DDW-2024-008764

Water/Sewer Separation - Exception Request Form
INSTRUCTIONS
Send the completed Exception Request Form, drawings, and Water/Sewer Exception Request Spreadsheet to [e-mail]
PROJECT INFORMATION
Water System Number*:DDW File Number:
Water System Name*:
Project Title*:
Project Description*:
Attachments:Drawings of water line and sewer line alignments
Water/Sewer Exception Request Spreadsheet
SUBMITTED BY
Engineer of Record
Name (Print):
PE License Number: Title:
Email: Phone:
Organization:
Signature: Date:
REVIEWED BY
DDW Permitting Engineer
Name (Print) Date:
APPROVED BY
DDW Permitting Manager
Name (Print):
Signature: Date:
Enclosures:
CC:
Digitally signed by DALLAS
BUCKNER
DN: cn=DALLAS BUCKNER, c=US,
o=GO CIVIL ENGINEERING,
email=[e-mail]
Date: 2024.06.11 16:22:16 -06'00'
DALLAS
BUCKNER
11002
CEDAR CITY MUNICIPAL WATER (CULINARY)
50 S., 4375 & CENTER ST. ROAD IMPROVMENTS
DALLAS BUCKNER
10622248 PRINCIPAL
[e-mail] 435-586-9592
GO CIVIL ENGINEERING
6-11-24
J. Paul Wright, P.E.6-17-24
Michael Newberry, P.E.
ROAD DEDICATION/IMPROVEMENTS PLAN WITHIN THE IRON
WEST PROJECT BOUNDARY FOR RESIDENTIAL
DEVELOPMENT.
Jeremy Robert, Southwest Utah Public Health Dept. [e-mail]
Dallas Buckner, P.E., Go Civil Engineering, [e-mail]
Robbie Mitchell, Cedar City Waterworks, [e-mail]
J. Paul Wright, P.E., DEQ Southwest District Office, [e-mail]
Nagendra Dev, Division of Drinking Water, [e-mail]
Exception Request Spreadsheet
Is a Water/Sewer Separation Exception Required per R309-550-7?

Are all requirements of
R309-500-7(3)* met?
No. Exception required
Yes. Do water and sewer
cross?
No. Is there at least 10'
of horizontal
separation?
No. There at least 6' of
horizontal separation,
sewer pipes in good
condition, AND there is
not high groundwater?
Yes. Is water at least 18"
above the sewer?
Yes. Exception not required
No. Exception required
No.
Exception required
Yes. Exception not
required
Yes. Is water at least 18"
above sewer?
No. Exception required
Yes. Exception not
required
Requirements of R309-500-7(3) are met if:
The groundwater is not high
Water transmission lines that may become unpressurized will not be installed within 20 feet of sewer lines
Disturbances of existing lines are prevented or minimized
Corrosive conditions do not exist
When sewer force main crosses under existing water main, all portions of the sewer force main within 10’ (horizontally) of the water
main will be enclosed in a continuous sleeve
When a new water main crosses over an existing sewer force main, the water main will be constructed of pipe materials with a
minimum rated working pressure of 200 psi or equivalent pressure rating
Water service laterals will conform to requirements for separation of water and sewer lines
Water/Sewer Separation - Exception Request Spreadsheet
0+37.50, SHEET 4 2+73.23 SHEET4 3+62.21 SHEET4
CONST. TO EX. SWR.CONST. TO EX. SWR.CONST. TO EX. SWR.
X-ING X-ING X-ING
0.54 1.37 1.23
ABOVE ABOVE ABOVE
>12'>12'>12'
Condition (New/Existing)NEW NEW NEW
Material DUCTILE DUCTILE DUCTILE
Size 16"8"8"
Pressure Rating 350 PSI 350 PSI 350 PSI
Is the line pressurized year-round?YES YES YES
Condition (New/Existing)NEW NEW NEW
Material PVC PVC PVC
Size 8" MAIN 4" LATERAL 4" LATERAL
Pressure Rating N/A GRAVITY N/A GRAVITY N/A GRAVITY
Is the line pressurized?NO NO NO
20' PVC sleeve on sewer line per Detail Sheet 11
centered on crossing
20' PVC sleeve on sewer line per Detail
Sheet 11 centered on crossing
20' PVC sleeve on sewer line per Detail
Sheet 11 centered on crossing
1. Separation distances shall be measured edge-to-edge.
2.     Examples of proposed means to mitigate risks include:
a.     remove/replace the aged vitrified clay sewer pipe;
b.     replace the aged or cracked existing sewer pipe;
c.      use thicker or higher pressure class PVC instead
d.     of the typical thin-wall sewer pipe; install an in-situ lining to the existing sewer pipe for XX feet;
e.     center the sewer line over the crossing to keep the joints as far as possible from the water line;
f.      add detectable or magnetic warning tape placed 12 inches above the sewer and/or the water line(s) to minimize possible damage during future excavations;
g.     use HDPE pipe for water line or sewer line to eliminate the joints [if there is no sagging or lack-of-sufficient slope problems for HDPE sewer pipes];
h.     use restrained joints for water line and/or sewer line near the crossing
Sewer
Line
Water
Line
Reason for not meeting R309-550-7
Mitigation Efforts2
Station or Location
Horizontal Clearance1
Vertical Clearance1
Water is Above or Below Sewer
Groundwater conditions
4+51.23 SHEET 4 5+40.23 SHEET 4 6+98.23 SHEET 4 14+51.12 SHEET 7
CONST. TO EX. SWR.CONST. TO EX. SWR.CONST. TO EX. SWR.CONST. TO EX. SWR.
X-ING X-ING X-ING X-ING
1.15 1.07 0.98 1.21
ABOVE ABOVE ABOVE ABOVE
>12'>12'>12'>12'
NEW NEW NEW NEW
DUCTILE DUCTILE DUCTILE DUCTILE
8"8"8"16"
350 PSI 350 PSI 350 PSI 350 PSI
YES YES YES YES
NEW NEW NEW NEW
PVC PVC PVC PVC
4" LATERAL 4" LATERAL 4" LATERAL 4" LATERAL
N/A GRAVITY N/A GRAVITY N/A GRAVITY N/A GRAVITY
NO NO NO NO
20' PVC sleeve on sewer line per Detail
Sheet 11 centered on crossing
20' PVC sleeve on sewer line per Detail
Sheet 11 centered on crossing
20' PVC sleeve on sewer line per Detail
Sheet 11 centered on crossing
20' PVC sleeve on sewer line per Detail
Sheet 11 centered on crossing