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MATERIALS DATABASE INVENTORY RECORD
North Dakota Department of Transportation, Materials & Research Division
SFN 53959 (Rev. 02-2007)
Project Prefix District Number Highway Agreement Number Reference Point Year Constructed
Project Engineer Prime Contractor
Material Category Supplier
Manufacturer Product Name Product Model
Application Rate/Dose/Percentage Bar Size Heat Number Lot/Manifest Number Production Date Coating Date
Product Acceptance (T=Testing, C=Certification, Spec=Conformed to Specifications)
Comments (How was this material used, purpose, etc?)
Material Category Supplier
Manufacturer Product Name Product Model
Application Rate/Dose/Percentage Bar Size Heat Number Lot/Manifest Number Production Date Coating Date
Product Acceptance (T=Testing, C=Certification, Spec=Conformed to Specifications)
Comments (How was this material used, purpose, etc?)
Material Category Supplier
Manufacturer Product Name Product Model
Production Date Coating Date
Bar Size Heat Number Lot/Manifest Number
Application Rate/Dose/Percentage
Product Acceptance (T=Testing, C=Certification, Spec=Conformed to Specifications)
Comments (How was this material used, purpose, etc?)
Material Category Supplier
Manufacturer Product Name Product Model
Application Rate/Dose/Percentage Bar Size Heat Number Lot/Manifest Number Production Date Coating Date
Product Acceptance (T=Testing, C=Certification, Spec=Conformed to Specifications)
Comments (How was this material used, purpose, etc?)
PCN