Concrete Equipment Procurement Request Form

Concrete Testing Equipment Request Form

Submission Date*

Required Invalid Date Format, please use MM/DD/YYYY

Submitter Name:*

Required

NCDOT Unit:*

Required

Division:*

Required

District:*

Required

Resident Engineer / Supervisor:*

Required

Physical Address (Include Zip Code):*

Required

Phone:*

Required

Fax:

Email:*

Required

Cost Center:

Courier Number:

View the Equipment Catalog

Swiss Hammer:

Concrete Vibrator:

Maturity Meter:

Maturity Probes:

Winsor Probe:

Type B Pressure Meter (Forney):

Volumetric Meter (Roll-A-Meter) (Forney):

Select One*

*Please note items can be delivered via courier or can be picked up at one of our two office locations. Required

Validating Fields

Submitting Form