CE0435_Atch-2_BNSF_2017_Pipeline,_Wire_Line_App_and_Instructions.pdf
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- W912DW17B0005
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ATTACHMENT 2 W912DW-17-B-0005
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PIPELINE / WIRE LINE PROCESS INSTRUCTIONS
Licensing Process:
1. Once the application package is received by Jones Lang LaSalle Brokerage, Inc. (JLL), the application and drawing will be forwarded to the engineering firm to prepare the Exhibit “A” drawings for the contract. This process takes approximately 10 to 15 working days.
2. When the Exhibit “A” is completed, a contract will be prepared and two (2) copies will be forwarded to you for an original signature. A letter will be sent to you that will provide directions regarding insurance and any additional fees.
3. Return the signed contracts (2 contracts with original signatures), along with the appropriate payment to JLL’s Permits Department.
4. The final contracts, with original signatures, will be presented for execution provided payment has been received and insurance has been approved.
5. Once the contract is executed, one original will be returned to you for your files.
6. Prior to commencing any work on the Premises, Licensee shall complete and shall require its contractor (all parties who will be working on the site) to complete the safety training program at Internet Website http://www.bnsfcontractor.com . This training must be completed no more than one year in advance of Licensee’s entry on the Premises.
7. The cover letter and the executed contract will list the Roadmaster’s name and phone number. You will need to contact the Roadmaster ten (10) days prior to beginning work.
Process Time:
Please be advised that the average time period for completion of this process is 4 weeks from the time that the application is received. Every effort will be made to complete this process in a timely manner. If you require RUSH processing please complete the attached form and send with your check for $4,250.
We cannot provide RUSH processing for longitudinals.
CE0435 Rpr/Rpl Elec Distro Line Main-Gingko Substations Atch-2 http://www.contractororientation.com/ http://www.bnsf.com/communities/faqs/pdf/rush.doc
Insurance Requirements for the following Agreements:
Pipeline, Overhead Pipe Truss or
Conveyor Electric Supply, Communication or Telephone Line
Commercial General Liability Insurance
Contractual Liability with a combined single limit of a minimum of $5,000,000 each occurrence and an aggregate limit of at least $10,000,000.
Contractual Liability with a combined single limit of a minimum of $2,000,000 each occurrence and an aggregate limit of at least $4,000,000.
Business Automobile Insurance
Combined single limit of at least $1,000,000 per occurrence.
Combined single limit of at least $1,000,000 per occurrence.
Workers Compensation and Employers Liability Insurance
Employers’ Liability with limits of at least $500,000 each accident, $500,000 by disease policy limit, $500,000 by disease each employee.
Employers’ Liability with limits of at least $500,000 each accident, $500,000 by disease policy limit, $500,000 by disease each employee.
Railroad Protective Liability Insurance
Coverage of at least $5,000,000 per occurrence and $10,000,000 in the aggregate.
Coverage of at least $2,000,000 per occurrence and $6,000,000 in the aggregate, with the exception of New Mexico in which coverage is $5,000,000 per occurrence and $10,000,000 in the aggregate
Pollution Legal Liability Insurance (if necessary)
In an amount of at least $5,000,000 per occurrence and $10,000,00 in the aggregate
Please Note: These limits are subject to change without notice. An Agreement will be provided to you, which contains details concerning insurance requirements.
Please send the following so we may process your License request:
1. Completed Application.
2. $800 non-refundable processing fee. Check should be made payable to BNSF Railway Company.
3. One set of drawings (no larger than 11 x 17) for the area to be occupied. (Include: streets, distance from tracks and streets, mileposts if available and any distinguishing land marks.) If required, attach the pole head diagram. Please ensure all information is accurate, as each change will add an additional $800 to the processing fee.
4. If you require this be expedited please complete the RUSH form and include an additional non-refundable $4,250. We cannot provide RUSH processing for longitudinals.
Forward to:
Jones Lang LaSalle Brokerage, Inc.
Attn: Permit Services 4200 Buckingham, Suite 110 Ft. Worth, TX 76155 http://www.bnsf.com/communities/faqs/pdf/rush.doc
APPLICATION FOR PIPELINE or WIRE LINE - CROSSING AND/OR LONGITUDINAL
Jones Lang LaSalle Brokerage, Inc. Applicants Tax ID # or SS # ___________________________ ATTN: Permit Services 4200 Buckingham, Suite 110 Fort Worth, TX 76155
We submit for your approval the following specifications for a pipeline or wire line we propose to build across and/or along BNSF RAILWAY COMPANY’S right-of-way, as shown on the enclosed location plan and detailed sketch.
Legal name of company/municipality who will own the pipeline/ wire line:
State in which incorporated: (If not incorporated, please attach name of owners or partners.) _________________
Name of contact for ownership entity: Phone #:
EMail Address: Fax:
Mailing Address:
Is this project ARRA funded? Yes No
Is applicant a condemning authority? Yes No
Is applicant a Railroad Shipper? Yes No
If yes, BNSF Marketing Rep. name: Phone #
Was this service requested by BNSF? Yes No
If yes, person requesting service: Phone #
Is this installation in conjunction with a track or track expansion project? Yes No
If yes, BNSF contact name: Phone #
Is this installation associated with a public road crossing/widening or a grade separation project? Yes No
If yes, please provide details and plans for said crossing/widening or grade separation project with your application.
Type of Encroachment: Crossing Longitudinal Both
Name of nearest town on RR County State
Name of nearest roadway crossing
RR?
Location of Encroachment: 1/4 Section Township Range
Railroad Mile Post Latitude Longitude
Within limits of public road or street? Yes No If yes, distance from center line of road: ft.
Width of public road or street: ft.
PIPELINE:
(Note: For wire line see pg. 2)
Contents to be handled through pipeline:
CARRIER CASING
Length of pipe on RR property (plastic pipe must be encased full width of ROW) ft. ft.
Inside diameter of pipe in. in.
Pipe Material
Specification & grade (Minimum yield strength casing 35,000 psi)
Wall thickness (minimum wall thickness of casing pipe under 14 in. –
0.188 in E-80 Loading)
Actual working pressure
Type of Joint Mechanical Welded Mechanical Welded
CARRIER CASING
Coating
Distance from base of rail to top of pipe (Flammable contents, steam, water or non-flammable – minimum 5 ½ ft. under main track) (uncased gaseous products – minimum 10’ under track) Minimum ground cover on RR property (minimum 3 ft.)
Cathodic protection casing (flammable substance)
Type of insulators or support: Size: Space:
Number of Vents (flammable substances require 2 vents) Size: Height Above Ground:
Method of Crossing:
Jacking/Dry Bore (Jacking pit location min. 30 ft. from centerline of track. Pit must not be open more than 48 hrs. and must be protected when not in use.)
Trench (RR to furnish flagman at applicant’s expense)
Horizontal Directional Drilling (HDD) (Jacking pit location min. 30 ft. from centerline of track. Pit must not be open more than 48 hrs. and must be protected when not in use.)
Does pipeline support an oil or gas well? Yes No
If yes, distance from RR property. ft. Name of well:
WIRE LINE:
Kind of encroachment: Electric Communication If other, describe:
Type of wires/cables: # of wires or cables: Volts Phase Cycles
Conduits:
Occupied conduits: Vacant conduits: Total Conduits:
Length of encroachment: Adjacent spans: ft. ft.
Appurtenances on RR Co. property:
Wire clearance over or under top of rail: ft. over or ft. under
If under track: kind of conduit size of conduit Wire clearance over RR Co. wire lines:
POLES
Kind: Size:
Height: Class:
Set in: Earth Rock Number of poles on RR property:
Distance of poles from track:
GUY WIRES
Overhead Down
Kind Size
CROSS ARMS
Material:
Size: x x
FRONT ELEVATION
INSULATORS
Type: Size:
BRACKETS
CONDUCTORS
SIDE ELEVATION
LINE CHARACTERISTICS
Voltage: Phase: Cycle:
I agree that I have read the instructions for the installation of wire lines as detailed in the Utility Accommodation Policy.
Attached to this sheet is a location plan and a detailed sketch. Sketch should show tie-down measurement to centerline of nearest road crossing, bridge or other railroad structure.
Please authorize us to proceed with this installation or advise what changes are necessary to meet BNSF’s specifications.
Date: Signed:
Print Name:
Company:
Title:
Phone #: Fax:
If you require additional assistance, please contact your Jones Lang LaSalle Brokerage, Inc. representative.
http://www.bnsf.com/communities/contact-us/permits.html
| Applicants Tax ID or SS: |
| Legal name of companymunicipality who will own the pipeline wire line: |
| State in which incorporated: |
| If not incorporated please attach name of owners or partners: |
| Name of contact for ownership entity: |
| Phone: |
| EMail Address: |
| Fax: |
| Mailing Address: |
| Is applicant a condemning authority: Off |
| undefined: Off |
| If yes BNSF Marketing Rep name: |
| Phone_2: |
| Was this service requested by BNSF: Off |
| If yes person requesting service: |
| Phone_3: |
| Is this installation in conjunction with a track or track expansion project: Off |
| If yes BNSF contact name: |
| Phone_4: |
| Is this installation associated with a public road crossingwidening or a grade separation project: Off |
| Crossing: |
| Longitudinal: |
| Both: Off |
| Name of nearest town on RR: |
| County: |
| State: |
| 14: |
| undefined_2: |
| Section: |
| Township: |
| Range: |
| Railroad Mile Post: |
| Latitude: |
| Longitude: |
| Within limits of public road or street: Off |
| If yes distance from center line of road: |
| Width of public road or street: |
| Contents to be handled through pipeline: |
| inPipe Material: |
| inPipe Material_2: |
| inSpecification grade Minimum yield strength casing 35000 psi: |
| inSpecification grade Minimum yield strength casing 35000 psi_2: |
| inWall thickness minimum wall thickness of casing pipe under 14 in 0188 in E80 Loading: |
| inWall thickness minimum wall thickness of casing pipe under 14 in 0188 in E80 Loading_2: |
| inActual working pressure: |
| inActual working pressure_2: |
| Mechanical: Off |
| Welded: Off |
| Mechanical_2: Off |
| Welded_2: Off |
| Type of insulators or support: |
| Space: |
| Number of Vents flammable substances require 2 vents: |
| Height Above Ground: |
| JackingDry Bore: Off |
| Trench: Off |
| Drilling HDD: Off |
| Does pipeline support an oil or gas well: Off |
| If yes distance from RR property: |
| Name of well: |
| ft: |
| Electric: Off |
| Communication: Off |
| If other describe: |
| Type of wirescables: |
| of wires or cables: |
| Volts: |
| Phase: |
| Cycles: |
| Occupied conduits: |
| Vacant conduits: |
| Total Conduits: |
| Length of encroachment: |
| Adjacent spans: |
| ft_2: |
| Appurtenances on RR Co property: |
| Wire clearance over or under top of rail: |
| or: |
| kind of conduit: |
| size of conduit: |
| Wire clearance over RR Co wire lines: |
| Kind: |
| Height: |
| Class: |
| Earth: Off |
| Rock: Off |
| Number of poles on RR property: |
| Distance of poles from track: |
| Overhead: |
| Down: |
| Kind_2: |
| Size_3: |
| Material: |
| Size_4: |
| x: |
| x_2: |
| Material_2: |
| Type: |
| Size_5: |
| Material_3: |
| Type_2: |
| Size_6: |
| Material_4: |
| Type_3: |
| Size_7: |
| Voltage: |
| Phase_2: |
| Cycle: |
| Policy: |
| Date: |
| Signed: |
| Company: |
| Print Name 1: |
| Print Name 2: |
| Phone_5: |
| Fax_2: |
| Inside diameter of pipe_ft: |
| Inside diameter of pipe_in: |
| Inside diameter of pipe_ft2: |
| Inside diameter of pipe_in2: |
| Coating: |
| Distance from base of rail to top of pipe Flammable contents steam water or nonflammable minimum 5 ½ ft under main track uncased gaseous products minimum 10 under track: |
| Minimum ground cover on RR property minimum 3 ft: |
| Cathodic protection casing flammable substance: |
| Size: |
| Size_2: |
| Coating_2: |
| Distance from base of rail to top of pipe Flammable contents steam water or nonflammable minimum 5 ½ ft under main track uncased gaseous products minimum 10 under track_2: |
| Minimum ground cover on RR property minimum 3 ft_2: |
| Cathodic protection casing flammable substance_2: |
File details come from the government source that posted it. Updated .