APPENDIX A. SAMPLE DATA COLLECTION FORMS
Sample forms used for recording the appropriate data during the verification testing are contained in this appendix. A checklist of items to be completed, arranged in an order designed to follow the proficiency procedure from start to finish, also is included.
Inspection Date: ______/_______/__________
Laboratory Name: ______________________________
Equipment Model: ______________________________
Channel Designation: ______________________________
Input Voltage Amplitude: (peak-to-peak, pp) _____________________
Data Collection Channels
| Input Freq. (Hz) |
Input Voltage (pp) |
Data Acquisition Recorded Voltage (pp) |
Data Acquisition Derived Input-Output Delay (ms) |
| 2 |
__ __.__ __ |
__ __.__ __ |
|
| 4 |
__ __.__ __ |
__ __.__ __ |
|
| 6 |
__ __.__ __ |
__ __.__ __ |
|
| 8 |
__ __.__ __ |
__ __.__ __ |
|
| 10 |
__ __.__ __ |
__ __.__ __ |
|
| 12 |
__ __.__ __ |
__ __.__ __ |
|
| 14 |
__ __.__ __ |
__ __.__ __ |
|
| 16 |
__ __.__ __ |
__ __.__ __ |
|
| 18 |
__ __.__ __ |
__ __.__ __ |
|
| 20 |
__ __.__ __ |
__ __.__ __ |
|
| 50 |
__ __.__ __ |
__ __.__ __ |
__ __ __ __ |
Gain Setting: ____________________________________
Filter Setting: ____________________________________
Figure 14. Form. Sample form 1—data collection channel check.
Inspection Date: _______/_______/__________
Laboratory Name: ______________________________
Equipment Model: ______________________________
Load Cell Zero Reading
| Load cell description |
_____________________________ |
| Vendor |
_____________________________ |
| Model number |
_____________________________ |
| Serial number |
_____________________________ |
| Capacity |
______________ kN |
| Sensitivity |
__ . __ __ __ mV/V |
| ax. Zero value (±1.5 percent of sensitivity) |
±1.5 percent of full scale |
| ±__ . __ __ __ mV/V |
| Strain indicator error |
±5 micro strain |
| Gauge factor on strain indicator |
2 |
| Balance range |
0 |
| Balance pot |
500 |
| Measured zero value (including strain indicator error) |
+ or - __ __ __ micro strain + or - __ . __ __ __ ±0.0025 mV/V |
| Load cell zero values within specified tolerances? |
Yes / No |
| Last calibration date |
_____ /_____ / ________ |
Figure 15. Form. Sample form 2—determination of load cell zero reading.
Inspection Date: _______/_______/__________
Laboratory Name: ______________________________
Equipment Model: ______________________________
Load Cell
| Nominal Load Level (kN) |
Dial Gauge Reading |
Proving Ring Load Level (kN) |
Laboratory Load Cell (kN) |
Ratio of Proving Ring to Load Cell Readings |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
| __. __ __ |
__ __ __ |
__.__ __ __ |
__.__ __ __ |
__.__ |
Figure 16. Form. Sample form 3—load cell check.
Inspection Date: _______/_______/__________
Laboratory Name: ______________________________
Equipment Model: ______________________________
Load versus Deformation
| Nominal Target Load* (kN) |
Mean Applied Load (kN) |
Mean LVDT Reading, mm |
Rv=Ymax/Y min 1.1 |
Point within ±5%? |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
| _ _._ _ |
_ _._ _ |
_._ _ _ _ _ |
Yes / No |
Yes / No |
*Load levels are dependent on the type of load cell and proving ring used to conduct the testing.
Figure 17. Form. Sample form 4—dynamic load versus deformation check.
Inspection Date: _______/_______/__________
Laboratory Name: ______________________________
Equipment Model: ______________________________
Triaxial Chamber: Type 1/Type 2 (circle one)
Triaxial Chamber
| Time, min. |
Pressure Level 1 (kPa) |
Pressure Level 2 (kPa) |
Pressure Level 3 (kPa) |
Pressure Level 4 (kPa) |
Pressure Level 5 (kPa) |
| System |
Gauge |
System |
Gauge |
System |
Gauge |
System |
Gauge |
System |
Gauge |
| 0 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 1 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 2 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 3 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 4 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 5 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 6 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 7 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 8 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 9 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
| 10 |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
_ _ _._ |
Figure 18. Form. Sample form 5—triaxial cell check.
Inspection Date: _______/_______/__________
Laboratory Name: ______________________________
Equipment Model: ______________________________
Environmental Chamber
| Time, min. |
Temperature Level 1 (°C) |
Temperature Level 2 (°C) |
Temperature Level 3 (°C) |
| System |
Gauge |
System |
Gauge |
System |
Gauge |
| 0.00 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 1 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 2 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 3 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 4 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 5 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 6 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 7 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 8 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 9 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
| 10 |
__ . __ |
__ . __ |
__ __ . __ |
__ __ . __ |
__ __ . __ |
__ __.__ |
Figure 19. Form. Sample form 6—environmental chamber check.
Figure 20. Form. Sample form 7—checklist for proficiency procedure
Figure 21. Form. Sample form 8—checklist for asphalt proficiency procedure.