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Home My WebLink AboutMFP17004498DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Franchise Permit: MFP17004498 IVR Number: 17004498 Permit Informa!on Permit Name:Puget Sound Energy Gas Permits Address/Loca!on:09/06/2017Applica!on Date:1253810020Parcel Number:660 SW 39TH ST Permit Type :10/06/2017Issue Date:Franchise Permit Work Class:10/08/2018Expira!on Date :Minor U&lity Job Number:109103168Franchise Type :Natural Gas Descrip!on:Replace exis&ng 4" PE gas main with new 4" PE main on SW 39th st. Test and &e one service . Restora&on per City of Renton standards . Contacts Name Address PhoneTypeBilling ANISH KUMAR PUGET SOUND ENERGY - GAS - BILLING 6905 S 228th St Kent, WA 98032 B: (253) 208-2183Applicant Stuart Benne? Infrasource Services LLC 14103 Stewart Rd Sumner, WA 98490 B: (303) 419-8755 H: (425) 677-5197 C: (713) 985-6489 Contractor Business License Number: BL.036742Construc!on Contractor : INFRASL871C2 CITY OF RENTON ROW 1055 S Grady Way Renton, WA 98057-3232 Owner ANISH KUMAR PUGET SOUND ENERGY - GAS - BILLING 6905 S 228th St Kent, WA 98032 B: (253) 208-2183Specialized Billing X General Condi!ons & Signature Permission is hereby given for the work described on this permit according to the conditions hereon and according to the approved plans and specifications pertaining thereto, subject to compliance with the Ordinance of the City of Renton. This permit and plans must be posted at the job site at all times. I hereby certify that no work is to be done except as described above and in approved plans, and that work is to conform to Renton Trench Restoration and Street Overlay Requirements. Call (425) 430-7203 or go to: www.MyBuildingPermit.com one working day in advance to schedule an inspections and for ANY work in the Right of Way. Call 8 1 1 to locate underground utilities at least two full business days prior to any excavation. In accordance with RCW 19.122.033(4) the permit holder is required to contact (Williams Northwest Pipeline at 425.868.1010) (Olympic Pipeline at 206.510.0575)(Puget Sound Energy at 425.457.5816) to request a consultation with the transmission pipeline company prior to performing any construction or excavation activities. This requirement to consult with the transmission pipeline company is in addition to the requirement to Call before You Dig as required in RCW 19.122. (Date)(Signature) Page 1 of 1THIS PERMIT AND PLANS MUST BE POSTED AT THE JOB SITE AT ALL TIMES DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Page 1 | Published: 3/30/2017 Planning Division | 1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200 Email: franchisepermits@rentonwa.gov Website: rentonwa.gov FRANCHISE PERMIT APPLICATION Published: 3/30/2017 TO THE APPLICANT: Submit an electronic copy of the plans with the Franchise Permit Application and the Traffic Control Application to franchisepermits@rentonwa.gov. Permit cost is $360.50. Inspection fee for trenching more than 60 lineal feet or installation of 6 or more poles will be billed at $60.00 per hour. Franchise Agency: Franchise Job Number: Phone: Contact Name: Email: Job Site Address: Project Name: Description of Work: Please check all that apply: ☐ New Construction ☐ Repair/Relocate ☐ Underground ☐ Overhead ☐ Sidewalk ☐ Street ☐ Open Trench ☐ Bore # of feet: Contractor Name: Phone: State Contractors License #: City of Renton Business License #: “I certify that I am the owner or applicant’s authorized agent and do hereby agree to abide to the terms and conditions set forth under this permit and shall comply with the City of Renton’s Trench Restoration and Street Overlay Requirements. ” Signature Date INSPECTIONS SHALL BE REQUESTED 24 HOURS PRIOR TO COMMENCEMENT OF ALL WORK BY CALLING THE INSPECTION LINE AT 425-430-7203 OR BY GOING TO MYBUILDINGPERMIT.COM Jobs are required to be called in for job start, re-inspection and project final. Re-inspection fees are billed at $75/hour. All Pre-Construction meetings shall be scheduled at a maximum of 14 days prior to the job start date. Plan Review/Development Engineering Date Approved as submitted Pre-Construction Meeting required Site Construction Inspector Date Approved with comments or redlines Camera inspection of utilities required Development Engineering Manager Date Restoration per City of Renton Standards MFP17004498 Scott Warlick 9/25/2017 Justin Johnson 10-4-2017 CITY OF RENTON TRAFFIC CONTROL PLAN PROJECT NAME: PERMIT# CONSTRUCTION COMPANY: PHONE#: CONTACT NAME: PHONE#: ADDRESS: CELL#: E-MAIL ADDRESS: FAX#: PROJECT LOCATION: N/E/S/W OF: WORK TIME: APPROVED BY: WORK DATE: APPROVAL DATE: OFFICE COPY T- CONTRACTOR DEV. SERVICE, INSPECTION P. MILLER DEV. SERVICE, PLAN REVIEW B. BANNWARTH POLICE CHARLES KARLEWICZ FIRE FIRE MARSHALL FS #13 Permit Holder agrees to all the following: • Comply with all traffic regulations of the City of Renton and the State of Washington. • Prepare a traffic control plan and obtain City approval of that plan. That plan shall be implemented for all street and lane closures, and the plan shall be performed in compliance with the Manual on Uniform Traffic Control Devices. • Notify emergency services (253-852-2121) twenty-four (24) hours before any street or lane closures. • Any lane or street closures not in conformance with the approved traffic control plan and/or without notification of emergency services may result in receiving a citation for violation of R.C.W. 47.36.200 through 47.36.220, 9A.36.050 Reckless Endangerment, and other applicable State and City codes. • Indemnify and hold harmless the City of Renton from any and all claims, actions, and judgments, including all costs of defense and attorney’s fees incurred in defending against same, arising from and related to implementation of the approved traffic control plans including claims arising from towing of private vehicles and the acts of the Permit Holder’s agents and employees. • The City of Renton shall be entitled, in its reasonable discretion, to settle claims prior to suit or judgment, and in such event shall indemnify and hold harmless the City for any such claims paid, including the City’s reasonable attorney’s fees and litigation costs incurred resulting from such claim. • In the event any claim or suit is brought against City within the scope of this Agreement, Permit Holder will pay for legal counsel chosen by the City to defend against same. • Flagger and sign placement are subject to revision by the City Inspector on site, if needed to address traffic or pedestrian safety or travel. • By my signature herein, I acknowledge all the above requirements. PRINT NAME: DATE: SIGNATURE: Reset FormPrint Form MFP17004498 10-4-2017 Justin Johnson8:00 am to 3:00 pm Monday through Friday SKETCH I -- NORTH -- I NOTES: • Work Zone Traffic Control shall be in accordance with the Manual on Uniform Traffic Control Devices (MUTCD) and shown by sketch or reference to WSDOT. • The plan must be submitted to the City’s PW/Transportation Division for review and/or approval at least three working days prior to work. • Approved Temporary Traffic Control Plan must be at the work site during work hours. • Contractor or entity must call Renton School District (425-204-4455) or any public/private agency to be affected by a temporary lane or road closure. • Complete assistance and accommodation shall be provided to all kinds of pedestrian traffic when sidewalk or walkway is impeded. • Total road closure lasting more than 24 hours is subject to the approval by the City Council. • Any vehicle, equipment, barricade, or portable tow-away sign used within the work area must display a company logo or any legally acceptable sign showing the company name, address, and telephone number at a conspicuous place on the vehicle or equipment. In the case of Temporary No Parking Zones, all the following apply in addition to previous: • Contractor must complete form to show limits of Temporary No Parking Zone identifying barricade locations for vacate parking or curb lane usage. • Contractor must post notice of dates and time of Temporary No Parking Zone with at least two signs per block 72 hours in advance of effective date and time. • The cover sheet of this Traffic Control Plan form must be attached to each Temporary No Parking Sign on the project site. • Temporary traffic control devices must be removed immediately when work is done or no construction activities are going on. If deemed abandoned, City crews will remove and store them at the City’s maintenance shop (3555 NE 2nd Street). SW 39th StRaymond Ave SW 111113M6-2W4-2LROADWORKAHEADW20-1RIGHT LANECLOSEDAHEADW20-5RX'X'X'1717ROADWORKAHEADW20-1 ROAD WORK AHEAD W20-1R9-9SIDEWALKCLOSEDR9-9SID E W A L K CL O S E D R9-9SIDEWALK CLOSED R 9 - 9 SIDEWALKCLOSEDPATH OF INSTALLATIONCREW WILL USE ADA COMPLIANTRAMPS FOR PEDESTRIANDIVERSIONCHANNELIZATIONDEVICE SPACINGMPH55/7035/4525/30TAPER403020TANGENT806040NPSEPUGETSOUNDENERGYJob#109103168660 SW 39th St Renton, WAAugust 4th, 2017Sheet 1 of 2 mitchell.peterson@pse.com425-398-6071PRINT ON11X17" SHEETS ONLYNotes:1. All signs and spacing to conform to the MUTCDand City of Renton standards.2. All sidewalks, driveways, exits and egressesshall be completely clear unless otherwise indicated.3. Channelizing devices are 28" traffic cones.4. Sign size can be a minimum of 48" x 48" andshall not obstruct pedestrian access.5. Crew is required to leave a minimum of 11' fortraveling lane width.6. Alert affected residents and businesses.7. Work to take place between 9 a.m. and 4 p.m.8. Work area will be 75' W of C/L of Raymond Ave SW& 20' S of C/L of SW 39th St.WORK PIT28" TRAFFIC CONEWORK VEHICLESIGN LOCATIONWARNING FLAGTRAFFIC FLOWLEGENDPuget Sound EnergyTraffic Control Supervisor:Gregory HarwoodCard No. 008997Card Exp. 08/13/2019gregory.harwood@pse.com(425)424-6425MFP17004498pothole existingstormwater andwater main SW 39th StRaymond Ave SW 111113 1717M6-2W4-2LROADWORKAHEADW20-1RIGHT LANECLOSEDAHEADW20-5RX'X'X'ROADWORKAHEADW20-1 ROAD WORK AHEAD W20-1FROMTOTOW AWAY AREAPHONE 888-9999INFRASOURCE LLC 000 0000000NO PARKINGR9-9SIDEWALKCLOSEDR9-9SI D E W A L K C L O S E DCREW WILL USE ADA COMPLIANTRAMPS FOR PEDESTRIANDIVERSIONPATH OF INSTALLATIONCHANNELIZATIONDEVICE SPACINGMPH55/7035/4525/30TAPER403020TANGENT806040NPSEPUGETSOUNDENERGYJob#109103168660 SW 39th St Renton, WAAugust 4th, 2017Sheet 2 of 2 mitchell.peterson@pse.com425-398-6071PRINT ON11X17" SHEETS ONLYWORK PIT28" TRAFFIC CONEWORK VEHICLESIGN LOCATIONWARNING FLAGTRAFFIC FLOWLEGENDPuget Sound EnergyTraffic Control Supervisor:Gregory HarwoodCard No. 008997Card Exp. 08/13/2019gregory.harwood@pse.com(425)424-6425Notes:1. All signs and spacing to conform to the MUTCDand City of Renton standards.2. All sidewalks, driveways, exits and egressesshall be completely clear unless otherwise indicated.3. Channelizing devices are 28" traffic cones.4. Sign size can be a minimum of 48" x 48" andshall not obstruct pedestrian access.5. Crew is required to leave a minimum of 11' fortraveling lane width.6. Alert affected residents and businesses.7. Work to take place between 9 a.m. and 4 p.m.8. Work area will be 477' E of C/L of Raymond Ave SW& 20' S of C/L of SW 39th St.MFP17004498 N Vicinity Map Owner / Developer Contact Info officeATTN: THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF EXISTING FACILITIES CALL 811 2 BUSINESS DAYS BEFORE YOU DIG For contacts below dial 1-888-CALL PSE (225-5773) Inspected Steel and PE pipe per GOS 2450.1400 and 2450.1500 Reviewed and complied with all construction notes. Recorded all required information on the as-built per GOS 2500.1700. Completed post installation inspection per GOS 2525.1200 and 2525.2700. Left the work area in a clean and safe condition. FITTER'S CHECKLIST Foreman's Name (printed) ___________________________________ Foreman's Signature________________________________________ Company: InfraSource Construction Date ______________ (CHECK BOX TO CONFIRM COMPLETION) 4680 06/11 11287710 109103168 109103169 108596666 108596665 GAS PROJECT PHASE Notification #Order # Retirement Relocate SAP Superior Service/Meter Service/Meter HP Svc/MSA Dis. Reg. / FT Ind. MSA Ind. Service Service/Meter Service/Meter SYSTEM MAOP DENOTED BY: SYSTEM MAOP = ___ PSIG BOX (TEST LEAD) INSTALLATION. THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2600 FOR ALL HP VALVES IF THE LOCATION IS TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS, NO TWO MAINS SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE. RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION. MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS OPERATING STANDARDS 2525.3300 AND 2525.3400. PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3300, AND 2525.1200. ANY CHANGE IN ROUTE, PIPE SIZE/TYPE, TIE-IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY COMPLETE "PIPE CONDITION REPORT" ON ALL METALLIC PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE INSTALL MAIN VALVES OUT OF TRAFFIC WHERE POSSIBLE. VALVE MARKERS SHALL BE INSTALLED AND RECORDED BY THE OPPORTUNITY TO PURCHASE AN EXCESS FLOW VALVE WHEN THEIR SERVICE IS INSTALLED OR REPLACED PER GAS OPERATING STANDARD 2550.1600. ALLOW ADEQUATE TIME FOR CUSTOMER DECISION AND RESPONSE. DELIVER FLYERS BE SURE TO INCLUDE THE LIST OF FREQUENTLY ASKED QUESTIONS AND INFORMATION ABOUT PRIOR TO BEGINNING CONSTRUCTION. USE iSi TO DISTRIBUTE FLYERS IF JOB IS LARGE, OTHERWISE HAND NOTIFY PROPERTY OWNERS ADJACENT TO PROPOSED CONSTRUCTION ACTIVITIES A MINIMUM OF TWO WORKING DAYS EROSION AND SEDIMENT CONTROL AND ANY ADDITIONAL LOCAL JURISDICTION REQUIREMENTS. EROSION AND SEDIMENT CONTROL SHALL BE PER PSE STANDARD PRACTICE 0150.3200 TECHNIQUES FOR TEMPORARY ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES. TO CONSTRUCTION, IN WESTERN WASHINGTON CALL: 1-800-424-5555. OR CALL NATIONWIDE: 811 FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL "ONE-CALL" TWO WORKING DAYS PRIOR TO STANDARD GAS CONSTRUCTION NOTES: 14. 13. 15. 10. 11. THE APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE. 9. 6. 7. 5. 4. 3. 1. 45 16. IF METALLIC PIPE IS INVOLVED, COORDINATE INSTALLATION WITH CP TECH. ------------------ NOTIFY APPROPRIATE PERMITTING AGENCY PRIOR TO JOB START (SEE PERMIT REQUIREMENTS).2. 8.PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2500. NOT READILY ACCESSIBLE, AND FOR ALL VALVES WHERE PERSISTENT SNOWFALL MAY OBSCURE THE VALVE BOX. GAUGE AND MONITOR USE OF ALL STOPPERS TO ENSURE ADEQUATE FEED.12. ___________________________, PHONE______________. NOTE ALL ACTUAL FOOTAGE, LOCATION AND MATERIAL CHANGES ON THE AS-BUILT IN RED. ( ') DENOTES17. FOOTAGE BETWEEN FITTINGS. 18.EXCESS FLOW VALVE TO BE INSTALLED ON ALL NEW RESIDENTIAL SERVICES PER GOS 2500.2200. (RECORD ALL INFORMATION ON D-4 CARD) PLUG ENDS OF DEACTIVATED OR INSERTED MAINS AND SERVICES IN ACCORDANCE WITH PSE GAS OPERATING INSIDE METER SETS SHALL BE MOVED OUTSIDE WHENEVER POSSIBLE OR SET REGULATORS AND VENTS OUTSIDE PER PROJECT MANAGER TO MAKE EGOR RUN IMMEDIATELY PRIOR TO STARTING CONSTRUCTION. MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS OPERATING STANDARDS 2525.3300, 2525.3400 REFER TO PSE GAS OPERATING STANDARD 2525.1700 FOR MAIN AND SERVICE COVER REQUIREMENTS. INSTALL CURB VALVE AT PROPERTY LINE OR 5/8" PE WHIP AT MAIN (AS REQUIRED) ON NEW AND EXISTING SERVICES INSTALL ANODES AND TEST LEAD WIRES AS REQUIRED PER PSE GAS FIELD PROCEDURES 4515.1000 AND 4515.1020 AND PSE GAS OPERATING STANDARD 2600.1200. TEST LEAD WIRES ARE REQUIRED ON ALL TRANSITION FITTINGS. MAINTAIN CATHODIC PROTECTION FOR STEEL MAINS BY THE USE OF CONTINUITY BONDS OR OTHER MEANS DETERMINED BY THE PSE CORROSION ENGINEER PER PSE GAS OPERATING STANDARD 2600.1300. INSTALL ONE POUND ANODE FOR EVERY 1000' OF LOCATING WIRE. INSTALL ANODE AND TEST LEAD WIRES PER PSE NOTIFY GAS CUSTOMERS, OR DISTRIBUTE FLYER #1443 A MINIMUM OF TWO WORKING DAYS PRIOR TO A PLANNED REPLACE ALL "NO RECORD" SERVICES AND 1-1/8" PE SERVICES INSTALLED PRIOR TO 1985. REPLACE EXISTING ACTIVE SERVICES PER PSE GAS OPERATING STANDARDS 2525.2100 AND 2575.2300. REMOVE OR RENDER INOPERABLE DEACTIVATED VALVES ON CASING WHERE MPE PIPE IS INSERTED. INSTALL REPLACEMENT MAINS PER PSE GAS OPERATING STANDARDS 2525.2100 FOR INSERTIONS AND 2525.3600 FOR STANDARDS 2525.2100 AND 2525.3600. PSE GAS OPERATING STANDARDS 2575.2300 AND 2550.1700. 11. 12. 14. 13. AND 2525.1200, AND PSE GAS FIELD PROCEDURE 4700.1500. PER PSE GAS OPERATING STANDARD 2550.1600. ABANDONMENT OR DEACTIVATION. 10. 9. 5. 6. 7. 8. GAS OPERATING STANDARD 2525.2300. 4. 1. 2. 3. OUTAGE. STANDARD IP & LP GAS REPLACEMENT CONSTRUCTION NOTES 15.ACTIVE SERVICES TO BE REPLACED DENOTED BY: HOLE HOG TABLE CALLOUT LOCATION DEPTH LENGTH BP1 START BP2 END BP3 START BP4 END BP5 START BP6 END BP7 START BP8 END BP9 START BP10 END BP11 START BP12 END BP13 START BP14 END BP15 START BP16 END BP17 START BP18 END BP19 START BP20 END STOP TIME START TIME GAS MAIN PRESSURE & TESTING TESTED BY GAS MAIN INSTALLATION/RETIREMENT SOAP AIR NITROGEN WATER SOAP AIR NITROGEN WATER STOP TIME START TIME TESTED BY TEST RESULTS P F TESTED BY PSE PRESSURE CONTROL, SEE FORM 1928 P F Type/Work ManufacturerPipe Size Type Est Length Act Lgth TYPE TEST / / DATE OFF PRESSURE DATE ON DATE OFF TYPE TEST PRESSURE SYS MAOPDESIGN PRESS DATE ON 2023 03/10 TEST RESULTS / / / / / / INSTALL 4"MPE 556' INSTALL 2"MPE 3' RETIRE 4"PE-A 530' RETIRE 2"PE-A 18' 60 45 PSIG DESIGNED BY UTILITIES CONTACT PHONE# COUNTY 1/4 SEC OP MAP Emer Sect GAS WK CTR PLAT MAP JOINT FACILITIES ARRANGEMENTS DRAWN BY CHECKED BY APPROVED BY CP APPROVAL MAPPING SCALE PAGE ENGR - GAS FUNCTION PROJECT MGR PERMITREAL ESTATE/EASEMENT 2 1 REV# 3 DATE DESCRIPTIONBY CONTACT PHONE NO DATE Drawing Number SAP Sup Order Nbr J.ANDERSON 425-398-6006 . . T.LY 425-424-6414 8/21/17 E.VOLIANSKYI 425-424-6428 8/22/17 M. JANSSON 425-466-9047 . N/A . N/A RENTON DUPONT PIPE MAIN REPLACEMENT 660 SW 39TH ST RENTON, WA 98057 PSE 109103168 1"=50'1/2 KING 31 SYSSKGPM SE-25-23-04, SW-30-23-05 212.074, 212.080 213.079, 213.080 ##### Cell Phone: "Locates Required" "Flagging Required" Yes No Yes No E-Mail: Manager: Project Manager Contact Information: JEFF ANDERSON 425-417-1764 jeff.anderson2@pse.com 109103168FIELD NOTES: 2. NOTIFY PROJECT MANAGER IF ADDITIONAL DUPONT AND/OR STW MATERIALS ARE FOUND DURING CONSTRUCTION, 1. ALL DUPONT AND STW PIPES SHALL BE RETIRED PER SCOPE OF WORK. INCLUDING AT OR BEYOND THE CONNECTION POINTS. FIELD DESIGNER: CELL: EMAIL: CONSTRUCTION QUESTIONS: PROJECT CONTACT INFORMATION: CONST MANAGER: CELL: EMAIL: PROJ MANAGER: CELL: EMAIL: FOR MAIN DESIGNS REALIGNMENTS - FIELD DESIGNER SHALL BE CONTACTED: BILLING QUESTIONS: 425-466-9047 MARK JANSSON mark.jansson@pse.com 206-255-4824 STEVE MELLINGER steve.mellinger@pse.com 425-417-1764 JEFF ANDERSON jeff.anderson2@pse.com SAP BATCH YEAR & FOOTAGE ACTUAL LENGTH OF RETIREMENT MATERIAL RETIRED ORIGINAL JOB ORIGINAL YEAR PROPOSED LENGTH OF RETIREMENT SIZE OF RETIRED MAIN WORK SITE MFP17004498 SW 39TH ST RAYMOND AVE SWIP GAS FLOW IP GAS FLOW IP GAS FLOW 701T&T 660 THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF EXISTING FACILITIES CALL 811 2 BUSINESS DAYS BEFORE YOU DIG For contacts below dial 1-888-CALL PSE (225-5773) DESIGNED BY UTILITIES CONTACT PHONE# COUNTY 1/4 SEC OP MAP Emer Sect GAS WK CTR PLAT MAP JOINT FACILITIES ARRANGEMENTS DRAWN BY CHECKED BY APPROVED BY CP APPROVAL MAPPING SCALE PAGE ENGR - GAS FUNCTION PROJECT MGR PERMITREAL ESTATE/EASEMENT 2 1 REV# 3 DATE DESCRIPTIONBY CONTACT PHONE NO DATE Drawing Number SAP Sup Order Nbr J.ANDERSON 425-398-6006 . . T.LY 425-424-6414 8/21/17 E.VOLIANSKYI 425-424-6428 8/22/17 M. JANSSON 425-466-9047 . N/A . N/A RENTON DUPONT PIPE MAIN REPLACEMENT 660 SW 39TH ST RENTON, WA 98057 PSE 109103168 1"=50'2/2 KING 31 SYSSKGPM SE-25-23-04, SW-30-23-05 212.074, 212.080 213.079, 213.080 Cell Phone: "Locates Required" "Flagging Required" Yes No Yes No E-Mail: Manager: Project Manager Contact Information: JEFF ANDERSON 425-417-1764 jeff.anderson2@pse.com PLOT PLAN SCALE: 1" = 50'-0" LEGEND ### T&T ### T&T KEY TO SERVICE ACTION Inspected Steel and PE pipe per GOS 2450.1400 and 2450.1500 Reviewed and complied with all construction notes. Recorded all required information on the as-built per GOS 2500.1700. Completed post installation inspection per GOS 2525.1200 and 2525.2700. Left the work area in a clean and safe condition. FITTER'S CHECKLIST Foreman's Name (printed) ___________________________________ Foreman's Signature________________________________________ Company: InfraSource Construction Date ______________ (CHECK BOX TO CONFIRM COMPLETION) 4680 06/11 Scale: NONE TIE-IN DETAIL1 - 1 - 2 Scale: NONE TIE-IN DETAIL2 LIND AVE SWMFP17004498