Reline Project Design Worksheet

Project Information

Date:

Respond By Date:

Site Drawings Available:

Select an option Yes No

Regulatory Agency:

Project Name:*

End Market / Land Use:

Select an option Municipal Golf Course Timber/Forest County School Hospital Industrial Railroad Airport Mining DOT Other - See Notes

Specifications Available:

Select an option Yes No

Project City:

State:

Select an option Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northern Mariana Islands Nova Scotia Northwest Territories Nunavut Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon

Project Zip Code:

LEED:

Select an option Yes No

Funding:

Select an option Public Private

Design Status:

Preliminary

In Progress

Permitted

Approved

Percent Complete:

Deliverable:

Size/Cost Est.

Proposal

Drawing

Quote

Feasibility

Rush Request?

Yes No

Upload Supporting Documents:

Upload Supporting Documents

Pipe Data

Existing Pipe Type:

Select an option Culvert Storm Sewer Sanitary Sewer Irrigation Bridge Slotted Drain Conduit Roof Drain Underdrain Liner Pipe Multiple - See Notes Other - See Notes

Proposed Material Type:

Select an option CMP - Steel CMP - Aluminum DuroMaxx PVC - A2000 PVC - SDR23.5 PVC - Truss Pipe Multiple - See Notes Other - See Notes

Other:

Select an option ALT2 Galvanized Bituminous Polymer Double Wall Other - See Notes

Diameters (in):

To

Height of Cover (ft):

Min.

To

Max.

FHWA Abrasion Level:

Select an option 1 2 3 4

Design Service Life (yrs):

Live Load:

Select an option H20 HS20 HS25 HL93 E80 Other - See Notes

Joint Requirements:

Select an option Soil-Tight Silt-Tight Leak-resistant Special Design - See Notes

Water chemistry at low flow:

pH:

R:

Manhole Connections:

Select an option Boot A-Lock Grout Other - See Notes

Testing Requirements:

Select an option None Mandrel Laser Hydrostatic Low Pressure Air Testing TV Inspection Visual Inspection Multiple - See Notes Other - See Notes

Other Info:

Design Storm:

Select an option 10 yr 25 yr 50 yr 100 yr

End Treatments (Final):

Run Lengths:

Access:

Open end (s)

Manhole only

Manhole lid size:

Application:

Culvert

Storm Sewer

Sanitary Sewer

Hydraulic Properties:

Hydraulic Properties (if available)

Hydraulic Modeling / Data Available:

Yes No

Design Flow Rate (cfs):

Slope (%):

Velocity (ft/s) 2yr:

Max:

Sanitary Sewer:

Sanitary Sewer

% Full During Install:

Bypassed:

Yes

No

Testing:

Yes

No

Test Pressure Duration and Frequency:

Diagram:

Soil Properties:

Soil Properties

Geotechnical Report Available:

Yes No

E':

Soil Bearing Capacity (psf):

Groundwater Elevation (ft):

Resistivity (ohm-cm):

pH:

R:

Pipe Shape Data

Typical Dimensions:

Typical Dimensions

Uniform Deflection Worse Case Dimensions:

Uniform Deflection Worse Case Dimensions

Triangulation Dimensions at Local Distortion(s):

Triangulation Dimensions at Local Distortion (s)

(use d, e and f is two distortions at same location)

Span:

Inv. Elev. Inlet:

Sag (invert):

Diameter:

Rise:

Inv. Elev. Outlet:

Sag (crown):

Span:

Rise:

Sag (invert):

Sag (crown):

Shape Data or Profile Info Available:

Yes No

Span:

a:

b:

c:

x:

Rise:

d:

e:

f:

y:

Notes (Design Assumptions, Pollutant Concerns, Challenges, Constraints, etc.):

Contact Information

First Name:*

Phone:*

Last Name:*

Province/Postal Code:*

Email:*

City:

Company:*

State:

Select a state Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northern Mariana Islands Nova Scotia Northwest Territories Nunavut Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon

Address:*

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