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CityofPuyallup,WA CollectionSystemInfiltration&InflowStudy2012 APPENDIXB SiteReports ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_01 FS 5000 AG 8.00" 166.219.8.140 8.13" 5-037 21251 Shaw Rd just north of 27th Ave SE Drive Site Location Site Location Concrete / Good 8' - 0" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 12:30 1 inlet / 1 outlet No influence Small waves, choppy, steady 1207 3 inlets / 1 outlet 1.50" 0.25" 2.00 fps 0.00" 6.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 8.13" x 8.00" Ultra, velocity, pressure sensors location 27th Ave SE Outlet 47° 9'57.62"N 122°15'15.14"W Shaw Rd Inlet 8.13" x 8.00" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_01 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 12 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_02 FS 5000 AG 9.75" 166.219.8.54 9.88" 6-077 21246 2901 Briarwood Ct S Drive Site Location Site Location Concrete / Good 12' PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 11:02 2 inlets / 1 outlet No influence Ripples and steady flow 2901 1 inlet / 1 outlet 2.25" 0.25" 2.25 fps 0.00" 7.75" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 15 PSI Pressure to be used Outlet Inlet 9.88" x 9.75" Ultra, velocity, pressure sensors location Outlet 47° 9'51.04"N 122°15'43.23"W Forest Glen Blvd Inlet 9.88" x 9.75" Briarwood Ct S 24th St SE Briarwood Ct N 2900 ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_02 Site is located adjacent to low volume intersection, follow attached traffic plan for traffic control ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Inches Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 7-0 ft. deep flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_03 FS 5000 AG 36.25" 166.213.6.99 36.00" 80-027 21252 1909 13th Ave NW Drive Site Location Site Location Concrete / Good 7' - 0" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 14:19 2 inlets / 1 outlet No influence Smooth slow flow 2 inlets 1 outlet 3.50" 0.25" 1.25 fps 0.00" 32.50" 0.25" Standard Ultra, Velocity, Pressure 4 RG_01 5 PSI Pressure to be used Outlet Inlet 36.00" x 36.25" Ultra, velocity, pressure sensors location Outlet 47°12'9.36"N 122°19'13.37"W Inlet 36.00" x 36.25" 13th Ave NW 19th St PL NW 20th St NW in MH ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_03 Site is located in low volume intersection, follow approved TCP which is attached ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 10 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_04 FS 5000 AG 14.13" 166.213.163.228 14.25" 137-017 21480 1207 Shaw Rd Drive Site Location Site Location Concrete / Good 10' - 0" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 11:48 2 inlet / 1 outlet No influence Small waves, choppy, steady 1207 1 inlet / 1 outlet (45 degree bend) 2.50" 0.25" 2.00 fps 0.00" 12.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 14.25" x 14.13" Ultra, velocity, pressure sensors location Highlands Blvd Outlet 47°10'46.63"N 122°15'22.27"W Shaw Rd Inlet 14.25" x 14.13" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_04 Manhole doesn’t have rungs, tripod use only and self rescue equipment needed ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 9-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_05 FS 5000 AG 11.75" 166.213.163.227 12.00" 133-048 21243 1325 12th Ave SE Drive Site Location Site Location Concrete / Good 9' - 0" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 12:00 2 inlets / 1 outlet No influence Smooth slow flow 3 inlets 1 outlet (trunk line) 3.50" 0.25" 1.00 fps 0.00" 8.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 12.00" x 11.75" Ultra, velocity, pressure sensors location Outlet 47°10'51.02"N 122°16'33.25"W Inlet 12.00" x 12.00" 1325 ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_05 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 15-5 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_06 FS 5000 AG 17.88" 166.219.8.46 18.00" 84-005 21347 219 N Levee Rd Drive / Walk Site Location Site Location Concrete / Good 15' - 5" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 13:53 2 inlet / 1 outlet (T-pipe MH configuration) No influence Wavy and steady flow 219 1 inlet / 1 outlet (wavy) 2.75" 0.25" 2.50 fps 0.00" 15.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 15 PSI Pressure to be used May be able to drive to site but check ground, could be too soft in the winter Outlet Inlet 18.00" x 17.88" Ultra, velocity, pressure sensors location N Levee Rd Outlet 47°12'16.95"N 122°17'50.74"W N Meridian Ave Inlet 18.00" x 17.88" Park here ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_06 Have to walk through wooded area to get to site, watch footing and blackberry bushes ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 11-2 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_07 FS 5000 AG 8.00" 166.213.163.229 8.00" 102-003B 21547 1823 E Main Ave Drive Site Location Site Location Concrete / Good 11'-2" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 10:18 3 inlet / 1 outlet No influence Choppy steady flow (may surcharge during pump station fill) 1823 Pump station wet well 2.00" 0.25" 2.50 fps 0.00" 6.00" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Outlet Inlet 8.00" x 8.00" Ultra, velocity, pressure sensors location 17th St SE Outlet 47°11'31.16"N 122°16'9.62"W 12th Ave SE Inlet 8.00" x 8.00" E Main Ave 10' (d/s) ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_07 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Inches Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_08 FS 5000 AG 18.00" 166.219.8.93 18.00" 109-039 21697 324 7th Ave NW Drive Site Location Site Location Concrete / Good 8' - 0" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 14:52 2 inlets / 1 outlet No influence Ripples with steady flow 2 inlets 1 outlet 3.50" 0.25" 1.50 fps 0.00" 14.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG_01 5 PSI Pressure to be used Outlet Inlet 18.00" x 18.00" Ultra, velocity, pressure sensors location Outlet 47°11'47.94"N 122°17'54.28"W Inlet 18.00" x 18.00" 7th Ave NW 4th St NW 324 7th Ave NW ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_08 Site located just south of intersection, follow approved TCP that is attached ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Inches Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 7-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_09 FS 5000 AG 10.75" 166.219.8.1 10.75" 107-065 21464 703 4th St SE Drive Site Location Site Location Brick / Poor 7' - 0" Clay / Ok Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 11:30 2 inlets / 1 outlet No influence Small waves steady flow 2 inlets 1 outlet (trunk line) 3.00" 0.25" 1.25 fps 0.00" 7.75" 0.25" Standard Ultra, Velocity, Pressure 3 RG_01 5 PSI Pressure to be used Outlet Inlet 10.75" x 10.75" Ultra, velocity, pressure sensors location Outlet 47°11'10.27"N 122°17'24.15"W Inlet 10.75" x 10.75" 7th Ave SE 4th St SE 703 4th St SE 50' (d/s) ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_09 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 10-2 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_10 FS 5000 AG 11.50" 166.213.8.225 11.50" 10-031 20087 7th St SE (between Mosolf Rd and College Way), Bradley Lake Park. (MH located at north tip of Lake Bradley, next to trail) Drive/walk Site Location Site Location Concrete / Good 10' - 2" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 10:45 2 inlet / 1 outlet (wavy flow) No influence Smooth steady flow Park entrance SW Barton St 2 inlet / 1 outlet (wavy flow) 3.25" 0.25" 1.50 fps 0.00" 8.75" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 11.50" x 11.50" Inlet 11.50" x 11.50" College Way 21st Ave SW Ultra, velocity, pressure sensors location 7th St SE Outlet Side line Side line 47° 9'46.25"N, 122°17'4.33"W ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space Site is located beside a walking path, make sure to create blockade for pedestrians * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/13/11 10/13/11 Signed copy can be obtained from ADS Puyallup_10 ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 10 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_11 FS 5000 AG 11.50" 166.219.8.217 11.75" 5-022 21766 2505 30th Ct SE Drive Site Location Site Location Concrete / Good 10' - 0" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 11:22 2 inlets / 1 outlet No influence Small waves, steady flow 2505 3 inlets / 1 outlet 2.25" 0.25" 2.50 fps 0.00" 9.75" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 11.75" x 11.50" Ultra, velocity, pressure sensors location 26th Ave SE Outlet 47°10'0.97"N 122°15'16.08"W Shaw Rd Inlet 11.75" x 11.50" 30th St CT SE Cherokee Blvd Side line ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_11 Site is located in low volume intersection, follow attached traffic plan for traffic control ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-1 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_12 FS 5000 AG 7.88" 166.219.8.50 7.75" 140-038 21489 2520 20th Ave Ct SE Drive Site Location Site Location Concrete / Good 8' - 1" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 11:35 1 inlet / 1 outlet (fast low flow) No influence Smooth slow flow 20th Ave Ct SE 1 inlet / 1 outlet 2.75" 0.25" 1.00 fps 0.00" 5.25" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Install up pipe as far as possible to get away from influence of other line Outlet Inlet 7.75" x 7.88" Inlet Brookmonte Dr 2520 Ultra, velocity, pressure sensors location 19th Ave Ct SE Outlet Side line 47°10'21.23"N 122°15'40.75"W 2509 2517 Brookmonte Dr Inlet 7,75" x 7.88" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space Site is located on low traffic volume sidewalk, close sidewalk and detour pedestrian to other side of street * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/13/11 10/13/11 Signed copy can be obtained from ADS Puyallup_12 ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_13 FS 5000 AG 14.50" 166.219.8.45 14.25" 108-008 21475 E Pioneer Ave at HWY 512 on/off ramp (east side of HWY) Drive Site Location Site Location Concrete / Good 8' - 0" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 13:41 1 inlet / 1 outlet (45 degree bend) No influence Small waves steady flow Hwy 512 on/off ramp 2 inlets / 1 outlet 3.00" 0.25" 2.00 fps 0.00" 11.25" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Outlet Inlet 14.25" x 14.50" Ultra, velocity, pressure sensors location Hwy 512 Outlet 47°11'24.28"N 122°16'54.48"W E Pioneer Ave Inlet 8.13" x 8.00" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_13 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 7-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_14 FS 5000 AG 24.00" 166.219.8.194 24.13" 111-120 21019 1312 9th Ave SW Drive Site Location Site Location Concrete / Good 7' - 0" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 11:40 3 inlets / 1 outlet No influence Smooth steady flow 1 inlet / 1 outlet (90 degree bend) 5.50" 0.25" 1.50 fps 0.00" 18.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Need to contact Community Center day of closure ([PHONE REDACTED]), to let them know work will be performed on road way Outlet Inlet 24.13" x 24.00" Ultra, velocity, pressure sensors location Outlet 47°11'4.06"N 122°18'43.44"W Inlet 24.13" x 24.00" 13th St SW 14th St SW 1312 1311 ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found at this site Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_14 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-9 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallp_15 FS 5000 AG 7.88" 166.219.8.89 8.00" 14-003 21509 Intersection of 29th Ave Ct SW and 12th St Pl SW Drive Site Location Site Location Concrete / Good 8' - 9" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 13:58 2 inlet / 1 outlet No influence Very low depth with ripples Lift Station 0.25" 0.25" 1.00 fps 0.00" 7.75" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Flow is very low and will be hard to obtain velocity readings, install monitor to see if reaction to I&I is present Outlet Inlet 8.00" x 7.88" Ultra, velocity, pressure sensors location Outlet 47° 9'48.93"N 122°18'26.76"W Inlet 8.00" x 7.88" Side line inlet ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_15 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 10-2 ft. deep flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_16 FS 5000 AG 11.75" 166.219.8.224 11.75" 16-044 21724 804 South Hill Rd Drive Site Location Site Location Concrete / Good 10' - 2" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 09:45 2 inlet / 1 outlet No influence Small waves steady flow 2 inlet / 1 outlet 2.50" 0.25" 3.25 fps 0.00" 9.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 11.75" x 11.75" Ultra, velocity, pressure sensors location Outlet 47° 9'40.18"N 122°18'14.62"W Inlet 11.75" x 11.75" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_16 Just south of intersection follow attached traffic plan ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 7-6 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_17 FS 5000 AG 14.50" 166.219.50.113 14.13" 129-042 21688 602 15th Ave SW Drive Site Location Site Location Concrete / Good 7' - 6" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 13:00 1 inlet / 1 outlet No influence Smooth steady flow 2 inlets 1 outlet (trunk line) 3.00" 0.25" 1.50 fps 0.00" 12.00" 0.25" Standard Ultra, Velocity, Pressure 0 RG_02 5 PSI Pressure to be used Outlet Inlet 14.13" x 14.50" Ultra, velocity, pressure sensors location Outlet 47°10'38.52"N 122°18'1.34"W Inlet 14.13" x 14.50" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_17 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 6-3 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_18 FS 5000 AG 8.00" 166.219.8.49 8.00" 134-049 21565 1222 7th St SE Drive Site Location Site Location Concrete / Good 6' - 3" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 12:15 2 inlet / 1 outlet No influence Smooth slow flow 1222 2 inlet / 1 outlet (drawdown) 2.00" 0.25" 1.50 fps 0.00" 6.00" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Outlet Inlet 8.00" x 8.00" Ultra, velocity, pressure sensors location 7th St SE Outlet 47°10'50.67"N 122°17'8.28"W 12th Ave SE Inlet 8.00" x 8.00" 9th St SE Side Inlet Side line ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_18 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-1 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_19 FS 5000 AG 10.00" 166,213.163.244 10.50" 129-034 21515 Puyallup Fairgrounds, 5th St SW service gate entrance (Just south of W.H Paulhamus Arena) Drive Site Location Site Location Concrete / Good 8' - 1" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 11:35 1 inlet / 1 outlet (fast low flow) No influence Smooth slow flow 15th Ave SW 1 inlet / 1 outlet 2.75" 0.25" 1.00 fps 0.00" 5.25" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Outlet Inlet 10.50 X 10.00" Inlet 8.00" x 8.00" Hwy 512 Ultra, velocity, pressure sensors location 5th St SW Outlet 47°10'42.93"N 122°17'49.38"W Service gate W.H Paulhamus Arena Inlet 10.50" x 10.00" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/13/11 10/13/11 Signed copy can be obtained from ADS Puyallup_19 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 6-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_20Fifth FS 5000 AG 21.00" 166.219.8.95 20.50" 132-012 21704 1602 5th St SW Drive Site Location Site Location Concrete / Good 6' - 0" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/12/11 @ 12:27 1 inlet / 1 outlet (very erratic flow) No influence Fast choppy flow 2 inlets 1 outlet 3.00" 0.25" 4.00 fps 0.00" 21.00" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Outlet Inlet 20.50" x 21.00" Ultra, velocity, pressure sensors location Outlet 47°10'34.19"N 122°17'56.00"W Inlet 20.50" x 21 .00" 15th Ave SW 5th St SW HWY 512 ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above Site requires two flaggers follow attached traffic plan for set up Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_20Fifth No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 7-7 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_20Meridian FS 5000 AG 8.00" 166.219.8.121 8.00" 135-037 21730 Just north of intersection of S Meridian and 21St Ave SW Drive Site Location Site Location Concrete / Good 7' - 7" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 12:31 1 inlet / 1 outlet / 1 overflow line No influence Very low depth with ripples Lift Station 0.25" 0.25" 1.00 fps 0.00" 7.75" 0.25" Standard Ultra, Velocity, Pressure 0 RG02 5 PSI Pressure to be used Flow is very low and will be hard to obtain velocity readings, install monitor to see if reaction to I&I is present Outlet Inlet 8.00" x 8.00" Ultra, velocity, pressure sensors location Outlet 47°10'20.53"N 122°17'36.45"W Inlet 8.00" x 8.00" ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_20Meridian No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 6-5 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_21 FS 5000 AG 12.88" 166.219.8.13 13.00" 116-070 21729 708 18th St. SW Drive Site Location Site Location Concrete / Good 6' - 5" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 12:45 2 inlet / 1 outlet No influence Smooth slow flow 708 1 inlet / 1 outlet 2.75" 0.25" 0.75 fps 0.50" 9.25" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Inlet 13.00" x 12.88" Ultra, velocity, pressure sensors location 18th St SW Outlet 47°11'10.21"N 122°19'11.46"W 7th Ave SW Inlet 13.00" x 12.88" Outlet ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_21 No hazards found at this site ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial x N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_22 FS 5000 AG 11.75" 166.213.6.63 11.88" 116-024 21520 Intersection of W Pioneer Ave and 17th St NW Drive Site Location Site Location Brick / Fair 8' - 0" Clay / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 11:01 3 inlets / 1 outlet No influence Smooth steady flow 2 inlets / 1 outlet (trunk line) 2.50" 0.25" 1.20 fps 0.00" 9.50" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Outlet Inlet 11.88" x 11.75" Ultra, velocity, pressure sensors location Outlet 47°11'25.32"N 122°19'3.46"W Inlet 11.88" x 11.75" 17th St NW W Pioneer Ave HWY 512 Tacoma Rd ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found at this site Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_22 Site located in 5 way intersection follow attached TCP for proper site access ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Inches Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_23 FS 5000 AG 8.00" 166.219.8.106 8.00" 116-010 21725 1829 W Pioneer Ave Drive Site Location Site Location Concrete / Good 8' - 0" Concrete / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 10:50 2 inlets / 1 outlet No influence Small waves slow flow 3 inlets / 1 outlet (trunk line) 3.00" 0.25" 1.00 fps 0.00" 6.00" 0.25" Standard Ultra, Velocity, Pressure 0 RG_01 5 PSI Pressure to be used Outlet Inlet 8.00" x 8.00" Ultra, velocity, pressure sensors location Outlet 47°11'25.56"N 122°19'13.85"W Inlet 8.00" x 8.00" 1829 W Pioneer Ave 70' (d/s) 20' (d/s) ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found at this site Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS PY_23 Just north of low volume intersection follow approved TCP that is attached ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Site Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Date/Time of Investigation: Site Hydraulics: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Cross Section Planar Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Gage Zone: Feet Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: IP Address: Manhole # Quality Form Address/Location: Storm Combined x Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial N N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 M.H 8-0 ft. deep x flow dir. N Puyallup RDII Puyallup, WA SW Puyallup_24 FS 5000 AG 10.00" 166.219.8.91 9.75" 130-007 21511 Just north of intersection of 14th St SW and 10th Ave SW Drive Site Location Site Location Concrete / Good 8' - 0" PVC / Good Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 10/13/11 @ 11:50 2 inlets / 1 outlet No influence Smooth slow flow 1 inlet / 1 outlet (close to stagnant) 4.00" 0.25" 0.75 fps 0.00" 11.00" 0.25" Standard Ultra, Velocity, Pressure 0 RG01 5 PSI Pressure to be used Need to contact Community Center day of closure ([PHONE REDACTED]), to let them know work will be performed on road way Outlet Inlet 9.75" X 10.00"" Ultra, velocity, pressure sensors location Outlet 47°10'59.29"N 122°18'47.49"W Inlet 9.75" x 10.00" 10th Ave SW 14th St SW ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No site specific hazards found at this site Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located in a high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager x Puyallup RDII Sean Winder Mike Pina Signed copy can be obtained from ADS 10/14/11 10/14/11 Signed copy can be obtained from ADS Puyallup_24 Located just north of a low volume intersection, follow attached TCP for proper traffic control ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Activation Date and Time: GPS Lat / Long coordinates: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Access View Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Guage Zone: Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: GPS Coordinates: Pipe Height: Pipe Width: Phone Number: Rain Gauge S/N: Quality Form Address/Location: Puyallup RDII Seattle, WA SW FS 5000 AG Puyallup_RG01 Drive Storm Combined Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial X N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 1602 18th St. NW Wastewater Treatment Plant X FlowShark Schematic Tipping Bucket Initial Confirmation Date and Time: 47°12'18.01"N 8.00'’ diameter bucket Not applicable Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Antenna for wireless capability TB3 tipping bucket Doesn’t apply Puyallup Wireless Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply 122 19' 20.29" W , 47 12' 17.54" N Site Location N Site Map Access to treatment plant Call Don Lange ([PHONE REDACTED]) for site access, at least 24 hours notice Code 3690 will get you in the gate 08-655 166.219.8.123 21484 Grass area Grass area Bldg. 5 RG location Main office Parking for access Gate with code access 122°19'15.67"W ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No Site Specific Safety Requirements Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x Sean Winder Mike Pina This worksite does NOT require a traffic control Plan Standard Traffic Control Plan TA-18 is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located ina high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Puyallup_RG01 10/14/11 Signed copy can be obtained from ADS Signed copy can be obtained from ADS 10/14/11 No Hazards found ---PAGE BREAK--- ADS Site Report FM Initials: Project Name: Site Name: Monitor Series: City / State: Access: Type of System: Sanitary Access Map Investigation Information: Manhole Depth: Manhole Material / Pipe Material / Condition: Mini System Commercial Telephone Information: Access Pole Distance From Manhole: Road Cut Length: Trench Length: Feet Feet Feet Activation Date and Time: GPS Lat / Long coordinates: Upstream Input: (L/S, P/S) Upstream Manhole: Manhole: Depth of Flow: Range (Air DOF): Peak Velocity: Silt: Access View Installation Information Installation Type: Sensors Devices: Surcharge Height: Rain Guage Zone: Backup Yes No ? Distance Trunk Lift / Pump Station WWTP Other QF 675007 Rev A0 Uncontrolled Copy Monitor S/N: Thomas Guide Page: Pipe Height: Pipe Width: Phone Number: Rain Gauge S/N: Quality Form Address/Location: Puyallup RDII Seattle, WA SW FS 5000 AG Puyallup_RG02 Drive Storm Combined Manhole Information: Investigation Information: Condition Character: Trunk Residential Industrial X N Other Information: Additional Site Information / Comments: N x x x x Effective Date 09/09/2003 Page 1 of 2 1100 39TH Ave SE (Public Works Corporate Yard) X FlowShark Schematic Tipping Bucket Initial Confirmation Date and Time: 8.00'’ diameter bucket Not applicable Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Antenna for wireless capability TB3 tipping bucket Doesn’t apply Puyallup Wireless Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Doesn’t apply Site Location N Site Map Access to yard Call Don Henry ([PHONE REDACTED]) for site access, at least 24 hours notice 07-683 166.219.8.242 21709 Parking for access Main office 835 D5 Potential TB placement 47° 9'6.12"N 122°16'49.27"W 39th Ave SE ---PAGE BREAK--- ADS Site Report Quality Form Flow Monitoring Site Safety Plan Project Name: Site Classification: (see below) Site ID: Note: Class 5 Site Safety Plans must be approved by the Corporate Safety Manager * Hazards found at this site (Discuss checked items below) Type Communications Special Hazard # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 * Hazards found at this site (Discuss checked items below) Traffic Access Worksite Confined Space * Site Classification Class Description 1 2 3 4 5 * Site Specific Safety Requirements. Must Complete for any site Class 2 & Above No Site Specific Safety Requirements Traffic Control Plan Note: All worksites located in a roadway or immediately adjacent to a roadway, where the operation may impede the normal flow of traffic, are required to have a Traffic Control Plan. Standard Traffic Control Plans are to be carried in the vehicle and referred to when setting up the worksite. Special Traffic Control Plans are to be are to be developed when required by clients or regulating agencies or when a standard Traffic Control Plan is not sufficient to control traffic at the worksite. Approved Reviewed Field Mgr Name: Signature: Date: Project Mgr Name: Signature: Date: QF 675007 Rev A0 Effective Date 09/09/2003 Uncontrolled Copy Page 2 of 2 x x Sean Winder Mike Pina This worksite does NOT require a traffic control Plan Standard Traffic Control Plan is to be used at this work site This site requires a special Traffic Control Plan which is attached The site is located on hill, curve, or where motorists visibility of the site or other vehicles is reduced Confined Space has active drop connections CO, H2S, low O2 or other toxic / flammable gases present or anticipated Confined Space subject to surcharge during / after a rain event Flow is hazardous due to depth, velocity, pipe diameter, or is industrial process flow The site is located ina high speed (>45MPH) or high density roadway roadway Site is located in a high crime area (check with client & local authorities if unsure) Confined Space does not have useable rungs Pedestrian control necessary as the site is located in or near a walkway, school, playground, etc. Elevated work requiring a ladder / work near an unguarded edge. Raised manhole (indicate height below) Work may be performed during darkness; requiring additional site lighting Site has access obstacles (rough terrain, fences, deep easement, etc.) Site traffic is congested at peak hours Worksite contains hazards (terrain, slope, obstructions, etc.) The site is located in or adjacent to an intersection Confined Space depth is greater than 50 feet Confined Space has internal platforms, weirs or other obstructions that interfere with or prevent unobstructed vertical retrieval Work requires lateral movement that would interfere with or prevent unobstructed vertical retrieval The site is in a communications “Dead-Zone” 2-person crew. Standard procedures and equipment. No special requirements Worksite (non-traffic) with access obstacles and or worksite hazards Traffic site requiring special scheduling, additional personnel and / or traffic control equipment, or outsourcing Confined Space Entry requiring special scheduling, additional personnel and / or safety equipment Special Operation requiring a separate safety plan. Must be approved by Corporate Safety Manager Puyallup RDII Puyallup_RG02 10/14/11 Signed copy can be obtained from ADS Signed copy can be obtained from ADS 10/14/11 No Hazards found