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Home My WebLink AboutMFP21000986.pdfDEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Minor Franchise Permit: MFP21000986 IVR Number: 21000986 Permit Information Permit Name: Puget Sound Energy Gas Permits Address/Location:03/08/2021Application Date:6198400125Parcel Number: 19016 116TH AVE SE Permit Type:04/01/2021Issue Date:Franchise Permit Work Class:04/01/2022Expiration Date:Minor Utility Job Number: 107059526Franchise Type:Natural Gas Description: PSE Gas Install 2" HVTT tie in on existing main 107025166 88'E of 117TH PL SE & 16'S of SE 191ST ST. Install 2" MPE 7 main via open trench approx. 40' to property line. Install 2" B.O. tie in on existing main 7428 10'W of 116TH AVE SE & 1397'S of SE 189TH PL. Install 2" MPE 7 main via open trench approx. 40' to property line. POTHOLE ALL EXISTING UTILITIES. RESTORATION PER CITY OF RENTON STANDARDS. Contacts Name Address PhoneTypeBilling Corrie Rydberg Puget Sound Energy 6905 S 228TH St KENT, WA 98032 C: (253) 905-5031ApplicantX INFRASOURCE SVCS B: (206) 949-5846Contractor Business License Number: 36742Construction Contractor: INFRASL871C2 CITY OF RENTON ROW 1055 S Grady Way Renton, WA 98057-3232 Owner General Conditions & 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. Ÿ This permit and plans must be posted at the job site at all times.Ÿ 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. Ÿ Call 425.430.7203 or go to: https://permitting.rentonwa.gov one working day in advance to schedule an inspections and for ANY work in the Right of Way. Ÿ Call 8 1 1 to locate underground utilities at least two full business days prior to any excavation.Ÿ 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 425.375.3397) 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. Ÿ (Date)(Signature) Page 1 of 1THIS PERMIT AND PLANS MUST BE POSTED AT THE JOB SITE AT ALL TIMES DEPARTMENT OF PUBLIC WORKS Note: The Applicant is responsible for compliance with all codes and regulations, whether or not described in this document. Page 1 of 2 | Published: 1ϭ/Ϯϱ/2019 Transportation Division | 1055 South Grady Way, 5th Floor | Renton, WA 98057 | 425-430-7380 Website: rentonwa.gov TRAFFIC CONTROL PLAN (TCP) APPLICATION Published: 1ϭ/Ϯϱ/2019 TRAFFIC CONTROL PLAN (TCP) MUST BE SUBMITTED TO PUBLIC WORKS TRANSPORTATION DIVISION FOR REVIEW/APPROVAL NO LATER THAN FIVE (5) WORKING DAYS BEFORE THE DATE OF WORK. The City of Renton requires any contractor, firm, corporation, or other public/private agency to prepare a TCP and obtain City of Renton's approval of that plan when construction, repair, or maintenance work is to be conducted within the city's right-of-way. TO THE APPLICANT: Submit the TCP application form and required submittal documents to TCP@rentonwa.gov with the subject line “TCP Application – [Project Name]” or the above address. The following items, electronic copies preferred, are all required for submittal of the TCP Application: 1.܆ A copy of the Traffic Control Plan (TCP) Application form. 2.܆ A copy of the required TCP layout, preferred 11” X 17” paper size format, which shall: ܆ Include map(s) showing the location of the project and work area. ܆ Be legible lettering and clear, contrasting, symbols of viewing or printing. ܆ Must indicate street names, and north arrow and scale. ܆ All signs and detour routes shall conform to the MUTCD, WSDOT TCPs, and the Washington State Traffic Control Flagger Certification handbook, by the Evergreen Safety Council. ܆ Types of plans required: ܆ Work hour plan – show all mobility impacts during construction hours. ܆ Non-work plan - show all mobility impacts after work hours when limited or no work is happening in the right-of-way (ROW), if applicable. ܆ Changing construction phases – show construction sequence and each construction phase change even if the traffic control is not modified, if applicable. ܆ Pedestrian access/detour plan, if applicable. Project Name: ______________________________________________ Permit #: _____________________ Project Address: ____________________________________________________________________________ Work Date: From _____________ To _____________ Work Time: Start ______________ End ______________ Description of Work, Work Schedule, Equipment Used: _____________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Construction Company: ________________________________________ Phone/Cell: (_____) _____-________ Applicant Name: _________________________________ Email: ______________________________________ Business Address: _________________________________ City/State: __________________ Zip: __________ Approved By: _______________________________________________ Date: ________________________ Transportation Operations Engineering 4 4 4 4 4 4 4 4 4 4 4 107059526 19016 116TH AVE SE Monday Friday 8:00am 3:00pm PLEASE SEE ATTACHED POTELCO, INC 425 892 0416 RANDY BLACKIE RANDY.BLACKIE@PSE.COM 6905 S. 228TH ST KENT, WA 98032 MFP21000986 Scott Warlick CED 3/29/2021 MFP21000986 Note: The Applicant is responsible for compliance with all codes and regulations, whether or not described in this document. Page 2 of 2 | Published: 1ϭ/Ϯϱ/2019 APPLICANT AGREES TO ALL THE FOLLOWING: x TCP must be approved prior to commencing the work, and all permit conditions shall be met. x Existing pedestrian access shall be maintained. The work on pedestrian facilities shall be limited to one corner at a time, with the least possible inconvenience or delay to pedestrians. x Signage shall be used to warn motorcyclists/bicyclists of the potential hazards on any uneven surfaced or slippery road conditions during work and non-work hours. x The start of Work Time begins when any street or travel lane is fully/partially closed or impacts the follow of traffic. This includes set up within the traveled way or immediately adjacent to the roadway. x Emergency services (253-852-2121) shall be notified twenty-four (24) hours before any street or lane closures. x Contractor or entity must call Renton School District (425-204-4455) or any public/private agency, including public transit, to be affected by a temporary lane or road closure. x TCP for all street and/or lane closures shall be implemented and performed in compliance with the Manual on Uniform Traffic Control Devices (MUTCD) and/or State of Washington Department of Transportation (WSDOT) and all traffic regulations of the City of Renton and Revised Code of Washington (RCW). x 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 RCW 47.36.200 Signs or Flaggers at thoroughfare work sites and RCW 9A.36.050 Reckless Endangerment, and other applicable State and City codes. x 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 Applicant’s agents and employees. x 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. x In the event any claim or suit is brought against the City within the scope of this Agreement, Applicant will pay for legal counsel chosen by the City to defend against same. x Flagger and sign placement are subject to revision by the City Inspector on site, if needed to address traffic or pedestrian safety or travel. x Total road closure lasting more than twenty-four (24) hours is subject to the approval by the City Council. x Approved Temporary TCP must be at the work site during work hours. x Complete assistance and accommodation shall be provided to all kinds of pedestrian traffic when sidewalk or walkway is impeded to safely redirect pedestrians around a work zone. x 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: x Contractor must complete form to show limits of Temporary No Parking Zone identifying barricade locations for vacate parking or curb lane usage. x Contractor must post notice of dates and time of Temporary No Parking Zone with at least two signs per block seventy-two (72) hours in advance of effective date and time. x The cover sheet of this TCP form must be attached to each Temporary No Parking Sign on the project site. x 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; 425-430-7423). _______________________________ _______________________________ _______________________ Applicant’s Signature Print Name Date CORRIE RYDBERG MFP21000986 19016 116th Ave SE Renton WA 98058 USA 11111111 111111111111 SE 192ND ST 116TH AVE SE1111SE 190TH LN 116TH AVE SE1111 SE 189TH LN 101012.512.5171111 1111 STOP FLAGGER STOP FLAGGER W20-7AROAD WORK AHEAD W20-1W20-4ONE LANEROADAHEAD200'200'200'W20-7AROADWORKAHEADW20-1W20-4ONE LANEROADAHEAD200'200'200'ROADWORKAHEADW20-1BEPREPAREDTOSTOPW3-4100'100'ROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4 100'100'ROADWORKAHEADW20-1BEPREPAREDTOSTOPW3-4350'350'ROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4 350'350' W20-7AROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4 100'100'100' SE 192ND ST SIGN SPACING MPH 60/65 45/55 35/40 30 25 "X" 1000' 500' 350' 200' 100' CHANNELIZATION DEVICE SPACING MPH 55/70 35/45 25/30 TAPER 40 30 20 TANGENT 80 60 40 TEMPORARY TRAFFIC CONTROL PLAN TRENCH 28" TRAFFIC CONE LEGEND TRAFFIC FLOW SIGN LOCATION FLAGGER STOP WORK VEHICLE/ FLASHING LIGHTS RIGHT OF WAY PSE PUGETSOUNDENERGY JOB#107059526 19016 116th Ave SE, Renton, WA 98059 3/2/2021 safaa.alneema@pse.com (425) 398-6077 SHEET 1 of 4 Notes: 1. All signs and spacing to conform to the MUTCD and City of Renton standards. 2. All sidewalks, driveways, exits and egresses shall be completely clear unless otherwise indicated. 3. Channelizing devices are 28" traffic cones. Use traffic drums (barrels) with steady burning Type C lights on all State State Routes and Hwys. 4. Sign size can be a minimum of 36" x 36" and shall not obstruct pedestrian access. 5. Crew is required to leave a minimum of 11' for traveling lane width. 6. Alert affected residents and businesses. 7. Work to take place between 9 a.m. and 4 p.m unless otherwise specified. All work for arterials and major roadways will be from 9 a.m. to 3 p.m. 8. Work area will be 397' SCL of SE 189th Ln & 10' WCL of 116th Ave SE. N Puget Sound Energy Traffic Control Supervisor: Safaa Al Neema Card No. 012611 Card Exp. 10/31/2024 Safaa.alneema@pse.com (425)398-6077 MFP21000986 19016 116th Ave SE Renton WA 98058 USA 11111111 111111111111 SE 192ND ST 116TH AVE SE1111SE 190TH LN 116TH AVE SE1111 SE 189TH LN 101012.512.5171111 1111 STOP FLAGGER STOP FLAGGER W20-7AROAD WORK AHEAD W20-1W20-4ONE LANEROADAHEAD200'200'200'W20-7AROADWORKAHEADW20-1W20-4ONE LANEROADAHEAD200'200'200'ROADWORKAHEADW20-1BEPREPAREDTOSTOPW3-4100'100'ROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4 100'100'ROADWORKAHEADW20-1BEPREPAREDTOSTOPW3-4350'350'ROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4 350'350' W20-7AROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4 100'100'100' SE 192ND ST RESIDENT(S) WILL BE INFORMED OF TEMPORARY DRIVEWAY CLOSURE EMERGENCY VEHICLES WILL BE ALLOWED TO PASS WORK ZONE. SIGN SPACING MPH 60/65 45/55 35/40 30 25 "X" 1000' 500' 350' 200' 100' CHANNELIZATION DEVICE SPACING MPH 55/70 35/45 25/30 TAPER 40 30 20 TANGENT 80 60 40 TEMPORARY TRAFFIC CONTROL PLAN TRENCH 28" TRAFFIC CONE LEGEND TRAFFIC FLOW SIGN LOCATION FLAGGER STOP WORK VEHICLE/ FLASHING LIGHTS RIGHT OF WAY PSE PUGETSOUNDENERGY JOB#107059526 19016 116th Ave SE, Renton, WA 98059 3/2/2021 safaa.alneema@pse.com (425) 398-6077 SHEET 2 of 4 Notes: 1. All signs and spacing to conform to the MUTCD and City of Renton standards. 2. All sidewalks, driveways, exits and egresses shall be completely clear unless otherwise indicated. 3. Channelizing devices are 28" traffic cones. Use traffic drums (barrels) with steady burning Type C lights on all State State Routes and Hwys. 4. Sign size can be a minimum of 36" x 36" and shall not obstruct pedestrian access. 5. Crew is required to leave a minimum of 11' for traveling lane width. 6. Alert affected residents and businesses. 7. Work to take place between 9 a.m. and 4 p.m unless otherwise specified. All work for arterials and major roadways will be from 9 a.m. to 3 p.m. 8. Work area will be 397' SCL of SE 189th Ln & 30' ECL of 116th Ave SE. N Puget Sound Energy Traffic Control Supervisor: Safaa Al Neema Card No. 012611 Card Exp. 10/31/2024 Safaa.alneema@pse.com (425)398-6077 MFP21000986 13131515SE 191ST ST116TH AVE SE STOPFLAGGERSTOPFLAGGER W20-7AROAD WORK AHEAD W20-1W20-4ONE LANEROADAHEAD100'100'100'W20-7AROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4100'100'100'PLACE SIGNSBOTH SIDES OFWORK AREAFROMTOTOW AWAY AREAPHONE 888-9999INFRASOURCE LLC 000 0000000NO PARKINGNO-PARK FROM TO TOW AWAY AREA PHONE 888-9999 INFRASOURCE LLC 000 0000000 NO PARKING NO-PARK RESIDENT(S) WILL BE INFORMED OFTEMPORARY DRIVEWAY CLOSUREEMERGENCY VEHICLES WILL BEALLOWED TO PASS WORK ZONE.TEMPORARY TRAFFIC CONTROL PLANTRENCH28" TRAFFIC CONELEGENDTRAFFIC FLOWSIGN LOCATIONFLAGGERSTOPWORK VEHICLE/FLASHING LIGHTSRIGHT OF WAYSIGN SPACINGMPH60/6545/5535/403025"X"1000'500'350'200'100'CHANNELIZATIONDEVICE SPACINGMPH55/7035/4525/30TAPER403020TANGENT806040NPuget Sound EnergyTraffic Control Supervisor:Safaa Al NeemaCard No. 012611Card Exp. 10/31/2024Safaa.alneema@pse.com(425)398-6077PSEPUGETSOUNDENERGYJOB#10705952619016 116th Ave SE, Renton, WA 980593/2/2021safaa.alneema@pse.com(425) 398-6077SHEET 3 of 4Notes:1. All signs and spacing to conform to theMUTCD and City of Renton standards.2. All sidewalks, driveways, exits and egressesshall be completely clear unless otherwise indicated.3. Channelizing devices are 28" traffic cones.Use traffic drums (barrels) with steady burningType C lights on all State State Routes and Hwys.4. Sign size can be a minimum of 36" x 36" 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.munless otherwise specified. All work for arterialsand major roadways will be from 9 a.m. to 3 p.m.8. Work area will be 16' NCL of SE 191st St & 110'ECL of 117th Pl SE.MFP21000986 13131515SE 191ST ST116TH AVE SE STOP FLAGGERSTOPFLAGGER W20-7AROAD WORK AHEAD W20-1W20-4ONE LANEROADAHEAD100'100'100'W20-7AROADWORKAHEADW20-1 BEPREPAREDTOSTOPW3-4100'100'100'PLACE SIGNSBOTH SIDES OFWORK AREAFROMTOTOW AWAY AREAPHONE 888-9999INFRASOURCE LLC 000 0000000NO PARKINGNO-PARKFROM TO TOW AWAY AREA PHONE 888-9999 INFRASOURCE LLC 000 0000000 NO PARKING NO-PARK RESIDENT(S) WILL BE INFORMED OFTEMPORARY DRIVEWAY CLOSUREEMERGENCY VEHICLES WILL BEALLOWED TO PASS WORK ZONE.FLAGGERS WILL ASSISTPEDESTRIAN AROUNDWORK ZONETRENCH28" TRAFFIC CONELEGENDTRAFFIC FLOWSIGN LOCATIONFLAGGERSTOPWORK VEHICLE/FLASHING LIGHTSRIGHT OF WAYSIGN SPACINGMPH60/6545/5535/403025"X"1000'500'350'200'100'CHANNELIZATIONDEVICE SPACINGMPH55/7035/4525/30TAPER403020TANGENT806040NPuget Sound EnergyTraffic Control Supervisor:Safaa Al NeemaCard No. 012611Card Exp. 10/31/2024Safaa.alneema@pse.com(425)398-6077Notes:1. All signs and spacing to conform to theMUTCD and City of Renton standards.2. All sidewalks, driveways, exits and egressesshall be completely clear unless otherwise indicated.3. Channelizing devices are 28" traffic cones.Use traffic drums (barrels) with steady burningType C lights on all State State Routes and Hwys.4. Sign size can be a minimum of 36" x 36" 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.munless otherwise specified. All work for arterialsand major roadways will be from 9 a.m. to 3 p.m.8. Work area will be 16' SCL of SE 191st St & 110'ECL of 117th Pl SE.TEMPORARY TRAFFIC CONTROL PLANPSEPUGETSOUNDENERGYJOB#10705952619016 116th Ave SE, Renton, WA 980593/2/2021safaa.alneema@pse.com(425) 398-6077SHEET 4 of 4MFP21000986 116TH AVE SESE 189TH PLACE (PUBLIC) SE 191ST ST (PUBLIC) SE 189TH PLACE (PUBLIC)(PUBLIC)116TH AVENUE SE(PUBLIC)ROAD A ROAD A TRACT B LOT 1 LOT 2 LOT 3 LOT 4 LOT 5 LOT 6 LOT 7 2" MPE IP 16'S 107025166 - 2006 JT 2" MPE IP 16'S TO 12'S 107025166 -- 2006 JT 153'W 139'S 325'N 2" MPE IP 21'W107026163 - 2007 JT5/8" MPEI2010-E36'E11719 5/8" MPE 1996 562'N 2" STW IP 10'W7428-19652" STW IP 10'W7428-6530'E17'S2" MPE IP 16'W107025166 - 2006 JTF.H.UTILITY CONFLICT 117TH PL SE(PUBLIC)11725 11731 19015 19009 1911319101 19107 11645 60'26'47'33'FLOWFLOW FLOWFLOWFLOW FLOW'A' 'B' SEE CONST. DETAIL TRACT A 19030 19021 441'N 5.5' ROW DEDICATION9'WOwner / Developer Contact Info officeATTN: 19016 116th LLC 39805 212TH AVE SE ENUMCLAW, WA 98022 SCOTT L JEPSON 253.592.4299 THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF EXISTING FACILITIES CALL (800) 424-5555 2 BUSINESS DAYS BEFORE YOU DIG For contacts below dial 1-888-CALL PSE (225-5773) GENERAL NOTES - GAS (JOINT TRENCH): 1" = 50'105094139 107059526 Excavator to contact Utilities Underground Location Center (One-Call) 48 hours prior to construction, to two working days prior to construction. 1-800-424-5555 Notify appropriate permitting agency prior to job start (see permit requirements). Erosion and sediment control shall be per PSE Standard Practice 0150.3200 Techniques for Temporary Erosion and Sediment Control and any additional local jurisdiction requirements. Any change in route, pipe size/type, tie-in method or additional main footage must be approved by the appropriate Engineer/Project Manager. Complete "Exposed Pipe Condition Report" on all exposed existing Steel PSE Facilities. Check box on report for wire box (Test Lead) installation. Pipeline Markers and Warning Signs shall be installed and recorded by the Contractor per PSE Gas Operating Standard 2525.2500. To prevent accidental overpressure of adjoining systems, no two mains shall be connected, except as shown on this design, unless approved by the appropriate Engineer/Project Manager. System MAOP denoted by System MAOP = 60 PSIG Install Main Valves out of traffic where possible. Gauge (use Manometer for LP Systems) and monitor use of all stoppers and squeezes to insure adequate feed. Install one pound Anode for every 1000' of locating wire. Install Anode and Test Lead Wires per PSE Gas Operating Standards 2525.1200 and 2525.2300. If STW pipe involved, coordinate installation with CP Tech. ____________ Cell # ___________ . Purge Points and Pressure Taps shall be installed per PSE Gas Operating Standards 2525.3400 and PSE Gas Field Procedures Manual 0812 and 0813. Mains and services shall be tested and purged per PSE Gas Operating Standards 2525.3300 and 2525.3400. Unless otherwise noted: All pipes installed in plat to be 2" MPE-___. All crossings to be Yellow 4" PVC. All Services to be 1-1/8" PE. / denotes service stub location. (________') denotes footage between fittings. Customer to dig and backfill on private property or easement only. Trenches must conform to PSE Gas Operating Standards 2525.1500, 2525.1600 and 2525.1700. Note all recordable footages, locations and material changes on the as-built in red. Upon completion of the project send the print copy, along with the completed work order, listing crew & actual materials used to the appropriate design group. On site pre-con required before start of job. At symbol: install natural gas main piping and fixtures. Size as indicated on tables and work sketch (gas main is to parallel power system unless otherwise shown on work sketch). Inclement weather conditions may cause delays in construction times and dates. 19. 20. 18. 16. 17. 15. 14. 13. 6. 9. 11. 12. 10. 8. 7. 3. 5. 4. 2. 1. 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 ELEC Order Number SAP Sup Order Nbr PC APPROVAL R. BLACKIE 425.457.2614 . K.COSTLEY 425.272.7075 11.23.20 E. PASAYE . 11.18.20 REDT # ( RW-117396 )CITY OF RENTON WANG SHORT PLAT 2" MPE-___ GAS MAIN EXTENSION - 7 S/F LOTS 19016 116TH AVE SE, RENTON, WA 98058 PUGET SOUND ENERGY 107059526 105094139 1" = 50' 1 OF 2 KING 132A CIKNC 33SW-T23N-R05E 212.080 215.084 COMCAST TODD ZIMNY . LUMEN TECHNOLOGIES KENNETH LUU 206.346.0144 RIGHT OF WAY AMBER YANG 425.456.2774 . . . ... ... 21. 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: __________________ Date ______________ (CHECK BOX TO CONFIRM COMPLETION) 509074578 107059526 N/A 106365570 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A GAS PROJECT PHASE Notification #Order # Retirement Relocate SAP Superior Service Stubs Service/Meter HP Svc/MSA Dis. Reg. / FT Ind. MSA Ind. Service Service/Meter Service/Meter 4680 06/11 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 02/18 TEST RESULTS / / / / / / Verify Testing Requirements, Chart vs Gauge GOS 2525.3300 sec. 5, Table 5-1 and sec. 5.5 INSTALL 2" MPE-_ 97 FT JOINT 2" MPE-_ 563 FT .. .. .. .. .. .. .. .. Cell Phone: Project Manager Contact Information: "Locates Required" "Flagging Required" Yes No Yes No E-Mail: Manager:RANDY BLACKIE 425.457.2614 randy.blackie@pse.com 60 IP 132-60 N/A N/A SITE PLAN xx INSTALL 2" = 97 FT JOINT 2" = 563 FT ... ... ... Scott@AnaiyahHomes.com IP 132-60 STOP TIME START TIME GAS MAIN PRESSURE & TESTING TESTED BY 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 TEST / / DATE OFF PRESSURE DATE ON DATE OFF TYPE TEST PRESSURE SYS MAOPDESIGN PRESS DATE ON 2023 03/10 TEST RESULTS / / / / / / STOP TIME START TIME TESTED BY SOAP AIR NITROGEN WATER P F TYPE TEST / / DATE OFF PRESSURE DATE ON TEST RESULTS / / STOP TIME START TIME TESTED BY SOAP AIR NITROGEN WATER P F TYPE TEST / / DATE OFF PRESSURE DATE ON TEST RESULTS / / STOP TIME START TIME TESTED BY SOAP AIR NITROGEN WATER P F TYPE TEST / / DATE OFF PRESSURE DATE ON TEST RESULTS / / STOP TIME START TIME TESTED BY SOAP AIR NITROGEN WATER P F TYPE TEST / / DATE OFF PRESSURE DATE ON TEST RESULTS / / GASSED UP PIPELINE PIPE SEGMENT FOREMAN'S DATENAME 60 Verify Testing Requirements, Chart vs Gauge GOS 2525.3300 sec. 5, Table 5-1 and sec. 5.5 N Vicinity Map 47.4316, -122.1863 SITE 2" HVTT TIE-IN 16'S C/L & 110'E C/L ______'S C/L & _____'E C/LPROP. 2"PROP. 2" T01 CONSTRUCTION DETAIL N.T.S. BEGIN JOINT MAIN 14'N C/L & 110'E C/L ______'N C/L & _____'E C/L 2" POLYVALVE/OPEN W/ BOX & SUPPORT 19'N C/L & 110'E C/L ______'N C/L & _____'E C/L 2" 90° ELBOW 28'N C/L & 110'E C/L ______'N C/L & _____'E C/L JOINT 2" MPE-___ 5' @ 110'E C/L (______)' @ _____'E C/L JOINT 2" MPE-___ 9' @ 110'E C/L (______)' @ _____'E C/L INSTALL 2" MPE-___ 30' @ 110'E C/L (______)' @ _____'E C/L JOINT 2" MPE-___ 549' @ 28'N C/L TO 18'N C/L (______)' @ _____'N C/L TO _____'N C/L CROSSING CONDUIT TABLE X-ING # LOCATION GAS POWER XING LENGTH TYPE OF CROSSING (Feeder, Primary, Secondary, etc.)FROM TO SIZE (IN)TYPE QTY LOCATION SIZE (IN)TYPE QTY CONDUIT OFFSET (As Built) X01 'A' 'B' 4 40 1 E 2 80 1 ( )' ECL 55 GAS MAIN, PRIMARY 3 80 1 ( )' ECL 55 SECONDARY 4" PVC PLUG /CAPS = 2 4" YELLOW SCH 40 PVC = 55 FT 2" SCH 80 GREY PVC = 55 FT 2" PVC PLUG /CAPS = 2 3" SCH 80 GREY PVC = 55 FT 3" PVC PLUG /CAPS = 2 2" B.O. TIE-IN W/ 90 DEG WELD 397'S C/L & 10'W C/L ______'S C/L & _____'W C/L 2" T.L. & T.F. 397'S C/L & 11'W C/L ______'S C/L & _____'W C/L BEGIN JOINT MAIN & 2" POLYVALVE/OPEN W/ BOX & SUPPORT 18'N C/L & 57'E C/L ______'N C/L & _____'E C/L INSTALL 2" MPE-___ 66' @ 397'S C/L (______)' @ _____'S C/L INSTALL 2" MPE-___ 1' @ 397'S C/L (______)' @ _____'S C/L MFP21000986 This is a private storm system. city separations do not apply to private systems. Please adjust your conduits north to provide room for the fire hydrant. RESTORATION PER CITY OF RENTON STANDARDS POTHOLE ALL EXISTING UTILITIES THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF EXISTING FACILITIES CALL (800) 424-5555 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 ELEC Order Number SAP Sup Order Nbr PC APPROVAL R. BLACKIE 425.457.2614 . K.COSTLEY 425.272.7075 11.23.20 E. PASAYE . 11.18.20 REDT # ( RW-117396 )CITY OF RENTON WANG SHORT PLAT 2" MPE-___ GAS MAIN EXTENSION - 7 S/F LOTS 19016 116TH AVE SE, RENTON, WA 98058 PUGET SOUND ENERGY 107059526 105094139 N/A 2 OF 2 KING 132A CIKNC 33SW-T23N-R05E 212.080 215.084 COMCAST TODD ZIMNY . LUMEN TECHNOLOGIES KENNETH LUU 206.346.0144 RIGHT OF WAY AMBER YANG 425.456.2774 . . . ... ... ... ... ... EX PLAT MAP 215.084 NOT TO SCALE 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: __________________ Date ______________ (CHECK BOX TO CONFIRM COMPLETION) JOINT TRENCH DETAIL NOTES: 1. If the final backfill contains rocks greater than 8 inches in diameter, install 12 inches compacted sand shading across the full width of the trench. * If the final backfill contains rocks 8 inches in diameter or smaller, install 6 inches compacted sand shading across the full width of the trench. * 2. Rocks greater than 10 inches diameter are not permitted in the final backfill. 3. Sand bedding is required under PSE gas pipe. Bedding is not required for the full width of the trench; it shall extend from the side of the trench nearest to where the gas main/service is installed to a minimum of 6 inches on the opposite side of the gas line. 4. Utilities shall not be stacked over the gas line in the trench. 5. If wet utilities will be included in the trench, please contact PSE or local power company directly for clearance requirements. 6. Reduced clearance of 4 inches between power and communication, must have approval of the communications companies. * Alternatives to full-width trench shading require PSE approval. Primary & Secondary-Mainline Gas & Communications (NTS) Primary Dirt Pile Final Grade 24" Min 36" Min Cover Over Power 48" Max Depth Final Backfill Gas 4" Sand Bedding Property Line intercept (depth varies). SidewalkCurb Location of roof drain 48" Typical Width may vary per Number of Utilities and Conduits 6" or 12" Min Sand Shading Over Gas after Compaction 12" Min R/W or Excavated 12" Typical Power Secondary Power TV & TEL 12" Min 12" Min Separation 4,5 1,2 1 3 6 6" or 12" Min Sand Shading Over Power after Compaction1 42" 45°42" 1' 45°Property LineRoad Side Top View of Mainline Trench for Single Stubout Location 4'Property LineRoad Side Top View of Mainline Trench for Pedestal or Double Stubout Location 42"45° 4' 45° STUBOUT EXCAVATION DIMENSIONS NOT TO SCALE GAS SERVICE PIPE TABLE DESCRIPTION OF ACTIVITIES LOCATION PIPE DESIGN AS-BUILT FROM TO LOT SIZE (IN)TYPE LENGTH (FT)LOCATION LENGTH (FT) EFV SIZE LOCATION REMARKS SS SINGLE 2" MAIN 1 1 1/8 MPE-__10 ( ')ECL 2600 SS SINGLE 2" MAIN 2 1 1/8 MPE-__10 ( ')ECL 2600 SS SINGLE 2" MAIN 3 1 1/8 MPE-__10 ( ')ECL 2600 SS SINGLE 2" MAIN 4 1 1/8 MPE-__10 ( ')ECL 2600 SS SINGLE 2" MAIN 5 1 1/8 MPE-__10 ( ')WCL 2600 SS SINGLE 2" MAIN 6 1 1/8 MPE-__10 ( ')WCL 2600 SS SINGLE 2" MAIN 7 1 1/8 MPE-__10 ( ')ECL 2600 SS SINGLES = 7 70 FT 1 1/8" PE PIPE SITE NOT TO SCALE CROSS SECTION - SE 191ST ST LOOKING WEST N 47' ROW PROP. 2" MPE IP - 28'NCL S GGEX 2" MPE IP - 16'S 107025166-2006 JT NOT TO SCALE CROSS SECTION - ROAD A LOOKING WEST N 26' ROW PROP. 2" MPE IP - 18'NCL S G MFP21000986