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FORMTEXT      (Resident Engineer has Reviewed this Questionnaire) MATERIALItem Nos.SUPPLIER/SOURCE & MAILING ADDRESSPRODUCER/PLANT LOCATION & MAILING ADDRESS*PORTLAND CEMENT CONCRETE  APPROVED BY REGIONAL MATERIALS (Attach list of mixes)  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      HOT MIX ASPHALT  APPROVED BY REGIONAL MATERIALS (Attach list of mixes)  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      SOIL AGGREGATES DGABC  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      REINFORCEMENT STEEL Coated  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Uncoated  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      JOINTS Dowel Type A  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Premoulded Filler FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Joint Filler FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Preformed Elast. Expansion Joint FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT        Armor Deck Joint  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       MATERIALItem Nos.SUPPLIER/SOURCE & MAILING ADDRESSPRODUCER/PLANT LOCATION & MAILING ADDRESS *PRE-CAST CONCRETE PRODUCTS FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      PRESTRESSED CONCRETE  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      STRUCTURAL STEEL FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      SIGN STRUCTURES  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      TIMBER FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       SIGNS GA/GO FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       MR&W FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Reflective Sheeting FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT      PIPE Concrete FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Other FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      &(*46HJ^`bln * , @ B D N P v x jhCJUj4hCJUjhCJU hCJj\hCJUjhCJUjthCJUjhCJUmHnHujhCJUjhCJU hCJ28Hpx$If  $Ifkd$$Iflִ t|,#*$]50P+    4 la  * R T $If^kd`$$Ifl4U*P+0P+4 laf4T V v zttttt$Ifkd`$$Ifl4F)*1  50P+    4 laf4     ( * > @ B L N   . 0 2 < >   " jhCJUj^hCJUj> hCJUj hCJUjR hCJUjhCJUjhCJUmHnHuj<hCJU hCJjhCJU4  ( P R TNNNNN$Ifkd $$Ifl4r #)*o*50P+4 laf4R T V TNENNNN $$Ifa$$Ifkd($$Ifl4yr)* H50P+4 laf4  A;;;;;$IfkdD $$Ifl4ֈ )*f50P+4 laf4 @ B D F (kd $$Ifl4h֞D !)*+S50P+4 laf4$IfF $If $$Ifa$ .$$If $If]kd4 $$Ifl4֞D !)*+S50P+4 laf4  H J $If" 6 8 : D F (*02FHJTVXZnpr|~ƿͻ{jrhCJUjhCJUjhCJUjhCJU h] h6>*h h5CJ h5CJ hCJjhCJUmHnHujhCJUjJhCJU hCJ0J L N .( $$Ifa$$Ifkd$$Ifl4_֞: !)* -50P+4 laf4 $$Ifa$$If .,&$Ifkd$$$Ifl4(֞: !)* -50P+4 laf4 .C9  $Ifkd@$$Ifl?r x (*   0P+4 la$If $$Ifa$*,.0X$If $If $$Ifa$ dfRH?999$If $$Ifa$  $Ifkd$$IflAr x (*   0P+4 lafh|~ *BDXZ\fhjlzjPhCJUjhCJUjdhCJU h>*CJjhCJUjhCJUj0hCJUjhCJUmHnHujhCJU hCJjhCJUh0 *BL?5 $If $ $Ifa$kd$$Iflr x (*   0P+4 la$IfBjL? $ $Ifa$kd>$$Iflr x (*   0P+4 la$If .02<>@BVXZdfhj~߱ߤߗߊ}j.hCJUjhCJUjphCJUjhCJUjhCJU h>*CJjhCJUjhCJU hCJjhCJUmHnHujhCJU1@h?kd^$$Ifl8r x (*   0P+4 la$If $ $Ifa$Bjl$If $If  024>@BDXZ\fhln$&(*>߸߫ߧߚߍj!hCJUjN!hCJUhj hCJUjhCJUjhCJUjhCJU hCJjhCJUmHnHujhCJU2(PRE;555$If $If $ $Ifa$kd~ $$Ifl8r x (*   0P+4 la>.02<>BPvxҸҫҞґҍ{j&hCJU h>*hjZ%hCJUj$hCJUjn$hCJUj#hCJUj"hCJU hCJjhCJUmHnHujhCJUj:"hCJU0PRz|~LBB $Ifkd(#$$Ifl8r x (*   0P+4 la$If@BPvLBB  $Ifkd%$$Ifl8r x (*   0P+4 la$If FH\^`jlnp "j*hCJUj8*hCJUj)hCJUjL)hCJUj(hCJUj'hCJUjhCJUmHnHuj'hCJUjhCJU hCJ4FnLB $Ifkd|($$Ifl8r x (*   0P+4 la$Ifn 4LB $Ifkd&+$$Ifl8r x (*   0P+4 la$If"$&0246JLNXZ\^rtv "$8:<FHJL`bdnptvҸҫҞґ҄j/hCJUj/hCJUj.hCJUjX-hCJUj,hCJUjl,hCJU hCJjhCJUmHnHujhCJUj+hCJU14\"LB $Ifkd-$$Ifl8r x (*   0P+4 la$If"Jrt$If  ",.02FHJTVZ\prt~DFJLҸҫҞҘrj4hCJUh hCJ \ hCJ\ h5CJ hCJj2hCJUj62hCJUj1hCJUjJ1hCJU hCJjhCJUmHnHujhCJUj0hCJU,0XZRHBBBBB$If $Ifkdz0$$Ifl8r x (*   0P+4 laDRLF=== $$Ifa$$If #kd$3$$Ifl8r x (*   0P+4 laDFJLI?99$If  $Ifkd3$$Ifl&r v(*   0P+4 la $$Ifa$ "&PRThjlvxz|߸ߴߡߔ߇jZ8hCJUj7hCJUjn7hCJU hCJhj&6hCJUj5hCJUj:5hCJU hCJjhCJUmHnHujhCJU2$&RzL@  B$Ifkd6$$Ifl&r v(*   0P+4 la$If@hL@  B$IfkdH9$$Ifl8r v(*   0P+4 la$If.02<>@BVXZdfhj~ *,.0ҴҧҚҍҀj8=hCJUj<hCJUjz;hCJUj;hCJUj:hCJUj:hCJUh hCJjhCJUmHnHujhCJUj8hCJU2h.LB  $Ifkd;$$Ifl8r v(*   0P+4 la$If0DFHRTXZnpr|~   "$.06BVXlnpz|jBhCJUj@hCJUjX@hCJUj?hCJUjl?hCJUhj$>hCJUjhCJUmHnHujhCJUj=hCJU hCJ2.VXLB  $Ifkd>$$Ifl8r v(*   0P+4 la$If 246BL?5  $If $ $Ifa$kdFA$$Ifl8r v(*   0P+4 la$IfBV~ $If] H$If]H$If $ $Ifa$|~ "$&0246JLNXZ\^rtvj#FhCJUjEhCJUj3EhCJUjDhCJU h>*jzChCJUjChCJUjhCJUmHnHujBhCJUjhCJU hCJ2 4\UKEEEEE$If  $IfkdC$$Iflr v(*   0P+4 la 2 Z \ UKEEEEE$If  $IfkdF$$Iflr v(*   0P+4 la    " , . 2 4 H J L V X \ ^ r t v !jJhCJUjJhCJUjHhCJUjTHhCJUjGhCJUjhCJUmHnHujfGhCJUjhCJUh h>* hCJ1 "!UKA;;;$If $If  $IfkdDI$$Iflr v(*   0P+4 la!!!! !$!&!:!!H!J!b!d!x!z!|!!!!!!!!!!!!!!!!!!!!!!"&NPdfhrҸҫҞґ؏҈{jaOhCJU h>*CJUjNhCJUjMhCJUj.MhCJUjLhCJUjuKhCJU hCJjhCJUmHnHujhCJUjJhCJU0"!$!L!N!b!!!!OE $IfkdK$$Iflr v(*   0P+4 la$If!!(NvOEE $IfkdN$$Iflr v(*   0P+4 la$IfBEAM GUIDE RAIL Rail and Posts FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Blockouts FORMTEXT       FORMTEXT        FORMTEXT        FORMTEXT       Pressure Treated Wood Posts FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       End Treatments FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       PILES Timber Piles FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Concrete Piles FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Steel H-Piles FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Sheet Piles FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      PROJECT FORMTEXT      SECTION FORMTEXT      D.P NO. FORMTEXT      DATE FORMTEXT      MATERIALItem Nos.SUPPLIER/SOURCE & MAILING ADDRESSPRODUCER/PLANT LOCATION & MAILING ADDRESS *METAL ALLOY MATERIALS Fence Materials FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       Metal Railing FORMTEXT       FORMTEXT        FORMTEXT         FORMTEXT       Drainage Castings  FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      TRAFFIC MARKINGS FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      EPOXY MATERIALS (ASTM C881) FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT      LANDSCAPE (CERTIFICATION UPON DELIVERY) FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       MISCELLANEOUS ITEMS FILL IN NAMES OF MATERIALS REQUIRED BUT NOT LISTED. MATERIALItem Nos.SUPPLIER/SOURCE & MAILING ADDRESSPRODUCER/PLANT LOCATION & MAILING ADDRESS* FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        FORMTEXT       ELECTRICAL COMPONENTS TO BE APPROVED BY AND SUBMITTED TO THE UNIT OF TRAFFIC SIGNAL AND SAFETY ENGINEERING IN ACCORDANCE WITH DIVISION 700 OF THE SPECIFICATIONS AND THE CONTRACT PLANS     Form DC-2891 12/2/02NEW JERSEY DEPARTMENT OF TRANSPORTATION MATERIAL QUESTIONNAIRE Page  PAGE 1 of 3 * To be completed by the Bureau of Materials   I  Inspection  C  Certification  R  Random Inspection  N  Not Approved 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