A06_WBI_Energy_-_Line_Crossing_and_Encroachment_Permit.pdf

Telephone: Fax: Email:

Project Name:

General scope of project:

WBI Energy Crossing/Encroachment Permit

Anticipated construction start date: Anticipated completion date:

Mailing Address:

Company Name: Company Representative:

WBI Energy (WBI) requires any party requesting to cross or encroach onto our easement to comply with the following conditions:

1. Youwill assume full responsibility for any and all damages caused by the construction,operationand maintenance of your facilities or the activities performed.

2. Your facilities will cross beneath our pipeline if at allpossible.

3. At the point of crossing, a minimum separation of 12” will be maintained between your facilities and our pipeline.

4. If Horizontal Directional Drilling(HDD), a separation of 12” greater than the size of the largest reamer will be maintained.

5. If HDD, pipeline shall be exposed 24” on bothsides of the proposed bore path, excavating to a depth 12” below our pipeline.

6. Excavation within 24" of our pipeline shall be performed by hand digging only.

7. Crossing angle shall be as near to 90oaspossible.

8. Crossing shall be inspected by WBI personnel prior tobackfill.

9. WBI Energy will be notified 48 hours prior to any excavation, grading, or drill that is planned to take place.

In addition to complying with conditions listed above, WBI requires more information regarding the potential crossing or encroachment to evaluate your project and the effects it may have on the safety of our facility. The more detailed information you can provide will help WBI evaluate any effect on our facility and expedite an approved crossing/encroachment permit. Please provide as much of the following data as possible for WBI review:

BLM Josh Helm 406-233-2880 jhelm@blm.gov

Type text here

Basin View Pipeline 7/18/2022 9/30/2022

111 Garryowen Rd, Miles City, MT, 59301

BLM to contract installation of 19,829 ft of stock water HDPE pipeline on BLM property.

HDPE pipeline to be buried with 5-6 ft of cover.

Open cut or directional drill option given to contractor (not yet awarded). Over/under to be determined by depth of WBI Energy pipeline.

Encroachment

a. Road surface:

b. Reason for building road:

Item A. and Item B. described below shall be submitted.

For office use only:

TWP RGE Section

County: State:

Approved by: Date:

**Required drawing**

Attach cross section drawing showing grading, ditch cuts, and any sub-excavation

Voltage (if electrical):

Line material (steel, plastic, fiberglass, etc.):

Type of cable (electrical, telecomm, fiber optic, etc.):

Cable crossing

Overhead power crossing

Proposed separtion between facilities:

Construction method (HDD, open cut, plow):

Construction method (HDD, open cut, plow):

Road or temporary access crossingPipeline crossing

Describe encroachment

(parking lot, subdivision, pond, trees, etc.)

Part 1. Type of Crossing or Encroachment

Voltage of line:

Complete and attach

Appendix A. Vehicle

Description form

**Required Appendix A.**

Attach drawing showing the

Location of power poles (not allowed on ROW) and minimum height of overhead line over the ROW.

Crossing position (above or below WBI pipeline):

Crossing position (above or below WBI pipeline):

Proposed separtion between facilities:

Part 2. Drawings or Exhibits

ADDITIONAL APPROVAL NOTES:

Stationing:Pipeline name:

If permanent road, complete

a. and b.

Cable cover (PVC, metal, Cathodic protection type:

**Required cross section**

A. Plan view of crossing or encroachment

a. Title block showing drawing number, revision number, and date

b. North arrow

c. Legal land description

d. Existing buried facilities, road allowances, and ROW, including those belonging to WBI

e. Angle of proposed crossing (crossing angle shall be as near to 90o as possible)

f. Location of encroachment activity

B. Profile view of crossing or encroachment

a. Depth of cover

b. Dimensions (a minimum of 12” separation for crossings)

c. Existing and proposed grade

TBD

TBD

2' min

HDPE (plastic)

N/A

Axle Grouping

Front (Steering)

Single (if necessary)

Tandem (eg. 8 Wheel)

Tri-Axle (eg. 12 Wheel)

TOTAL VEHICLE WEIGHT

(GVW)

Max Vehicle Weight Make Model Track Length Track Width

Appendix A. Vehicle Description Form lbs ft in lbs

(this number must be the total of all previous boxes)

Sketch of the equipment showing the tire configuration (use another page if necessary) psig psig psig psig

A. WHEELED VEHICLE

Make/Model/Description of heaviest wheeled vehicle that will cross the pipeline:

Weight per Axle Group Tire Pressure

B. TRACKED VEHICLE

Make/Model/Description of heaviest tracked vehicle that will cross the pipeline:

lbs lbs lbs lbs