FORMS Appendix D

CONTENTS Preliminary Design Request Form HeliCAP Helical Capacity Design Software Buyer Qualification and Order Form Chance Helical Anchor/Pile Axial Test Form Atlas Resistance Piers Installation Log Chance Helical Anchor/Pile Installation Log Helical Pulldown Micropile Installation Log Atlas Resistance Piers - Project Summary Log D-1 D-3 D-5 D-7 D-9 D-11 D-13

DISCLAIMER The information in this manual is provided as a guide to assist you with your design and in writing your own specifications. Installation conditions, including soil and structure conditions, vary widely from location to location and from point to point on a site. Independent engineering analysis and consulting state and local building codes and authorities should be conducted prior to any installation to ascertain and verify compliance to relevant rules, regulations and requirements. Hubbell, Inc., shall not be responsible for, or liable to you and/or your customers for the adoption, revision, implementation, use or misuse of this information. Hubbell, Inc., takes great pride and has every confidence in its network of dealers/installing contractors. Hubbell, Inc., does NOT warrant the work of its dealers/installing contractors in the installation of CHANCE Civil Construction foundation support products.

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PRELIMINARY DESIGN REQUEST FORM

Installing Contractor Firm: ______________________________________________ Phone: _________________________ Project Name: ________________________________ Address: _____________________________ _____________________________ _____________________________ Project Engineer ? Yes No Type:

Contact at CHANCE Civil Construction: _________________________________________________

Contact: ___________________________________________ Cell: ____________________________

Fax: ____________________________

Foundation New Construction Tieback Retaining Soil Nail Retaining

Underpinning/Shoring Rock Other: _______________ ________________________

Firm: _______________________________________________ Address: ___________________________________________ ___________________________________________ ___________________________________________ Geotechnical Engineer ? Yes No

Contact: ___________________________________________ Phone: Fax: Email: ___________________________________________ ___________________________________________ ___________________________________________

Firm: ____________________________________________ Address: ________________________________________ ________________________________________

Contact: ___________________________________________ Phone: Fax: Email: ___________________________________________ ___________________________________________

________________________________
Loads Design Load Compression Tension Shear Overturning _____________ _____________ _____________ _____________ FS (Mech) #1 ____________ ____________ ____________ ____________

___________________________________

FS (SSI) #1 ____________ ____________ ____________ ____________

Design Load ____________ ____________ ____________ ____________

FS (Mech) #2 ____________ ____________ ____________ ____________

FS (SSI) #2 ____________ ____________ ____________ ____________

Define the owners expectations and the scope of the project: ___________________________________________________

____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________

The following are attached: Plans Soil Boring Soil Resistivity Soil pH If any of the above are not attached, please explain: ___________________________________________________________ _________________________________________________________________________________________________________ Date: ___________________ Requested Response: ___________________ Chance #: _______

Response: _______

Please copy and complete this form to submit a design request.

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HeliCAP Helical Capacity Design Software Buyer Qualification and Order Form

Qty 1

Description HeliCAP Helical Capacity Design Software

Price Each $250.00

Hard Drive Serial # (see instructions on reverse)

Please send me a copy of HeliCAP on CD.

Three additional licenses are available per copy. Go to www.abchance.com or contact CHANCE Civil Construction for more information. BACKGROUND INFORMATION Engineer Structural Geotechnical Civil Mechanical Electrical Registered Professional Other __________________ Contractor General Sub Design-Build Other _________________ Architect Distributor Government Agency Educational Institute Student Power Utility End User Other _________________ Previous Helical Anchor/Pile Experience APPLICATION REFERENCE Utility Guy Anchors (Transmission Line) Telecommunication Towers Pipeline Anchors (Buoyancy Control) DOT/FFA Other _________________ Registered Professional Other __________________ Other Residential Underpinning (Foundation Repairs) New Construction Foundations Basement Wall Anchors Retaining Walls Commercial Underpinning (Foundation Repairs) Deep Foundations Earth Retention (Tiebacks and Soil Nails) Tiedowns (Uplift Restraint) Boardwalks - Walkways

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System Requirements Windows 95/98/2000/NT/XP Pentium 100 MHz processor 32 Mb RAM 35 Mb free hard disk space 2X CD-ROM drive MAC users must have Virtual PC installed.

How to Find Your Hard Drive Serial Number Your hard drive serial number is required in order to issue a license key for the HeliCAP Helical Capacity Design Software. To find your hard drive serial number: Click the Start button at the lower left corner of the desktop. Click Run in the popup window. The Run dialog box will open. Type command in the Open: field and click OK. A DOS window will open and display a DOS prompt. The DOS prompt will normally start with "c:" which is the default drive. If you want to install HeliCAP on a different drive, type the drive letter followed by a colon (e.g., "d:") at the prompt and press Enter.
P

Type vol at the DOS prompt and press Enter. The hard drive serial number (or Volume Serial Number) will be displayed. Record the serial number and close the DOS prompt window.

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Chance Helical Anchor/Pile Axial Test

Project: Anchor/Pile Number: Helix Configuration: Time: Start Finish Date: Sheet of Product Series: SS______ RS_______ Total Depth: Recorded by:
DISPLACEMENT PRESS (psi) LOAD (kip) TIME (min) GAUGE A (in) GAUGE B (in) GAUGE C (in)

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Atlas Resistance Piers Installation Log

Project: Pier Number: Pier Designator: Maximum Work Capacity: Installation Cylinder Effective Area: DEPTH (ft) 3'-6 7'-0 10'-6 14'-0 17'-6 21'-0 24'-6 28'-0 31'-6 35'-0 38'-6 42'-0 45'-6 49'-0 52'-6 56'-0 59'-6 63'-0 66'-6 70'-0 73'-6 77'-0 80'-6 84'-0 87'-6 PIER SECTION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Length of Cut-Off Section: Total Depth from Grade: PRESSURE (psi) LOAD (lbs) Installation Technician: NOTES Installation Date: Sheet of

Total Full Section Length: Depth to Pier:

LIFTING LOG
Lift Ram Effective Area: Final Lift Lift Amount (in) Pressure (psi) Load (lbs) Date of Lift: Comments:

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Chance Helical Anchor/Pile Installation Log

Project: Anchor/Pile Number: Helix Configuration: Time: Start DEPTH (ft) DP-1 (psi) Finish TORQUE (ft-lb) COMMENTS Date: Sheet of Product Series: SS______ RS_______ Installation Angle: Recorded by:

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Helical Pulldown Micropile Installation Log

Project: Anchor/Pile Number: Helix Configuration: Grout Column Diameter: Time: Start DEPTH (ft) DP-1 (psi) Finish TORQUE (ft-lb) Date: Sheet of Product Series: SS______ RS_______ Installation Angle: Sleeve Depth: From Recorded by: GROUT FLOW (Volume/Shaft/Length) to

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Atlas Resistance Piers - Project Summary Log Project: Project Completion Date: Sheet
PIER NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 LIFT DRIVE DATE TOTAL DEPTH INSTALL PRESSURE INSTALL LOAD STAGE

of
FINAL LIFT PRESSURE FINAL LIFT LOAD FINAL LIFT AMOUNT FS DRIVE vs LIFT

Report Prepared By:

Date:

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