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2145 Saison St - Correspondence/Water and or Sewer - 04/28/2016
Called In 4/28116 Requested For 4/28/16. Meet Scheduled Pm. Meet Time' BP �`DE41 Sys/t9 O :F�0 SANITARY.SEW' ER SYSTEM OWNERICONTACT: SAN/CARSON `EXCAVATION SERVICE ADDRESSILOCATION: 2145 SAISON ST `LOCATE REASON: SERVICE CALL PHONE: ©O - U4689 Boxelder Sanitation District 3201 E Mulberry St., Unit Q PO Box 161,8 . Fort Collins, CO 80522 {970) 498-0604 fax (970) 498.0701 bsdacctg@boxeldersanitation.org 5F6=0299 WORK ORDER . Warning to Excavators to Exercise Caution — Lateral sewer lines Boxelder Sanitation District does not customarily locate lateral sewer Ilees.(service lines).or their. connections to:... the District's. sewer mains.because In cases -It cannot.pre.cisely do so. Please be aware that any. attempt by. the District to do so is hampered by.the fact that such lines.and connections are not installed; maintained, operated or owned by the District. The District ha's.often,not been progided with plans, maps; or other documentation giving.. locational information. on lateral sewer lines by,their. owners. .Therefore, excavators:must understand..that any. . attempts by the District to locate lateral: sewer lines or their connections are necessarily based on deduction rather than hard information and that at best such.attempts.will.,indicate a lateral's. ESTIMATED location rather than its certain -one. In light of this, excavators should exercise all due caution. and care to. protect.themselves, other persons, and all property when excavating near lateral sewer lines that Boxelder has attempted to -locate. Reasonable effort has been made to accurately locate the center of Boxelder Sanitation District sewer mainlines jn the vicinity of the service address as requested and these have been marked on ground surface with green paint. The.sewei location markings represent approximate. horizontal.` - ' location of the sewer main (accurate to within 18 inches in either direction). Depth is estimated to be Always . use caution when excavating near any utility, and exposed pipes so that pipes are'not damaged and pipe bedding disturbance is minimized. . _Yes No District estimated the location of the lateral connection to the District's main.. Yes _ No District estimated the location of the la leral beyond the connection to. the Disidcl's main. XX NEW SERVICE LATERAL. INSTALLATION INSPECTION 1. Connection to sanitary sewer collection system cannot he made until a Wastewater Discharge Right is purchased from the District; 2. District saddle set charge includes labor; equipment, and tap saddle connector to drill the collector line and fasten the saddle connector to the collector line. . Ponnittee may NOT. under any ciicumstances, attempt to penetrate main collector lines'or manholes without the consent of the District; 3. Locator wire is required for burial along the service line for future localing of the line; 4. Pormlttee.shall provide all excavallon, sharing, dewatering, service line materials and labor.forinstallation of service line to main connection, and baekfiil as requlred by. the. District, Federal and State,requirements, and.applicable. Building. and plumbing Codes. Nu:excavation; shoring, .dewatering, or backfill work will be done by the.District, and the Manager or his agent will require any addilional.excavallon, sharing, or dewatering of the excavated space that in his judgment alone is necessary before. adequate inspection maybe' safely accomplished and. approval of the service line installation is granted; 5. The District requires. that all service line s.be installed such lhat'future use of the service line will not contribute Inflow or Infiltration of groundwaler to the .. collection system due to improper connections, grades; bedding materials, placement, or pipe, material. The District will require.conection of any Improper connection through its' enforcement authority; 6. Perminee shall notify the District at least 48 hours prior to when the service line isexpectedto be installed and ready for inspection and connection; 7. The District shall not be subject to any Iiabilily for any deficiency or defect of service line materials or installation which is not discovered. by inspection nor shall owner or permitlee be absolved from. liability for any defrciencyor defect'of service line materials or inslallation and any resulting damage or from responsibility to correct such deficiency or defect. The District does not assume any obligation nor acquire any liability (or. personal Injury -to any party.or damage to the connecting property or any portion thereof caused by or. resulting from any such'coriner:lion to'the wastewatercollection and treatment system; 8. The District requires payment of a constriction Inspection charge for this Inspection: rr Type of Pipe: y. r'dc Pipe Bedding Material:.Urlcc�ta� Installation Satisfactory? _' Disconnect Valve Satisfactory? fir " . Pipe Slope: Adequate (visual)? V Pipe Bedding Satisfactory? Locator Wire Properly Placed? Inspected By:..: )i;<rror :Date: For Boxelder Sanitation Distdd O.K. TO BACKFILL Date: Z Its .District Initial: 'J1� x O.K. TO ISSUE CERTIFICATE OF OCCUPANCY Date:. 4 2� :/� District �i;� By. signing, I acknowledge having re d no understood the forgoing and acknowledge receipt of.a copy of this form. Received by:.. ,�—� Date:.