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Local Assistance Procedures Manual Exhibit 16-T1 <br />Materials Requiring a Certificate of Compliance per Caltrans Standard Specifications <br />Exhibit 16-T1 Materials Requiring a Certificate of Compliance per Caltrans Standard Specifications <br />Table 6-2.3 Materials Accepted by Certificate of Compliance (1 of 7) <br />Material/Product Remarks (Including Requirements for Additional Back-Up Information <br />Required with Certificate of Compliance) <br />Asphalt <br />Asphaltic emulsion <br />Certificate of compliance must include the following: <br />1. Shipment number and shipment date. <br />2. Source refinery, consignee, and destination. <br />3. Type and description of material with specific gravity and quantity. <br />4. Contract or purchase order number. <br />5. Signature by the manufacturer of the material and a statement that the <br />material complies with the contract. <br />Asbestos cement pipe <br />Asbestos sheet packing <br />Asphalt modifier Test results required with each truck load. <br />Asphalt rubber joint sealant A certified test report of the results for the required tests performed within 12 <br />months before the proposed use. <br />Backer rods Must include manufacturer’s statement of compatibility with the joint sealant to be <br />used. <br />Barbed Wire <br />Blast cleaning material <br />Bonding Material <br />Brick <br />Cable-type restrainers <br />Lock nuts <br />Certificate of compliance must be submitted with a copy of each required test <br />report. <br />Cast iron pipe <br />Cast iron manhole rings and covers <br />Chemical adhesive for bonding tie <br />bars and dowel bars in concrete <br />pavement <br />Chemical adhesive for structures Certificate of compliance must state compliance with ICBO AC 58 and <br />Caltrans. Augmentation/Revisions to ICBO AC 58. <br />Concrete <br />Admixture <br />Certificate of compliance from the manufacturer must certify that the <br />admixture furnished is the same as that previously authorized or the <br />authorized materials list. <br />Concrete Cementitious <br />material <br />Certificate of compliance must include the source name and location. <br />If the cementitious material is delivered directly to the job site, the certificate of <br />compliance must be signed by the cementitious material supplier. <br />If the cementitious material is used in ready-mixed concrete, the certificate of <br />compliance must be signed by the concrete manufacturer. <br />If blended cement is used, the certificate of compliance must include a <br />statement signed by the blended cement supplier that shows the actual <br />percentage of SCM, by weight, in the blend. <br />Concrete <br />Curing compound <br />Certificate of compliance must include: <br />1. Test results for the tests specified in Section 90-1.01D(6) [90-7.01B] of the <br />Standard Specifications. <br />2. Certification that the material was tested within 12 months before use. <br />Concrete Minor <br />concrete <br />Before placing minor concrete from a source not previously used on the <br />contract, a certificate of compliance stating that the minor concrete to be <br />furnished complies with the contract requirements, including the specified <br />minimum cementitious material content. <br />Ceramic tile <br />Chain link fencing and railing Certificate required for protective coating system. <br />Concrete anchorage devices <br />Page 1 of 7 <br />January 2020 <br />  <br />  <br />City Council 21 – 48 9/16/2025