Document Change Record

Rail Design Request Form

Attention: MGF DESIGN SERVICES LTD Tel: 01942 402 704 Fax: 01942 402 766 Email: [email protected] General Details Preferred Contact for Design: Phone call prior to starting design: Status of scheme: CRM Project Ref (MGF):

Rep Customer Yes No Live Tender

MGF Representative Name: Date requested: Date design required: Date kit required on site:

Customer: Main Contractor & Client:

Site: Scheme title:

Site Contact (name): Tel: Email:

Temporary Works Co-ordinator (name): Tel: Email:

Contractor’s Responsible Engineer CRE (name): Tel: Email: (responsible for the Temporary Works)

Excavation details (All dimensions are in metres) Note: Please provide all relevant drawings including GA, section(s) plus any other as appropriate. If none available, Scheme Type: provide detailed hand sketches.

Cofferdam Single sided Trench Frame only Other (state)

Excavation depth: Over-dig included? Plan dimensions: Sheet to Yes No she et Muck to muck Inside (Note: 0.3m recommended) fra me( s) Clearance required below lowest frame/strut: Clearance required between frames/struts (in plan):

Ground Conditions Ground conditions described by: (indicate documents attached) SI Report BH / TP Log BH / TP Location Plan Verbal Soil Description Other (state)

Note: For verbal soil descriptions use Verbal Soil Description Form ED/QF002. MGF cannot provide cantilever solutions without a relevant Borehole. Nearest BH/TP: Distance from excavation: BH/TP Datum: Commencing Level:

Existing GL: Existing Slope: Topsoil Strip / Ground reduction / Batter (details):

Document is uncontrolled when printed. Printed copies are for information only. Page 1 of 4 Rail Design Request Form

Groundwater Level: Piezometer Readings: Local Influences (e.g. Well Pointing? tidal/flood): Yes No Level:

Additional Information Note: Please provide photographs of the site in support of the below information where possible. External Loading (Plant /Site traffic): At Distance:

Up to 30Te Up to 45Te Up to 60Te Other (state)

Adjacent Structures / Cranes / Roads / Railways / Embankments / Water Courses / Spoil / Materials: At Distance:

Adjacent Services / Infrastructure/ Overhead Cables: At Distance:

Anticipated duration of excavation: Notes: < 6 weeks < 12 weeks > 12 weeks

Are the Temporary Works to be installed during a full rail track possession? Yes No Details if No:

Are the Temporary Works to be subject to live rail loadings?

Yes No Details if Yes: RU Loading (50kN/m²) RL Loading (30kN/m²) Other:

Are any residual risks identified by permanent works designer or construction team for consideration in the Temporary Works Design? Yes No Details if Yes:

Are there any restraints regarding deflection or settlement? Yes No Details if Yes:

Is the Form 2 for the Permanent Works Available? Are there photos of the Temporary Works location? Yes No Yes No Method of Working Installation of sheets (method): Using (machine type):

Pre-Drive Dig & Push Slit Trench Dig & Drop Excavator Hammer Other (state)

Maximum (anticipated) achievable Construction sequence: toe: Leap frog frames 2 stage construction (concrete base thickness )

Preferred solution: Boxes Sheets & Frame(s) Cantilever sheets Back to back frames Knee braces Cross struts

Safety Ancillary’s (Edgesafe, Laddersafe, Davit) Other (state) GRiPSHORE Preferred solution:

Trench Boxes Modular Boxes Vertishore Vertishore c/w Backing Boards Sheet & Waler(s) Network Rail Approval Note: Please confirm if this design is subject to Network Rail Approval and if MGF are required to complete a F002 and/or F003 for the Temporary Works. Please be aware that MGF will require a minimum 5 working days to complete F002/F003 from receipt of full and final information. Documents to be completed by MGF:

F002 (Statement of Design Intent) (Note: £300 Design Charge)

F003 (Certification of Design) (Note: £650 Design Charge)

Network Rail Design Check Category (if known): Category 0 Category I Category II Category III

Notes e.g. Preferred Equipment/ Loading from Additional Rail Plant

Supporting Information Checklist (Please indicate documents attached with this Design Brief) Relevant Drawing(s)/Sketch(s) Details of Ground Conditions Photographs of Site

Permanent Works F002 Latest Revision of ‘For Construction’ Permanent Works Drawings

Customer Confirmation (To be completed by the Temporary Works Co-ordinator or the CRE) I confirm that the above information comprises the design brief, which should be used to prepare a Signed (by customer):temporary worksName shoring (print): scheme. Title: Date:

Document is uncontrolled when printed. Printed copies are for information only. Page 4 of 4