PSF 3b
Road Construction Information Page # of ##
Section 1 Location and Contract Details
This section should be filled in for each affected road section.
State Highway	Reference Station	Direction (Both, Inc or Dec)	Ramp/Roundabout Name (If applicable)
Date
Contract Number
Project Name
Recorded By (Name)
Contact Details
Company Name
Sealing Contractor

PSF 3b
Road Construction Information Page # of ##
Section 2 - Pavement Surfacing
Start Displacement	Length	Total Sealed Area	Construction Date	Surface Depth
m	m	m2	/ /
Design Life	Surface Width	Offset From LHS	Surface Material Chip Seal TAC Single Coat Seal SMA Two Coat Seal OGPA Locking Seal Macadam SAM Seal Dense A/C Sandwich Seal Slurry Seal Racked-in Seal OGEM Voidfill UTA Cape Seal Premium Skid Surface >70 PSV Other (please specify)
yrs	m	m
Chip Size	Chip
1st	2nd If applicable	PSV	ALD	Material Source
Cutter Type	Adhesion Type	Additive Type **
Quantity	Quantity	Quantity
pph	pph	pph
Note:	Surface Function 1st Coat 2nd Coat Membrane Reseal
Flux	Application Rate	Binder Type	NZTA/ P17 Specification
pph	1ts/m2 or %
Reason for Seal	FWP Treatment
** Fill this section in if polymer modified binders have been used
% Modification	Elastic Recovery	Softening Point
Milling or Removal of Surfaces If material has been removed, the following section needs to be completed.
Start (metres)	End (metres)	Date of Removal	Depth of Removal	Width	Offset
mm	mm	mm
Is the surface made from recycled material Y/N If Yes complete table below
Material Used	% Recycled
PSF 3b
Road Construction Information Page # of ##
Section 3 - Pavement Layer/Sub-Grade and Rehabilitation
This section should be completed for each layer (including Structural Asphalt layer) or sub grade layer constructed, as well as where any dimensions or materials have changed. The order of the layers needs to be defined by the construction date (e.g. 1 day apart for each layer in the order of construction from subgrade to top layer).
Start Displacement	Length	Layer Material Sub-grade / layer CBR*
m	m	All passing 40mm sieve All passing 65mm sieve All passing 100mm sieve Sub-grade Material Graded all passing 40mm Clay Graded all passing 65mm Gravel Graded all passing 100mm Rock Scoria all passing 40mm Sand Scoria all passing 65mm Silt Other (please specify) Other (please specify)
Construction Date	Material Source
/ /
Depth	Width	Offset
m	m	m
Design Life	Design ESA	Construction Plan No.
Stabilisation Agent	Quantity	Note:
%
Specification Used	Is this layer made from recycled material Y/N
*Use code X## where X = U (Unsoaked), S (Soaked) or F (Field), and ## = CBR% (eg. U25 for Lab Unsoaked CBR 25%)
If rehabilitation project, complete the section below:
Rehab Start metres	Length	Rehab Const. Date	Width	Offset
m	m	/ /	m	m
Design Life	Design ESA	FWP Treatment	Construction Plan No.
Rehab Type	Depth	Stabilisation Agent	Quantity
eg Rip and Remake/Stabilisation	m	%
Process Description in Words
An order of the actions completed, dimensions and materials used during each step needs to be described to facilitate the RAMM pavement builder process (e.g. 100mm M4 overlay on existing pavement & seal, followed by 200mm deep in-situ stabilisation etc.) . A sketch may be sufficient to describe the process.

PSF 3b
Road Construction Information Page # of ##
Section 4 - Sub-Soil Drainage
This section should be completed for each subsoil drain.
Start Displacement	Length	Construction Date	Material
m	m	/ /	PVC/Natural Ground/Other (please specify):
Diameter	Side	Offset	Inlet Structure	Outlet Structure
mm	L / R/ C	m	*Yes/No/Grate *Specify:	*Yes/No/Grate *Specify:
Section 5 - General Notes
In the case of several items per table, please fill a separate form for each item. Fill the "Page # / ##" box at the top right hand corner. If preferred, a spreadsheet template is available on request, from the Transport Agency’s Asset database administrator, to allow the information to be delivered in a table format.