CASED UTILITY LINE WAIVER

REQUIRED COMPLIANCE FOR WAIVER
OF CASED LINE CERTIFICATION

The undersigned, in applying for joint use of highway right-of-way, has requested the waiver of cased lines as required by the Kansas Department of Transportation Utility Accommodation Policy (UAP). The undersigned acknowledges that approval of this waiver by the Kansas Department of Transportation (KDOT) is conditioned upon the undersigned’s execution of this certification.

I hereby certify that I am a duly authorized representative of the

(Utility), and the Utility and I

represent that the line qualifies for a waiver of casing as the line complies with the conditions and provisions contained in the items below:

Welded steel pipelines.

Cathodically protected.

Coated in accordance with accepted industry standards.

Meets requirements of the Pipeline Safety Regulations—Code of Federal Regulations–Title 49—Transportation (Part 191 and 192–Natural Gas) or (Part 195–Liquid Petroleum Gas) with respect to wall thickness.

Designed for operating stress levels in accordance with Federal Pipeline Safety Regulations.

I acknowledge that this certificate, which is factual and reliable, is furnished to KDOT in connection with this request for joint use of highway right-of-way and is subject to State and Federal laws, both criminal and civil.

By:

Name of Utility:

Address:

Date:

Permit or Agreement No.

D.O.T. Form No. 308

Distribution:

( Const/Maint

( Petitioner

( District

( Area

KDOT Form 308 Cased Utility Line Waiver

J. William Lay

1999-07-21

Joe Archer

kdot