Attachment_7_-_Fort_Drum_Excavation_Permit.pdf

W911S2-16-B-8000 Asphalt Requirements

Fort Drum, NY

FORT DRUM EXCAVATION PERMIT

(Required for any excavations within Fort Drum boundaries) The excavator shall comply with New York State Code Rule Part 753 (Protection of Underground Facilities), REQUESTOR OF PERMIT:

Name: Eric White Phone: 609-890-7277

Address: Organization: Pars environmental

Fort Drum E-mail: ewhite@parsenviro.com

EXCAVATOR OF SITE:(Individual performing the dig) Name: Eric White Phone: 609-890-7277

Address: Organization: Pars environmental

Fort Drum E-mail: ewhite@parsenviro.com

Permit ID: 2139 Project ID: 5512 Project Name: Pars environmental

Project Number: Depth: 40 FT Status: PENDING

Dig Start Date: 15OCT2012 Dig Completion Date: 01DEC2012 Contract: 6098907277

PURPOSE: well installation

Location Description: concrete pad, near intersection of ontario and eight st w, In the 1800 area

The excavator shall personally contact each office below to coordinate identification of underground utilities. Identify the exact location of excavation in white on the ground prior to requesting an excavation permit. Provide information on the type of work, means of excavation, and provide construction drawings. The excavator shall be on-site during the identification of utilities to ensure first-hand knowledge, assist in locating utilities and identifying work areas. Once required signatures are obtained and utilities located, return to issuer (Government Project Manager/COR) for final approval. A signed copy of the completed Excavation Permit shall be on site at all times. Throughout the excavation period, the excavator shall maintain and preserve all marked utilities. Before use of mechanized equipment in the tolerance zone, the excavator shall verify the precise location, type, size, depth and direction of such underground facility or its encasement, by hand digging, vacuum excavation accepted. The marked utilities are to be assumed to be plus or minus 5' either side of markings. Changes to, enlargement of sites and/or start delay over 30 days requires a new Excavation Permit.

The undersigned have ensured existing underground utilities and other appurtenances have been identified prior to excavation. The excavator shall repair any damage to identified/located utilities and other appurtenances at no cost to the Government. Special instructions shall be annotated by marking authority if required. After identification, verification & completion all "as-built" construction drawings shall be submitted as per contract.

Obtain signatures within 30 days of excavation start. Excavation Permit is valid throughout the excavation period.

Signature

Discipline Status Comments Review Date Default Approved 2012-Oct-09

FDMCH Approved 2012-Oct-10

Master Planning Approved 2012-Oct-09

Env, Petroleum Approved 2012-Oct-09

Env, Water Quality Approved 2012-Oct-09

Env, Wetlands Approved 2012-Oct-09

Env, NEPA Pending 2012-Oct-10

Env, Cultural Approved 2012-Oct-09

O-M Plumbing Approved 2012-Oct-11

Engineering Approved 2012-Oct-09

O-M Electrical Approved 2012-Oct-11

NECÂ Planning Approved 2012-Oct-10

Power Plant Auto-Approved 2012-Oct-09

UFPO Auto-Approved 2012-Oct-09

FIRE Approved 2012-Oct-10

USACE Approved 2012-Oct-10

Overview:

Comments:

FORT DRUM FORM 555-E, NOV 2007 PE v6.5.0

W911S2-16-B-8000 Asphalt Requirements

Fort Drum, NY