Request for permission to work on a public sewer (part 2)

This form will be used to assess the competency of an appointed contractor to make a connection to the public sewer. You do not need to complete this form if making a connection to a private drain.

If you need any help completing the form please call us on 0345 026 8989 and we’ll be happy to help. We aim to respond to your enquiry within 10 working days.

Please provide as much information as you can so we can process your application as quickly and as accurately as possible. The information you provide will be used solely in accordance with United Utilities’ Privacy Policy.

If you'd prefer to complete a PDF version, please click here to download and email it to WastewaterDeveloperServices@uuplc.co.uk.

Section 1.1 - Site & Contractor Details

Address of site (including postcode)

Are the sewers subject to a S104 adoption or S185 diversion agreement? Yes No

Will your site be served by a NAV for water services? Yes No

Section 1.2 - Contractor Details

Company name

Name of contact on site

Contractor address (including postcode)

Preferred contact number

Email address

Section 1.3 - CDM

Is the project notifiable under the CDM Regulations 2015? Yes No

Are you the principal contractor? Yes No

Section 1.4 - Connection type to be made

Type of connection to be made Junction connection New manhole construction Connection to an existing manhole Other

Section 2 - Classification of Space

Please find below a guide to identify the classification of the confines space and the activities which must be assessed prior to working on the public sewer.

All of United Utilities manholes, inspection and sewer pipes are rated as Zone 2 under the 'Dangerous Substances and Explosive Atmospheres Regulations' (DSEAR)

All connections, whether low, medium or high risk, must be inspected by a United Utilities Technician.

YOU MUST NOT UNDERTAKE ANY WORK ON THE PUBLIC SEWER (REGARDLESS OF WHETHER THE WORK IS CONSIDERED TO BE LOW, MEDIUM OR HIGH RISK) WITHOUT APPROVAL FROM UNITED UTILITIES.

Low Risk - Manhole/inspection chamber less than 1.5m deep. Junction connections within excavations less than 1.5m deep. Pipe diameter less than 300mm. Does not require the use of self-rescue BA. Adequate natural ventilation. No likely risk of flooding. Confined space entry only by qualified persons to comply with the ‘The Confined Space Regulations 1997’ with safe systems of work and emergency procedures. Medium Risk Entry - Manhole depth greater than 1.5m, less than 7.0m with straight vertical access via fixed ladder or rungs. Excavation depth greater than 1.5m, less than 7m. Requires the use of self-rescue BA. Realistic risk of a specified hazard. Certification is required for every operative involved in the proposed work: SQA, City and Guilds or CABWI Level 2 Award in Working in Medium Risk Confined Spaces in the Water Industry (6150-02). High Risk Entry - Manhole depth greater than 3.0m with multiple stage landings or non-standard entry. Excavation depth greater than 7.0m. Requires a traverse within a sewer. There is a specified hazard to be encountered. Certification is required for every operative involved in the proposed work SQA City and Guilds or CABWI Level 2 Award in Working in High Risk Confined Spaces in the Water Industry (6150-03).

Section 3 - Supporting Information

Please upload the certificates required depending on the risk.

Manhole details (drawing) as appropriate, including the method of connection onto the new and/or existing manholes (for low, medium and high risk connections).

Copies of all relevant confined space certification to SQA, City and Guilds / CABWI standard for Works Supervisor and all Operatives carrying out work (for low, medium and high risk sites). It shouldn’t be mandatory to upload documents for this.

Evidence of public liability insurance with a minimum £5m cover (for medium and high risk sites)

Section 4 - Method Statement

Section 4.1 Please tick the boxes below to confirm that you have detailed control measures in place for the specific risks outlined within your method statement Confined spaces Excavations and buried services Work equipment Hot works (Potential to cause ignition) Working with wastewater Working in an excavation Dealing with flow including changes in weather conditions

Section 4.2 Please describe the works to be completed

Planned date for work

Section 4.3 - Equipment

Please provide a comprehensive list under the relevant headings of what equipment will be required to complete the proposed works to United Utilities asset.

PPE

General tools/equipment

Confined space equipment

Plant/machinery

Section 4.4 - People

The works supervisor must understand that it is their responsibility to ensure that all persons employed on this project are adequately confined space entry trained to EU skills standard (City and Guilds or CABWI) and competent to perform their tasks in a safe and appropriate manner.

Name of works supervisor on site?

Please provide the names of all Operatives who will be involved in confined space works on United Utilities asset

Section 4.5

Please provide a comprehensive method statement for carrying out the proposed task including any safe systems of work and control measures

Section 4.6

Please provide a site specific methodology for entering the confined space

Section 4.7 - Completing works

Name of person responsible for notifying United Utilities of any residual risks (even if to confirm there are none) and that the works are complete.

Contact telephone number

Section 5 - Emergency Procedures

Name of person responsible for reporting any emergency situations or alerts to United Utilities

Please provide details of emergency contacts both on and off site

Please provide the nearest hospital (with A&E facilities) details including the distance from the site

Please confirm that you have considered the actions required as part of your emergency procedures in the event of the following:
These actions are not exhaustive and should not be considered as part of your confined space emergency procedures.

Gas alerts

If the gas alarm sounds, all entrants to evacuate the space immediately or no entry should be made. The space should be ventilated and gas checked after a minimum of 10 minutes. Works supervisor is to be informed if alarm sounds again.

Operative Collapse Within a Confined Space (unknown reason)

In the event of a collapsed operative, the top man is to assume a gas alert and summon emergency assistance then, if appropriate to do so, recover haul casualty from space with rescue equipment. The top man is reminded not to enter the confined space in any circumstance.

Injury / illness

Minor: Casualty to exit space if possible assisted by top man. Top man reminded not to enter confined space under any circumstances.
Major: Top man to summon emergency services and if appropriate to do so, recover haul casualty from space with rescue equipment. Top man reminded not to enter confined space under any circumstances.

Please confirm that you have considered the actions required as part of your emergency procedures in the event of gas alerts, operative collapse within a confined space and injuries/illnesses I agree

In event of an incident, United Utilities must be notified on 0782 653 9459.

Declaration

Work involving confined spaces must only be carried out between 08:00 and 16:00 hours during normal working days. Work carried outside of these times must be agreed with United Utilities. Permission must be received before any work or entry is carried out on the public sewer network.

For access to the public sewer, log on before starting work each day and log off upon completion of the work or at the end of the day by contacting United Utilities on 0782 653 9459. You will need the United Utilities reference number which is supplied on your approval note.

Caution: if you fail to log off, an emergency plan may be invoked by United Utilities which could involve the Emergency Services and/or United Utilities employess being called out. Should this be the case, ALL charges incurred in implmenting this procedure will be dircted to the company or agent involved.

Please contact the United Utilities Development Support Technician as early as possible to arrange your inspection of the works giving a minimum of five working days notice. United Utilities retains the right to have any connections laid open for nspection should suitable notice not be given.

Failure to comply with the above procedure could compromise future permission to carry out work on United Utilities sewer network.

By clicking submit you confirm that you have considered the actions required as part of your emergency procedures in the event of the following: These actions are not exhaustive and should not be considered as part of your confined space emergency procedures.

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