01 41 26 - Permit Requirements.pdf

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Attached to
Contract 2026-01: Sewer Maintenance & Emergency Contract
Solicitation number
Not on record
Issued by
Lancaster County, Pennsylvania

About this file

This is a permit requirements specification document prepared by Herbert, Rowland & Grubic, Inc. for construction activities within the Pennsylvania Department of Transportation (PennDOT) and Borough of Elizabethtown rights-of-way. The document outlines contractor responsibilities for compliance with PennDOT and Borough of Elizabethtown regulations, including adherence to applicable publications such as PennDOT Publication 408 Specifications, Publication 213 Temporary Traffic Control Guidelines, and PA Code Title 67 regarding highway occupancy. Contractors must implement Highway Occupancy Permits (HOP) as required, submit completed PennDOT CS-430 forms for precast concrete structures, and provide CS-6 pipe installation inspection forms and TR-4276AC compaction density reports within two weeks of work completion. Materials including pipe, aggregate, paving, and fittings must comply with all applicable regulatory agency requirements. Traffic maintenance protocols require complete backfill and restoration or protection of trenches at end of each workday, prohibition of traffic or lane restrictions during special local events, maintenance of ingress and egress for residents and businesses, provision of emergency vehicle access, and coordination with school districts for bus access. Backfill compaction testing requires a minimum of one test per lift daily for openings greater than 500 total feet in pavement, shoulder, or sidewalk.

Contractors bear responsibility for all inspection coordination and costs, unless deficient workmanship by the contractor requires reinspection, in which case the Owner reimburses municipal and PennDOT inspection expenses. The contractor must provide dust control on all roads and maintain protection from pavement damage, assuming responsibility for all required repairs to paving damage during construction. For all work in PennDOT right-of-way, contractors must correct any defects or failures in materials or work without cost to the Owner for a period of two years following completion. The document includes detailed PennDOT forms—CS-6 Pipe Installation Inspection Form and TR-4276AC Report on Compaction Density by Nuclear Method—that require comprehensive field measurements, joint verification, materials certification, and documentation of compaction testing using nuclear density gauges with monthly standardization and daily gauge operating limit verification.

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01 41 26 - PERMIT REQUIREMENTS

Herbert, Rowland & Grubic, Inc. 01 41 26 - 1 000598.0465

SECTION 01 41 26 - PERMIT REQUIREMENTS

PART 1 - GENERAL

1.1 DESCRIPTION

A. Purpose:

1. The purpose of this section is to outline the requirements relating to the regulations pertaining to construction activities within PennDOT and Borough of Elizabethtown rights-of-way.

B. Compliance:

1. The Contractor shall be responsible for all notifications, coordination, and compliance with PennDOT and Borough of Elizabethtown regulations applicable to this work.

2. All work within the Borough of Elizabethtown rights-of-ways shall be in complete accordance with Borough of Elizabethtown specifications and Road Occupancy permit requirements.

3. All work within the PennDOT rights-of-way, shall be in complete accordance with PennDOT requirements.

1.2 REFERENCES

A. The following PennDOT publications shall be applicable to this job:

1. Publication No. 35, Bulletin 15: Approved Construction Materials.

2. Publication No. 72: Standards for Roadway Construction.

3. Publication No. 213: Temporary Traffic Control Guidelines.

4. Publication No. 408: Specifications.

5. PA Code, Title 67, Transportation, Chapter 441: Access to and Occupancy of

Highway by Driveways and Local Roads.

6. PA Code, Title 67, Transportation, Chapter 459: Occupancy of Highways by

Utilities.

B. References are made to the Pennsylvania Department of Transportation specifications.

Unless otherwise noted, the State specifications referred to are the Publication 408 Specifications, latest revision. Reference in the State specifications to “State”, “Chief Engineer”, or “Department” shall be interpreted as the Engineer as herein defined. When particular articles or sections are referred to, all paragraphs other than those relating to payment shall apply. Payment shall be as defined in these specifications.

PART 2 - PRODUCTS

2.1 MATERIALS

A. All materials including but not limited to pipe, aggregate, paving, fittings, valves, and similar items shall be in compliance with applicable regulatory agency requirements and the Contract Documents.

Herbert, Rowland & Grubic, Inc. 01 41 26 - 2 000598.0465

PART 3 - EXECUTION

3.1 COORDINATION

A. The Contractor shall comply with the coordination requirements in Section 01 31 19.

3.2 PROTECTION

A. Contractor shall make every effort to provide protection from and avoid pavement damage within the work areas. The Contractor shall be responsible for all required repairs to paving damage during the course of construction.

3.3 TRAFFIC MAINTENANCE AND PROTECTION

A. Traffic Maintenance and Protection within Borough of Elizabethtown or PennDOT rights-of-way. Comply with the PennDOT Publication 213: Temporary Traffic Control Guidelines and Applicable Permits.

B. All trenches along public roads must be completely backfilled and either restored or protected at the end of the workday.

C. No traffic or lane restrictions are permitted during special local events.

D. It shall be the responsibility of the Contractor not to interfere with or create any hazards to traffic. No equipment or material will be stored or permitted to stand where traffic must be maintained. It shall be the responsibility of the Contractor to control dust on all roads, drives, walkways, and parking areas on which traffic is being maintained. The Contractor shall provide and maintain ingress and egress for all residents along the construction route. Contractor must maintain access to all business within the project area during the course of construction. Contractor shall coordinate work schedule with local business owners.

E. Contractor shall provide for emergency vehicle access at all times and shall notify local EMS of work schedule.

F. Contractor shall provide for school bus access at all times and coordinate work schedule with the local school district.

3.4 INSPECTION AND COSTS

A. Municipal and/or PennDOT inspections may be required for work within PennDOT or Borough rights-of-way. The Contractor is responsible for coordinating any inspections.

The Owner will reimburse the Borough and PennDOT for the cost of inspections, unless it is identified that the required inspections are as a result of the Contractor’s poor workmanship.

Herbert, Rowland & Grubic, Inc. 01 41 26 - 3 000598.0465

3.5 PENNDOT RIGHT-OF-WAY REQUIREMENTS

A. The Contractor shall implement the HOP Permit, if required, in conformance with all applicable PennDOT requirements, as well as in accordance with the Contract Documents.

B. For all precast concrete structures within the PennDOT right-of-way, submit a completed PennDOT CS-430 form. This form shall be completed by the Contractor, not the material supplier.

C. If backfill compaction testing is required, a minimum one (1) test per lift daily. Typically, for openings less than or equal to 500 total feet in pavement, shoulder or sidewalk, the permittee may choose the compaction test method, provided the test method is performed consistent with department publications, and on the condition that the permittee provide the completed CS-6 (pipe installation inspection form) and accompanying TR-4276AC form within two (2) weeks of the completion of the work represented on the form.

3.6 CORRECTION OF DEFECTS

A. For all work in PennDOT right-of-way, the Contractor shall, for a period of two (2) years, correct any defects or failures in the materials or work without cost to the Owner.

END OF SECTION

Herbert, Rowland & Grubic, Inc. 01 41 26-A 000598.0465

PENNDOT FORMS:

1. CS-6: PIPE INSTALLATION INSPECTION FORM

2. TR-4276AC: REPORT ON COMPACTION DENSITY

BY NUCLEAR METHOD-CONTRACTOR FORM

PAGE INTENTIONALLY LEFT BLANK

CS-6 (7-24)

PiPe installation insPection Form

Project # ___________________________________________ County, Route & Segment

Inspector ___________________________________________ Installation Date

Item # ______________________ Ref. # ________________ Producer Code _____________ Contractor______________

Description ____________________________________________________________________________________________

Station ______________________ Plan Page ____________ Pipe Mat’l (RCP, Metal, HDPE, Iron, Other) ______________

Pipe Size _________ inches

W = Width of trench at Top of Pipe feet

Refer to RC – 30M Note: Trench or shoring walls to be vertical to Top of Pipe

B = Thickness of bedding under pipe. inches

T = Outside diameter of pipe to trench wall. inches

S = Total Depth of bedding. inches

Do = Outside diameter of pipe inches www.penndot.pa.gov

Do not lay slope back or cut extra trench width below top of pipe

W

DoBackfill

Bedding

T

S B

Field Measurements

(Depth - ft)

Grade Check Method (Ruler, laser)

Compaction Method/

Equipment

Soil or Aggregate

Type

% passing 3/8” sieve

Lift Thickness (inches)

Density required

(% SPD)

# compactor passes/lift

0’ - 3’ 100 %

3’ - %

Backfill (Document density using TR-478A or TR 4276A)

Type of Joints (601.3d) ____________________ Joints Installed Satisfactorily? . . . . . . . . . . . . . . . . . . . Yes No

Materials: Certified or Tested and approved prior to incorporation into the project? . . . . . . . . . . . . . . . . . . . . . . Yes No

All pavement undermining cut back and removed prior to compaction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

Check Stations & Location T W B S Do Initial Date

* Check every 50 feet, with a minimum of two checks per run.

Trench & Bedding Checks* (Actual Field Measurements)

In sp ec to r’s

In iti al s Date

Sketch Area:

Inspector’s Signature Date

By signing below, I certify that my company performed the work, the information on both pages of this form is accurate, the work complied with Publication 408, including Section 601 and references therein, and any deviations are noted on this form.

Name (print): ___________________________________________________ Title:

Company Name: ________________________________________________________________________________________

Signature: _____________________________________________________ Date:

CS-6 (7-24)

Remarks: Record problems, soft foundations, under cuts, rock, obstructions, utilities encountered, deviations, etc. Describe and note location of existing conduits encountered, whether connected, plugged and abandoned, reconnected, etc.

TR-4276AC (5-21)

REPORT ON COMPACTION DENSITY

BY NUCLEAR METHOD-CONTRACTOR FORM

www.dot.state.pa.us

Fill Out Completely. Original to be retained with project records. Remit copy to District Office

ECMS No.: ______________________________________

SR – Section: ______________________________________

District: ______________________________________

County: ______________________________________

Date: ______________________________________

Embankment Subgrade Pipe Backfill

Other: ______________________________________________

FILL MATERIAL: (Reference Pub. 408, Sec. 206)

Material Source:

Specific Gravity, SG:

Passing 3/8 Sieve (%):

Passing No. 200 Sieve (%):

Material Type (Check one)

Maximum Proctor Density (pcf) *:

Optimum Proctor Moisture (%) *:

Required Min. Compaction (% Proctor):

Required Min. Compaction (pcf):

Soil:

Type 1 Granular:

GAUGE IDENTIFICATION: (Reference PTM No. 418)

Manufacturer:

Model Number:

Date of Annual Calibration:

MONTHLY GAUGE OPERATING LIMITS

(from Annual Calibration Report)

Effective Month:

Upper Limit Density Count:

Lower Limit Density Count:

Upper Limit Moisture Count:

Lower Limit Moisture Count:

DAILY GAUGE STANDARDIZATION: (Reference PTM No. 418)

Standardization Date:

Standard Density Count:

Standard Moisture Count:

TEST LOCATIONS: (Reference PTM No. 402)

Test Identification Number: Test Elevation (feet):

Station: Compacted Lift Height (inches):

Offset: Source Rod Position (inches) **:

Final Subgrade Elevation (feet): Test Time (start):

TEST LOCATIONS: (Reference PTM No. 402)

Reading 1 (0°)

Reading 2 (90°)

Reading 3 (180°)

Reading 4 (270°)

Average Meets

Tolerances?

(Y or N)***

Density Count (Shift + Counts) – –

Wet Density, WD (pcf)

ΔWD from Average – –

Moisture Count (Shift + Counts) – –

Moisture, (pcf) – –

Dry Density, DD (pcf)

Moisture, w (%)

Δw (%) from Average – –

% of Proctor Density (%)

Zero Air Voids (ZAV) Formula:

show calculation:

ZAV Check: Yes: No: Pass: Fail:

Remarks:

Name of Gauge Operator: Cert. Number:

QC

Test

Acceptance Test

62.4

DD

SG

- w%≥

* Use data as shown on applicable Form TR-4247 ** For Backscatter Mode, enter 0.

*** If final averages exceed tolerances, a new location is to be tested

Page ______ of ______

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