Appendix F Index - ATCO Electric · appendix f forms description form ... f.2 asset documentation...

Date: 2014-MAY-01 Revision: 6.1

Supersedes: Revision 6.0, 2013-JUN-01

SPECIFICATIONS FOR NEW UNDERGROUND RESIDENTIAL DISTRIBUTION SYSTEMS

________________________________________________________________________________________________

This document is the property of ATCO Electric and is for authorized use only.

APPENDIX F

FORMS

Description Form THESE ARE MANDATORY TO BE FILLLED F.1 ATCO ELECTRIC UTILITY RIGHT-OF-WAY FORM F.2 ASSET DOCUMENTATION FORM F.3 NOTICE OF DISCLAIMER F.7 EQUIPMENT/GROUND TEST REPORT

F.10 COMMISSIONING FORM – 3 PHASE TRANSFORMER (IF REQUIRED)

F.12 CONSTRUCTION COMPLETION CERTIFICATE F.13 ENERGIZATION REQUEST FORM F.14 SITE CLEARED OF PERSONNEL FORM F.15 FINAL ACCEPTANCE CERTIFICATE F.16 PROOF OF COMPACTION FORM F.20 CABLE TERMINATION SIGN OFF F.21 URD TURNKEY COMMISSIONING FORM F.22 DESIGN TRANSMITTAL

I/We,

AS SHOWN ON RIGHT OF WAY PLAN

WAS SURVEYED BY , A.L.S. BETWEEN ,AND SURVEYED BY .

FOURTH: The Grantor gives the Grantee a right of access to the said right-of-way for the purposes aforesaid, across the

remainder of the land against which this right-of-way is registered, PROVIDED that the said right of access shall be used

only in case of emergency and PROVIDED that the Grantee pay reasonable compensation to the then owner of such

property for any damaged occasioned thereby.

DO HEREBY, in consideration of the sum of one dollar paid to the Grantor, the receipt whereof is hereby acknowledged,

and in consideration of the covenants and conditions herein contained, grant and transfer unto ATCO Electric Ltd. (herein

after called the “GRANTEE”), an exclusive right, license, privilege and right-of-way to use that portion of the said lands and

premises (herein after called “the RIGHT-OF-WAY”), more particularly described as follows:

(herein after called the “GRANTOR”) being the registered owner (or entitled to become registered owner under an

Agreement for Sale or unregistered Transfer of Land or otherwise) of an estate in fee simple, subject however to such

encumbrances, liens and interests as are notified by memorandum underwritten, in all that certain tract of land situated

in the Province of Alberta are being:

FULL LEGAL DESCRIPTION EXCEPTING THEREOUT ALL MINES AND MINERALS

FIRST: The said right, license, privilege, and right-of-way shall be for as long a period as the Grantee, its successors and

assigns or any person or corporation to whom a franchise is granted by the Grantee may desire to exercise the right,

privilege, and right-of-way hereby given.

SECOND: The Grantee shall have the right to do whatever may be requisite for the enjoyment of the rights herein granted

including the trimming and removal of all parts of trees.

THIRD: Upon the execution of these presents and at all times hereafter, the Grantee or any person, or corporation to

whom it has granted a franchise, may enter upon and occupy the right-of-way with its agents, employees, and

contractors, and with or without vehicles, machinery and equipment, for the purposes aforesaid.

LAND TITLES ACT

CONTAINING HECTARES (MORE OR LESS)

for laying down, replacing, repairing, maintaining, construction, inspection, operation and removal of an electrical

distribution system together with the appurtenances incidental thereto, subject to the following terms and conditions:

day of A.D.20 .

hand and seal this

Witness Landowner Name

SIGNED AND DELIVERED BY

SIGNED AND DELIVERED BY

ATCO Electric Ltd.

(SEAL) Tracy Davidson, Sr. Supervisor

FIFTH: The Grantor agrees that any utilities or appurtenances to be constructed, installed and maintained over, under or

through the said right-of-way by any person or corporation to whom a franchise is granted by the Grantee shall remain

chattels, but notwithstanding any rules of law to the contrary, shall remain the sole and exclusive property of such person

or corporation.

SIXTH: The Grantor will not without prior written consent of the Grantee excavate, drill, install, erect or permit to be

excavated, drilled, installed or erected over, under or through the said right-of-way any pit, foundation, pavement,

building or other structure or installation, but otherwise the Grantor shall have the right fully to use and enjoy the said

right-of-way except as the same may be necessary for the purposes herein granted to the Grantee.

SEVENTH: The Grantee by performing and observing the covenants and considerations herein contained shall peaceably

hold and enjoy all the privileges, liberties and covenants hereby granted without hindrance, molestation or interruption

from the Grantor or any person claiming through, under or for the Grantor.

IN WITNESS WHEREOF, we the GRANTOR AND GRANTEE have hereunto set our

Witness Landowner Name

) I, of the, of

)

) in the Province of Alberta

2. THAT the same was executed at the of

3. THAT I know the said

and (s)he is (they each are) in my

of

this day of A.D., 20

A Commissioner for Oaths in and for the

Province of Alberta

in the Province of Alberta, and that I am the subscribing witness thereto;

TO WIT:

(Occupation of Witness)MAKE OATH AND SAY

1. THAT I was personally present and did see

named in the within instrument, who is (are) personally known to me to be the person(s) named therein duly sign and execute the

PROVINCE OF ALBERTA

C A N A D A

SWORN / AFFIRMED at the in the Province of Alberta

AFFIDAVIT OF EXECUTION

belief of the full age of eighteen years.

same for the purposes named therein;

ALL boxes MUST be filled with DATA, DASH or N/A. Unused STRUCTURE TYPE, SWITCH # or COMMENTS boxes may be left BLANK.

Form F.2 - Asset Documentation Form

Region: Reg #:

Line #: Dist#: Name:

Plant Name: District: of Date:

Plant #: T.L.:

Line Asset Site ID # Lamp Type Traffic Festoon Year Powerfeed Switch Davit Comments

# Tag # (Billing) Light Outlet # Size

Light Billing 100W HPS Yes T (Telus) Yes Year installed UG CM (Cement) 9m BL (Blue) PT (Paint)

150W LED R380 N380 H26 X305B E16A E16B X409-1 X410-1 X411 No C (Cable) No from birthmark OH ST (Steel) 12m GN (Green) PC (Power Coat)

43W N/A N/A T/C (Both) N/A on pole, OH/UG (Breakaway N/A GY (Gray) GAL (Galvanized)

N/A N (None) or year N/A Base) BR (Brown) CT (Corten)

N/A (Not App.) lights/davits N/A (Not App.) N/A (Not App.) FB (Fiberglass)

N/A (Not App.) were installed. N/A (Not App.)

As-Built Engineering Identify Project Type (Yes)

New Construction

System Upgrade

Base

Use

Pole Replacement

Davit Replacement

TO BE VERIFIED

BY ATCO

ELECTRIC

Emergency Work

Auditor:

LSD/ Lot & Block

To be Filled Out by ATCO Electric

Joint

Salvage WO

Structure Type

0105 20-05-5 or

LT5 BK6 PL326BB

SE01 20-05-5 or

Davit

Color

Structure Type must be recorded separately:

Davit

Finish

Date:

Page:

W.O. #:

To be Filled by the Developer


Form F.3 - Notice of Disclaimer

Date: 2014-05-01

Revision: 6.1

Supersedes:

5. Receipt of this information in whole or part by any person shall not be construed to mean permission to use the same.

Underground Residential Distribution Systems Specifications BINDER #

Date Company

2. ATCO Electric Maps, and/or Drawings, and/or Documents, and/or Data and/or Software are the sole

and exclusive property of ATCO Electric.

By signing this Notice of Disclaimer, you acknowledge that you agree to comply with all of

the terms and conditions contained herein.

Name (please print)

3. This information has been prepared by ATCO Electric for internal use only; and external use of, or reliance

on same is prohibited.

1. ATCO Electric, Distribution Construction Standards, and/or Guides, and/or Practices, and/or Procedures

are the sole and exclusive property of ATCO Electric.

4. All rights reserved. No part of this information may be reproduced, stored in a retrieval system or transmitted, in any

form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written consent of

ATCO Electric. This information may not be lent, sold, hired out or otherwise disposed of by way of trade in any form

without the prior written consent of ATCO Electric. No use may be made of this information without the prior written

consent of ATCO Electric.

ATCO ELECTRIC SHALL NOT BE HELD LIABLE TO/BY ANY PERSON FOR INJURY, LOSS OR DAMAGE ARISING OUT OF

ANY USE OF, OR RELIANCE ON THESE MAPS, DRAWINGS, DOCUMENTS, DATA OR SOFTWARE, IN WHOLE OR PART.

6. All forms of this information will be returned to ATCO Electric at the completion of the project or at the request

of ATCO Electric.

Signature

LIMITATION OF LIABILITY

Revision 6.0, 2013-12-11



EQUIPMENT / GROUND TEST REPORT (Turn Key)

Service Area:

Plant #:

Land Location: Lot XX, Block XX, Plan XXX XXXX

Switch #: SXXXXXStructure Asset Tag #: XXXXXX

Customer Name:

Plant Name:

Proj # / Maximo WO # / O&M #: DXXXXX

Date:

Responsibility #:

Equipment Transformers

Other Equipment TypesSelect Equip Transformer Type: Padmount Loop

Select Other Equipment Type: Switch Cubicle

PRIMARY CONNECTION: WYE PHASE: Single Phase SECONDARY CONNECTION: WYE

INSTALLED REMOVEDMake/Switch style

Maximo ATCO Eq #Serial # XXXXX

KVA/AMP/KVAR XXXXXEquip/Primary Vol XXXXXEquip/Sec Voltag XXXXX

% Impedance XXXXXTap SettingYear Built XXXX

Oil Volume (L) XXXXXPCB Content XXXXX

Voltage ReadingCounter Reading

Controller Make/ModController Model

From: To:FUSE SIZE: BREAKER SIZE: CHANGE TAPS: (%)

INSTALLED DUE TO: New Installation DAMAGED DUE TO:

COMMENTS: XXXXX

1 2 3 Ground Rods Req'dEquipment Ground as Found XXXXXEquipment Ground as Left XXXXXGround Return as Found XXXXXGround Return as Left XXXXXLine Group XXXXX

Interconnected XXXXX

Signature:

TYPE & SIZE OF GRD WIRE XXXXX

READINGS AS LEFT: XXXGROUNDING SYSTEM MGN MOISTURE IN SOIL NORMAL

CONDITION OF GRD WIRE GOOD CONDITION OF GRD ROD GOOD

Originator: XXXXX

Responsibility: ATCO Electic Developer

Appendix B

Three Phase Distribution Transformer Commissioning Form

Test Date - Location- Type - Year of Man. Company # Year -Rated KV - ManufacturerRated Amps Serial # - Total Wt. - Rated KVA - Catalog # - Oil quantity -

Ratio Test

Tap Name Plate Calc. H1 - H0 % Phase Exc. H2 - H0 % Phase Exc. H3 - H0 % Phase Exc.Position Volts Ratio X1 - X0 Dev. Dev. (ma) X2 - X0 Dev. Dev. (ma) X3 - X0 Dev. Dev. (ma)

1 2 345 6 7

Cap. And Diss. Overall Test Megger

Capacitance Dissipation Readings in G-ohms Oil TestPos. Capacitance Multiplier Calculated Dial Scale Actual Time H to XGnd X to HGnd 1

CH-L Volts= Volts= 2CH-G 15 sec 3CH-L 30 sec 4

45 sec 5

Transformer Ohmeter 1 min Total

Tap Test Tap = 2 AVG.

Position H1-H0 H2-HO H3-H0 31 42 53 64 75 86 97 10

Test tap= X1-X0 X2-X0 X3-X0Secondary P.I index

Comments:

umgz

Typewriter

FORM F.10 COMMISSIONING FORM - 3 PHASE TRANSFORMER

Form F.12 - Construction Completion Certificate

Date: 2014-05-01

Revision: 6.1

Supersedes:

Development Name:

Developer:

Accepted On:

(ATCO Electric)

Rejected On:(ATCO Electric)

Reasons for Rejection:

I certify that the listed reasons for rejection have been corrected.

Project Engineer ATCO Electric

,“Consulting Engineers”, hereby, certify that the Work (as defined in the Underground Electrical Distribution

Underground Electrical

Distribution Subdvision Service

Dated:

Date of Application:

Agreement Number:

(Attach a separate page identifying deficiencies if required)

Revision 6.0, 2013-06-01


Electrical Distribution Subdivision Service Agreement and meets all the requirements for a Construction CompletionCertificate as specified in the Services Agreement, and I hereby approve the issuance of the Construction Completion

Certificate.

(Project Eng Seal)

Project Engineer

Independent Inspector (if required)

Subdivision Service Agreement) has been completed according to the requirements of the Underground

With reference to the Underground Electrical Distribution Subdivision Agreement identified above, Iof the firm


Form F.13 - Energization Request Form

Date: 2014-05-01

Revision: 6.1

Supersedes:

Development Area:

Developer:

Services Agreement

Dated:

Agreement Number:

Site Supervisor/

Foreman:

Developer/DeveloperRepresentative:

Accepted by ATCO Electric:

ATCO Electric Inspector:

The Developer hereby requests that the electric URD facilities installed on site be energized by ATCO Electric.

Date:

Date:

On behalf of the Developer, I (the Site Supervisor) declare that THIS SITE IS READY TO BE ENERGIZED.

Date:


Revision 6.0, 2013-06-01



Form F.14 - Site Cleared of Personel Form

Date: 2014-05-01

Revision: 6.1

Supersedes:

Development Area:

Developer:

Services Agreement

Dated:

Agreement Number:

ENERGIZED.

Contract ConstructionCompany Name

Site Supervisor/Foreman RepresentingContract Construction Company


Electric URD and Street Light System

(Contract Construction Company)

THAT ALL PERSONNEL AND EQUIPMENT ARE CLEAR AND NOW CONSIDERS THE SITE TO

Revision 6.0, 2013-06-01


Date:


Date:


Form F.15 - Final Acceptance Certificate

Date: 2014-05-01

Revision: 6.1

Supersedes:

Development Area:

Developer:

Consulting Engineer:

Contractor:

Dated:


Project Engineer,

Consulting EngineeringFirm:

Signing OfficerConsulting EngineeringFirm:


ATCO Electric Project

Engineer

Underground Electrical Distribution

Facilities meet all the requirements for Final Acceptance as specified in the Underground Electrical

Pursuant to the Underground Electrical Distribution Subdivision Service Agreement identified above, Iof the firm

Causes for Rejection: SEE ATTACHED REPORT

Distribution Subdivision Service Agreement, and I hereby recommend these Developed Distribution

Date:

Rejected On:

Revision 6.0, 2013-06-01


Facilities for Final Acceptance by ATCO Electric Ltd.

Subdivision Service AgreementAgreement No:

Boundaries of Development Area: AS PER ATTACHED PLAN

,“Consulting Engineers”, hereby, certify that as of the above Date of Application, the Developed Distribution

Date:

Approved On:

Date:


Form F.16 - Proof of Compaction Form

Date: 2014-05-01

Revision: 6.1

Supersedes:

Development Name:

Agreement No:

Compaction Sample No:

Date:

Location:

Certified Lab Name:

Name

Proctor Requirements Met (Yes/No ):

The Independent Inspector (if required) certifies that all samples were taken in

accordance with ASTM Standard D698-07e1, and I hold these results to be true and

accurate of the soil compaction for the specific area noted.

Date

Contract Construction Company Name

Site Supervisor/Foreman Representing Contract Construction Company

Date

Revision 6.0, 2013-06-01


Plan Reference (nearest facility plan or reference or GPS coordinate):

Date

Certified Lab Results for Standard Proctor Density Test: ATTACHED

Signature

Independent Inspector (if required)


Form F.20 - Cable Termination Sign Off

Date: 2014-05-01

Revision: 6.1

Supersedes:

Location Type Date Terminator Signature

Location Type Date Terminator SignatureS12345 A1 Elbow Nov. 15, 2010 Cable GuyS12345 B1 Elbow Nov. 15, 2010 Cable Guy

Signature is the signature of the individual completing the termination


Instructions for Use:

Revision 6.0, 2013-06-01

Location refers to the ATCO provided device number and cable identificationType refers to either a stress cone or a load break elbow Date refers to date termination was completedTerminator refers to the individual completing the termination


Form F.21 - Project Inspection – Quality Audit

– Commissioning Form for Turnkey Subdivisions

Project #: Project Description:

Crew Name:

YES NO N/A YES NO N/A YES NO N/A

Material Certification

1) All materials as specified in Appendix E

Trench/Cable Laying

1) Trench proper depth as per D.1.7

2) Sand bedding installed as per D.1.7

3) Proper separation from other utilities as per D.1.7

4) Warning tape properly installed as per D.1.7

5) Trench compaction meets standard D.1.7

6) Trench alignment as per design

UNDERGROUND EQUIPMENT

Transformer

1) Switch schematic installed as per D.5.7

2) Cable parked on proper bushing (ie: A1 to H1)

3) Cable ID tags installed as per D.5.7

4) Switch number installed as per D.5.7

5) Warning signs installed as per D.5.7

6) Ground meggered

7) Ground tags installed as per D.5.7

8) All ground connections completed

9) Warning stickers installed as per D.5.7

10) Clearance to fence and buildings (if applicable)

11) Voltage tested and verified correct

12) All secondary connections complete and tagged

13) Locks, penta bolts installed

14) Asset tags installed as per D.5.7

15) Equipment to grade

16) Equipment level

17) Equipment protection installed (if required)

Cable

DC High-Pot test results are acceptable

Date Due

Commissioning (ATCO Electric)

Accepted

(mark YES, NO or N/A with an "X" )DESCRIPTION

Action Required if "No"

Project Name:


Construction Inspection (Developer)Quality Inspection

(ATCO Electric)

Accepted

(mark YES, NO or N/A with an "X" )


Completed as per Scope/Design/Standard





YES NO N/A YES NO N/A YES NO N/A

Pedestals

1) Normal open secondary tagged and capped

2) Phase in all normal open

3) Ground tags installed as per D.5.7

4) Ground meggered


6) Warning stickers installed

7) Plumb


9) Service address tags or lot/blk numbers installed

10) Asset tags installed as per D.5.7

Street Lights

1) Plumb


3) Warning stickers installed

4) Asset tags installed

5) Base 50 mm above grade (D.6.1)

6) Cable identified as per D.5.6


Switches

1) Fusing/switches as per design (if applicable)

2) Fuse size tag installed (if applicable)

3) Switch number installed (if applicable)

N. Reports Completed

1) Equipment reports/documentation

2) Ground resistance results

3) Asset documentation

4) "As built" completed and signed

5) Operational SLD map updated (ATCO Electric)

Construction Inspection

Completed as per Scope/Design/Standard



Quality Inspection

Date DueDESCRIPTIONAccepted



Commissioning

Accepted






Construction Foreman Comments:

(ATCO Electric)

DOC Approval By:

(Operations Team Lead - Service)

(DOC Only)

Service Point Acceptance Date:

DOC Approval Date:

Accepted By:

Project Number:

Crew Name:

Quality Audit Completed By:

Crew Foreman Comments:

Date:

Construction Inspection Completed By:

Project Description:

Crew Foreman:

Commissioning Comments:

(ATCO Electric)

Commissioning Completed By: Date:

(Developer)

Date:

Project Name:


Form F.22 - Design Transmittal

Date: 2014-05-01

Revision: 6.1

Supersedes:

Project Name:

ATCO Electric Project Number (D#):

Date:

Submission Count:

Comments:

File NameRequired Copies

(mark with "X" )

Accept

(mark with "X" )

Return

(mark with "X" )

N/A

(mark with "X")Reason for Return (see Note 1 )

Issued for Construction One (1) electronic copy (AutoCAD)

(IFC) Drawings One (1) electronic copy (PDF)

(See Section 4.2.3.1) Two (2) authenticated hard copies

Single Line Diagrams One (1) electronic copy

(See Section 4.2.3.2) Two (2) hard copies

Voltage Drop Calculations One (1) electronic copy

(See Section 4.2.3.3) One (1) hard copy

Street Light Study File One (1) electronic copy

(See Section 4.2.3.4)

Street Light Study Results Two (2) authenticated hard copies


URW Agreements/Plan One (1) electronic copy


Crossing Agreements One (1) electronic copy


Easement for ATCO One (1) electronic copyElectric Facilities


Asset Documentation Form One (1) electronic copy(See Section 4.2.3.7)

Reviewed By:

Date:

Review Count:

NOTES:

1. Reason for return: M – Missing, IC – Incomplete, D – Deficiency

2. ATCO Electric will not issue IFC drawings until the receipt of following items

b. Proof of insurance

c. Developer’s payment for the ATCO Electric services

Two (2) hard copies

a. Signed copies of the Underground Electrical Distribution Subdivision Service Agreement

Revision 6.0, 2013-06-01

For ATCO Electric Use Only


Submitted By (Name of Consulting

Company, Name of Individual):

For Developer Use

Appendix F Index - ATCO Electric · appendix f forms description form ... f.2 asset documentation...

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