training Program CONTRACT DATA: Project Number_ ~fi.o 7;0 Project Name RWoDV Dp.~\Je cl/~ location C~tMA<:\.J""""" Prime Contractor ~~106 UJOuSN1.le<.. EEO Officer -roM Pc.lntJ Review Date Contract Amounl~ 19~ 11'1~~ Percent Complete - Start Date '11=IB7 Estimated Completion nec.eMAI2'A.. Contractor's Representative TOM.. "PeJ\JTLrJ MBE Omeer j1) ^^ "D'eJ.)n rJ LOCAL AGENCY DATA: Projact Engineer TOM r\A.o Il-eUD Local Agency EEO Ollicer ?"of? Ne$~lrr Field Inspector At- ScALF SUBCONTRACTORS OBSERVED ON DATE OF REVIEW: ) 1) 2) 3) 4) 5) \ \ \ '\ 6) 7) B) g) 10) \ \ \ \ \ PRIME CONTRACTORS EEO DATA: TABLE A TABLE B ~':.~~ AMERICAN UIANDA WHITt: ONT~ J08cnl!GORIU TOUL TOTAL HISPANIC INOI.l.HOII PACIFIC HolGI ,lPPIII!NTlCU '" UlPLOYEU MINORITIES Hllp""ICDrlgin ALASKAN ISLANDER HI,p.nlcO'!llln TRAINEES HATIV! " , " , " , " , " , " , " , " , " , ~I:.SC"'.""lll'll_ --. ,-+, - -- - .-..- -." - -.,. - -.._- - ,-- +--. -,. -.. ..-..- .-._- ,-.-- SUPERVISORS , ",,'. --.. ,.,. .- .' ., . FonCIJ[I.j;WOIJ[N I I ClfRIC"l EOUlPIJENT OPERATORS I IolECHAJ<lIC$ TRUCK DRiVERS IRO'MORK[RS CARPENTERS C~IJENT IJ"SONS ELECTRICLlNS PlPEFltf[RS:Pl.UI,II!ERS PAINTERS LA80flERS,5EIMSKll.LED L L"8DPEPS, UNSkilLED . __. =t=~t?::~_ -=- -. - -- z... lOTAL .~.~..- ..- .,~ .,~. -_... .. -, .. ---, TA8lf C A.PPIlE'IICU '- I 1 I I I 1 OfoIMJQ8TP"lhE($ 1'- I 1 I I I , DOT :~U. ',:~3~. APPENDIX '''7~9 . . \ \ "\ \ \ \ WORKFORCE OBSERVATIONS TRAINEES: (Interviews Supplemental Trainee Questionnaire should be completed for at least 3 trainees) Number of trainees/hours assigned to project Number of trainees on sile Number of hours' remaining .a- II SED "'TWt\ PM P~OD .G- e- (Circle) GENERAL EEO REOUIREMENTS: Ves No B No ~ No ~ No ~ No ~ No SUMMARY, FIND IN RECOMMENDATIONS: a. Are EEO posters conspicuously displayed? b. Ar~ facilities provided on a nonsegregal~d bas'is? C. Are supervIsory personnel oriented to the Cant actors EEO commilment? d. Is a minoritYJfemaleoff.the~street applicant register maintained? e. Are EEO/MBE/Training Reports being submitted on 8 timely basis? Does Contractor. inform its subcontractors of their EEO requirements? '\ " " " ~ " ConduCled by: Title 1/3D/87 I / Oate ~ ( ~ " APPENDIX '1-'-8 CONTRACT COMPLIANCE ON-SITE REVIEW ,EEO AND TRAINING ON SITE CHECKLIST: 'Critical Path 'Monthly U~~~::lion R~6~GMP.,f/< "Training Program I,Q81 CONTRACT DATA: Project Number tR.D 730 Project Name !?fl.oOY DR/liE oVeRlAY location C#IMAo.J-^^ Prime Contractor l.A1(ES/O~ IfUbUSrtlJE'S EEO Ollicer roM PE..,T/N - ~~~~~:ctD::ount ., ,q 3: 71:J f?.O Percent Complete /00 '"9- Start Date 't/U'/87 Estimeted Completion No'-' 2 S; I 'f 8? Contractor's Representative 7UM psvnAl MBE Officer 1't:lM. PeU'77N LOCAL AGENCY DATA: Proiect. Engineer 10M .j'f..4..0~ Local Agency EEO Ollicer /?;Or; t;ST3,""'" Field Inspeclor Ih-~ SUBCONTRACTORS OBSERVED ON DATE OF REVIEW: 1) IIf>PLY -,4- UI'I~ 6) m n m 00 ~ ~ m ~ PRIME CONTRACTORS EEO DATA: lULl! A TABLE . TOTAL fOTAL "'co ".,UICA,. "IAN Of! ...." OM 'HI JOI CATlQOIIIIS ("'PLOnES UINOIllT1U Nolol H1S1"AHlC ':~~~f: PACIfIC Holol ",""INTlCU ,.. H1tp...w;OdOIll MATlV! IILANDIII HillllftlCOrlOIn 'l'IIAINUS " , " , " , " , " , " , " , " , " , OHlCI4LS c....".O..., ,.. - --- - >-... -... r-- - .. 1--_. -. --. - -.- -.... .-- ...- -- SuPEIIV1SOllS - ~,-- '- _.0.. _4"'" -- .-... ..... ,oPEIolHfIWO"'(N I 1 CLIAICAL 101JIPt.l(H1OP(AAYOAS 7 ..., "2- l,/fCMAICCS TPOCK OlllvtAS S ~ Il'lONWOAK(AS C:AAPEHTlAS C:l...(HfIUSQolS flfC1ACI~HS ,....V.11fAS.I'\Ut.lB(AS '''INT[AS L,l8Oll(AS.!EutSKU[O I/o t... ,,, ,- LAtofI[AS.I.IHSKII,LfI) ---- TOTA.&. Z, G. . __L._ u_ n. ___. "_ - -- z'2 J.,__ .:?::n" _____ --. lULl C A""'folJIC($ I I I I u. 2- OfoIMJOlI1ll.lIOl(U I I I I I I APPENDIX 11-7.9 . . \ \ \ \, '. WORKFORCE OBSERVATIONS TRAINEES: (Interviews Supplemental Trainee Ouestionnaire auld be completed lor at least 3lrainees) Number ,of Irainees/hours assigned 10 project Number of Irainees on site Number 01 hours remaining "Z SS I:f) GENERAL EEO REQUIREMENTS: (Circle) ~ No ~ No ~ No @ No e No B No a. Are EEO posters conspicuously displayed? b. Are facilities provided on B nonsegregated basis? c. Are supervisory personnel oriented to the Contactors EEO commitment? d. Is a minority /female off.the.street applicant register maintained? e, Are EEO/MBE/Training Reporls being submitted on a timely basis? f. Does Contractor inlorm its subcontractors of their EEO requirements? SUMMARY, FINDINGS AND CONCLUSIONS: \ \ \ \ \ \ RECOMMENDATIONS: \ \ \ \ \ '\ 0000.,.. oo!6 Title vEi't'F I J..JJPIi'C/11tt Dete~/87 ( l Ii ~ I ~ ~ 1 ~ I ~ ~ I ~ ~,\ ~ ~~~ 11~",i':;(~1\ "^~~'I;I '\"ZI ~~ '%'\J -:~ '~~""J Ii ~ 'I i ,,, 1\..,1 I - "I '1\1 ~ ,\\' ~'i I ": ' I '\ I ! ~ ~I ~I ~: \~(I 1\ I r-j I ! \.,1 ~ I ; ,;; I! i i I ! i:' I I I 1 I ! I I i ~ ~ . , . i~ !~ E ~ ::;~ ,m ~ C ~ ~ " ~ I "I ") , \~ _ ~ ~ 0 v r ~ ~ ~ z;f ~ f) t\ ~ ~ e5 ~ " ~ g ~~ ~ ~ Jl ; *~ 1 ~ ~ ~ ~.., ~ I~ ~ ~ ~ -i ~ ~" ~ ~ l-st; ~ ~ I ~ l i' - ~ I )' 0 ~~~ j~~ {~, ~ ~1f: ~~@ ~~ ~ ~ 0 ~ \'\ ~ ~ ~ ~ f ~ ~~ ~ ~ l;:lS:s o~z .0. ~~~ :~'i "I ~1~ I ',' i~;!' ~)',~i~ _~ I:~ ~ , ~ ~ ,i~..i~L':-,~ ~ ~ n,~ ~,~~Ii ! <i 8 ,: ilill~;1 T , ~ .~I~i~O'Ul!O ~" i~ i ~~ ~~. :t~ Ii I ~ ~ ~ ~ ,it- ~ ~ ~- ~ ~ ~ ~r~ '~~ ~ II~ " 'I SIriOUcll'I]O ~ . ... . ;:?NIQ'~~"~b: ~ ~I-- ~ I ~ '.1"11 ~i f ] ~~ ~ I w. ~'" ~cr. I :2 g ~ I' ~ I' i i~ ,1 8 ig I ~ ~ ~. ~ dj ~ Ii! i I ! I , 0: 'oZ mO , Siil Ll.~ 00 >-'" z" ",0 :<:1: lio <" e;< 0", ~~ . ~ "'- ~ " ~ ~ '1 .R " " ~ %' '< '" "71 .-( '" VI 0 In 0 VI 0 ~ ~l{ 4- If ~ n !~ i~ ~'G~ !~ I \f i~ 1 \'-- i" ~I , " t:: .,J ,y'(' ~~ ~ ~ ~v b~~~ I '"\~ KJ I ~ i~ '" ~I 1 ~I ~I '" o "" " " i), ~ ", "0, '" I i \ 1 I :~ ! Ii I I~ I "'- .-\ \j "- ~ " ~ ~ -3 ~ " " ~ ~ ::.., \ \ \ ! I I \ \ I I I I I ! \ i I I I i I : ~ lK "" I ! \ I I I t'<) r-{ i I '.... ). ~ ',,~ I (,~>~ ~ ~ o en ~. en 0 III ~ ~'% 1,,1l~ ~ ~ 0''> ':.;,; '.i\~ ~ I ~ ~ \~ ~ I ~..~ ~~~ .' : :t: i \~ ~ ~ w 0 : ; II'~ ""', (:) &', I' fj il7/"j ) 186! I J Noll:) Sl,/','l~, 7, ~,'I;'QV ,(]]t' \ SI'/ON/ J'i1P', " / · (, > ~ 'L:YS;;'~ 1<-'1:)3 ' '''''-=- ~ ~, r.! is :l; " " o o ::; t: " U) '" :J: ... ~ 3: I e ",' ~ . ",. ~.o S e z~~ i\, :/ ~ fY) d :;~ C\. 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'1/'1 IX ,0_ X<< - t '0 ;1- ok '0 "'IIl ",.'<< III ,'" :- "'.. ,- 10 ,. 0<< ,. I~ 0 ilL'. :it OX: .. % 'W en .tc w W NI- "'.. i..... I- '... .... '... ,... '~. 0 . . APPENDIX IV-IB-IO DEVIA nON ANALYSIS AGENCY: PROJECT TITLE: PROJECT NO.: I. Posted Speed Limit: 2. PhysicaJ Co'mparison: (a) Standard Geometrics (b) Deviation Geometries (c) Discusslon 3. Cost Comparison: (a) Standard (b) Oeviation \ (c) Dhcussion ~ 4. Reasons Standard Cannot be Achieved: 5. Certification: J have examined this deviation request and believe it to be in the best public interest that it be granted. Date City/County Engineer lla:D:LAG7 J.... J!l7 . . >- Il: o I- Z III > ! .p 5 " . p ~et ~...::! i=:g~ ~l"JU , Q . . . Q I; ~ ~ 8 ~ . Z Q ~ ~ . > " ~ Q U 31 0 ... ~ i z ~ ~ ~ ~ - . 31 - ~ ~ ~ g i~. ~ ~- il~ . 0 5 g - . 0 ~. . 0" ~ I ~~ ROADSIDE CLEAR ZONE INVENTORY Figure 212-1, Sheet 1 of 2 , 212-9 April 1987 VI m :E: on J o J :E: on . Q ~ W '" . . > w . ~ z o Q ~ ~ :i ~ . '" , . ! Ii .. ~i g .. z " >= u c w . > >= ~ " u " z ;c ~ ... " Z 0: " .. '" z " '" ~ ~ I April 1987 ROADSIDE CLEAR ZONE INVENTORY . Figure 212.1, Sheet2of2 . 212-10 I! '. ~. I- 8