Laboratory Certification
Enrollment Form    

Phone:  479-575-3997     Fax:  479-575-7639

www.cttp.org

Application Date:  _____       ___________

Laboratory Number:  _____       ________

Recorded by:  ___________       _________

Comments:  ___________________________
 

Signed:___________________ Date:________

Original Inspection Date:  ___       ______

Do Not Write in this Space - Official Use Only

Company Name:       

Laboratory Name:  (if different)                

Laboratory Phone:       

Laboratory Address:       

City:                                      

State:             

ZIP:       

Contact Person:                  
(person responsible for all correspondence)        

Contact Phone:

Mailing Address:                     

Contact Fax:       

City:                                      

State:             

ZIP:       

Contact e-mail address:                                      

Other Phone:             

(specify)       

 AREA CERTIFICATION - Circle the desired areas of certification and indicate test methods requested.

  Aggregate

  Concrete

  Hot Mix

  Soils

 T2 – Sampling

 T21 – Organic Imp.

 T30 – Extract. Sieve

 T87 – Dry Prep.

 T11 – Washing

 T22 – Comp. Strength

 T166 – Bulk Sp. Gr.

 T89 – Liquid Limit

 T27 – Sieve Analysis

 T23 – Cylinders

 T168 – Sampling

 T90 – Plastic Limit

 T84 – Fine Sp. Gr.

 T24 – Cores

 T209 – Max. Sp. Gr.

 T99 – Std. Proctor

 T85 – Coarse Sp. Gr.

 T119 – Slump

 T245 – Stability/Flow

 T134 – Soil/Cement

 T96 – LA Abrasion

 T121 – Unit Weight

 T308 – Ignition AC

 T146 – Wet Prep.

 T104 – Soundness

 T141 – Sampling

 T312 – Gyratory Comp.

 T180 – Mod. Proctor

 T113 – Lightweight

 T152 – Air Content

 AHTD449 – Nuclear AC

 T217 – Speedy Moist.

 T248 – Splitting

 T231 – Capping

 AHTD455 – Moist Sens.

 T265 – Moisture Cont.

 T255 – Moisture Cont.

 T309 – Temperature

 AHTD461 – Nuc. Density

 T310 – Nuc. Density

 T304 – Fine Agg. Ang.

 M201 – Moist Rooms

 

 

 AHTD302 – Del. Mtls.

 M205 – Molds

 

 

 

 R39 – Lab Cyl.

 

 

 SINGLE TEST CERTIFICATION

**In lieu of an Area Certification, a Single Test Certification is available for AASHTO T310 (Nuclear Density of Soils)
and AASHTO T152 (Air Content of Concrete by Pressure Method).  Circle below to apply.

                     AASHTO T310            &nb