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Materials & Tests Division - Field Operations

6601 Centennial Boulevard
Nashville, TN 37243.0360
phone (615) 350.4104
fax (615) 350.4128

FORMS
To open a fillable form click a name below.

Form Number

Reference

Form Name

Use or Material

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Correcting a Report

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Form Index

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Read Me

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DT-0044

T-0002

Material Certification/Sampling and Testing Record

General

DT-0062

T-0002A

Concrete Cylinder Test Report

Concrete, Lab

DT-0161

T-0033

Lab Report Log

Lab

DT-0165

T-0039

Physical Lab Receiving Record

Lab

DT-0193

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Boring Log

Geotechnical, Soil

DT-0197

SG-103

Boring Record

Geotechnical, Soil

DT-0210

SG-105

Bridge Foundation Report

Geotechnical, Soil

DT-0212 (English)

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C.B.R. Report on Sample of Embankment Material

Geotechnical, Soil

DT-0212 (Metric)

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C.B.R. Report on Sample of Embankment Material

Geotechnical, Soil

DT-0218 (English)

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Report on Sample of Soil

Soil

DT-0218 (Metric)

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Report on Sample of Soil

Soil

DT-0254

T-0117

Notarized Mill Test Report

Miscellaneous Materials

DT-0256

T-0118

Asphalt Job Mix Formula

Bituminous Materials

DT-0267

T-0201

Daily Report of Asphalt Plant Inspection - Batch Plant

Bituminous Materials

DT-0273

T-0208

Report on Inspection of Timber Treatment

Miscellaneous Materials

DT-0275

T-0209

Fine and Coarse Aggregate Inspection Report

Aggregate

DT-0277

T-0210

Concrete Pipe Inspection Report

Concrete

DT-0280

T-0213

Report on Inspection of Corrugated Metal Pipe

Miscellaneous Materials

DT-0283

T-0214

Daily Report of Prestressed Concrete Plant Inspection

Concrete

DT-0286

T-0215

Report on Inspection of Materials

General

DT-0289

T-0217

Report on Precast or Prestressed Concrete

Concrete

DT-0290

T-0218

Report on Inspection of Reinforcing Steel

Steel

DT-0292

T-0219

Daily Report of Cement Concrete Paving

Concrete

DT-0293

T-0220

Bituminous Materials Inspection Report

Bituminous Materials

DT-0293 Emulsion

T-0220

Emulsified Asphalt Materials Certification

Bituminous Materials

DT-0293 PG

T-0220

Performance Graded Asphalt Materials Certification

Bituminous Materials

DT-0298

T-0223A

Daily Report on Soil and Aggregate Stabilization

Aggregate, Soil

DT-0304

T-0226

Daily Report on Embankment

Aggregate, Soil

DT-0307

T-0230

Daily Report on Mineral Aggregate Base

Aggregate

DT-0308

T-0231

Hot Mix Plant Inspection Report

Bituminous Materials

DT-0309

T-0233

Equipment Inspection for Concrete Plant Laboratories and Jobsite

Concrete

DT-0311

T-0235

Contractor's Daily Report of Concrete Inspection

Concrete

DT-0314

T-0239

Density Worksheet - Nuclear Method

Aggregate, Soil

DT-0315

T-0240

Daily Asphalt Density Report

Bituminous Materials

DT-0316

T-0241

Density and Roller Pattern Test Strip

Bituminous Materials

DT-0317

T-0242

Report on Inspection of Grey Iron Castings

Miscellaneous Materials

DT-0319

T-0244

Report on Precast Manhole Section

Concrete

DT-0320

T-0301

Coarse Aggregate Quality Report

Aggregate

DT-0321

T-0302

Fine Aggregate Quality Report

Aggregate

DT-0323

T-0303

Report on Sample of Cement

Cement

DT-0324

T-0304

Report on Sample of Miscellaneous Material

Miscellaneous Materials

DT-0325

T-0309

Report on Sample of Calcium Chloride or Sodium Chloride

Miscellaneous Materials

DT-0327

T-0311

Report on Reinforcing Steel

Steel

DT-0328

T-0312

Report on Asphalt Mixes and Designs

Bituminous Materials

DT-0332 (English)

T-0319

Proctor Density Report

Aggregate, Soil

DT-0332 (Metric)

T-0319

Proctor Density Report

Aggregate, Soil

DT-0333

T-0320

Report on Sample of Grass Seed

Miscellaneous Materials

DT-1296

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Daily Pavement Marking

Miscellaneous Materials

DT-1314

T-0209A

Aggregate Inspection Report

Aggregate

DT-1368

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Report on Sample of Culvert Metal

Miscellaneous Materials

DT-1399

T-0201A

Daily Report of Asphalt Plant Inspection - Drum Plant

Bituminous Materials

DT-1411

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Daily Report on Aggregate-Fly Ash Stabilization

Aggregate

DT-1450

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Physical Testing Laboratory Monthly Report

Lab

DT-1451

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Road Surface Roughness Evaluation

Pavements

DT-1479

T-0232

Ready Mix Concrete Plant Inspection Report

Concrete

DT-1480

T-0224

New Product, Material, Equipment or Process Evaluation

General

DT-1550

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Independent Assurance Sample Report

General

DT-1695

workbook

Lab Inspection Sheet - Balances

Lab

DT-1695

Lab Inspection Sheet - Marshall Molds

Lab

DT-1695

Lab Inspection Sheet - Ovens

Lab

DT-1695

Lab Inspection Sheet - Thermometers

Lab

DT-1695

Lab Inspection Sheet - Water Baths

Lab

DT-1695A

Aggregate Test Equipment Inspection

Aggregate

DT-1695B

Bituminous Material Test Equipment Inspection

Bituminous Materials

DT-1695H

Hydraulic Cement Test Equipment Inspection

Cement

DT-1695P

Portland Cement Test Equipment Inspection

Cement

DT-1695S

Soils Test Equipment Inspection

Soil

DT-1696

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Materials and Tests Certification

General

DT-1696LP

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Local Programs Materials & Tests Certification

General

DT-1704

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Surface Roughness Evaluation for Concrete Pavement on Ramps

Pavements

DT-1705

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Surface Roughness Evaluation for Bridges

Pavements
DT-1706

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Surface Roughness Evaluation for Asphalt Roadways

Pavements
DT-1707

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Surface Roughness Evaluation for Mainline Concrete Pavements

Pavements
DT-1716

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Utility Item Certification/Final Acceptance and Summary of Installed Items

Utilities