Campus Infrastructure & Services CIS STANDARD PERMIT-TO-DIG FORM (CIS-ENG-F003) – This permit applies for all excavation and ground penetration works to a depth greater than 150mm. This permit must be submitted at least 15 working days prior to the proposed commencement of the excavation. PART A - PROJECT DETAILS Type of Works (tick one) Project Planned Maintenance Emergency Project Name and Location Description of Works (Proposed Service/Size) Details of Ground Excavation (Length/Width/Depth) Excavation Works Start date: End date: Programme Head Contractor’s Name: Company: Supervisor Mobile: Email: Sub Contractor’s Supervisor Name: Company: Mobile: Email: University Representative/ Name: Company: Project Manager Mobile: PART B EXISTING ASSET INVESTIGATION BY CONTRACTOR – Asset investigations must be conducted before any excavation and/or ground penetration works to identify existing underground assets and services, potential risks and site control measures required for the excavation works. Underground Assets Location Checklist - Authority Owned Utilities (Dial Before You Dig Search) Utility (include details of owner) on to 30 works visibly vicinity indicate indicate ground site works < requires attached due of during in & vicinity on on DBYD and verified services date plans in plans owner owner by holing existing marking Current DBYD DBYD Assets Asset days) assets easement site pot proximity presence excavation received requires (issue locating to infrastructure Electricity (e.g. Ausgrid) Yes Yes Yes Yes Yes Yes No No No No No No Gas (e.g. Jemena, AGL) Yes Yes Yes Yes Yes Yes No No No No No No Water (e.g. Sydney Water, Council) Yes Yes Yes Yes Yes Yes No No No No No No (e.g. Sydney Water, Council) Yes Yes Yes Yes Yes Yes No No No No No No Stormwater (e.g. Sydney Water) Yes Yes Yes Yes Yes Yes No No No No No No Communications (e.g. Telstra, Yes Yes Yes Yes Yes Yes Optus) No No No No No No Traffic Signals (e.g. RMS/Council) Yes Yes Yes Yes Yes Yes No No No No No No
Campus Infrastructure & Services CIS STANDARD – PERMIT-TO-DIG FORM (CIS-ENG-F003) This permit applies for all excavation and ground penetration works to a depth greater than 150mm. This permit must be submitted at least 15 working days prior to the proposed commencement of the excavation. PART A - PROJECT DETAILS Type of Works (tick one) Project Planned Maintenance Emergency Project Name and Location Description of Works (Proposed Service/Size) Details of Ground Excavation (Length/Width/Depth) Excavation Works Programme Start date: End date: Head Contractor’s Supervisor Name: Company: Mobile: Email: Sub Contractor’s Supervisor Name: Company: Mobile: Email: University Representative/ Project Manager Name: Company: Mobile: PART B – EXISTING ASSET INVESTIGATION BY CONTRACTOR Asset investigations must be conducted before any excavation and/or ground penetration works to identify existing underground assets and services, potential risks and site control measures required for the excavation works. Underground Assets Location Checklist - Authority Owned Utilities (Dial Before You Dig Search) Utility (include details of owner) Current DBYD received & attached (issue date < 30 days) DBYD plans indicate assets in vicinity DBYD plans indicate easement in vicinity Assets verified on site by services locating and visibly marking on ground owner requires pot holing due to proximity of works to existing infrastructure Asset owner requires on site presence during excavation works Electricity (e.g. Ausgrid) Yes No Yes No Yes No Yes No Yes No Yes No Gas (e.g. Jemena, AGL) Yes No Yes No Yes No Yes No Yes No Yes No Water (e.g. Sydney Water, Council) Yes No Yes No Yes No Yes No Yes No Yes No (e.g. Sydney Water, Council) Yes No Yes No Yes No Yes No Yes No Yes No Stormwater (e.g. Sydney Water) Yes No Yes No Yes No Yes No Yes No Yes No Communications (e.g. Telstra, Optus) Yes No Yes No Yes No Yes No Yes No Yes No Traffic Signals (e.g. RMS/Council) Yes No Yes No Yes No Yes No Yes No Yes No