NCDOT Materials & Tests Unit: QC/QA Sampling and Testing Application (DOT Employee Only)

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HOME » TRAINING COURSES » QC/QA AGGREGATE SAMPLING AND TESTING CLASS »
QC/QA Sampling and Testing Application (DOT Employee Only)

QC/QA Sampling and Testing Application
(DOT Employee Only)

Required Fields*

Student Contact Information:

*First Name: *Last Name:

*Home Mailing Address:

*City: *State: *Zip Code:

*Personnel #: Division/Unit:

NCDOT Personnel:

Supervisor Name: Location:

Office Number: Fax Number:

*Contact Person: *Email Address:

Class Information:

*Desired Class(es): Sampling Testing

*Class Location:

*Class Date:

Have you ever been certified as an aggregate NCDOT QC Technician before? Yes No

If "Yes" what is your certificate number?

Who is the State Materials Inspector who visits your plant?

Note:

Class sizes are limited. Submission of this form does not guarantee a slot in the desired class. If enrolled, the student will be contacted for pre-certification.

Mailing Address:

Materials and Tests Unit
Soils Laboratory
Mehdi Haeri
1801 Blue Ridge Road
Raleigh, NC 27607

Office Number: (919) 329-4150

Fax Number: (919) 733-8742


		The North Carolina Department of Transportation