HRSD Project Initiation Form
South Shore Interceptor Engineers:
Bambos C. Charalambous, P.E. (O) 757.460.7015, Cell: 757.374.1758 Email: bcharalambous@hrsd.com
Gene Rutledge, P.E. (O) 757.318.4338, Cell: 757.284.7222
North Shore Interceptor Engineer:
Ryan Brewster, P.E. (O) 757.833.1729 Fax: 757.875.5210 Email: rbrewster@hrsd.com
Project Name:
Type of Project: (check all that apply)
Commercial
Private Residence
Industrial
Roadway
Public Utility
Educational
Military
Private Utility
Residential Subdivision
Project Owner
Contact Name
Phone No.
Project Location
Jurisdiction:
Street Address or Intersection:
Tax Map Parcel ID or GPIN:
Military Facility (if applicable)
If Roadway Project, provide Route No:
Begin work at
street/route:
End work at
Street/Route:
NOTE: Please provide project location map to include HRSD connection point if applicable.
Project & Sewer Utility Infrastructure Description
Engineering Firm Information
Name:
Address:
Project Manager:
Project Engineer:
Construction Firm Information
Name:
Superintendent:
Main Office No:
Email:
Email:
Main Office No:
Contact No.
Other
Project Proposed Connection Type (check all that apply)
Directly to HRSD Interceptor Force Main
Existing Branch Valve
New Tap Valve
Directly to HRSD Interceptor Gravity Main
Existing Sewer Manhole
New Sewer Manhole
To Existing City Force Main branch valve/tee
To New City Force Main tapping valve/tee
To Existing City Gravity Sewer Manhole
Private Pump Station/Force Main
Public Pump Station/Force Main
Project Theoretical Design Flows (Regional Technical Standards)
New Development
Avg Daily Flow (gpd):
Peak Daily Flow (gpd)
Residential:
Commercial:
Redevelopment
Existing Flows
Q (avg)
Q (peak)
gpd
gpd
Re-Development Flows
Q (avg)
Q (peak)
gpd
gpd
Residential
Commercial
Industrial Permitted – Regulated Waste Stream
Will your project generate industrial waste other than domestic and discharge into HRSD’s interceptor
network?
Yes
No
If yes, please call Matt Cox at 460-7048 for South Shore, or call Mike Martin at 833-1750 for North
Shore.
Available HRSD Resources:
HRSD map book pages can be accessed online at www.hrsd.com/gisonline.htm
Access requires a username and password. You can apply for access at this same website.
HRSD record drawings can be requested directly from the HRSD Drafting Division by sending an
email with specific description of the area needed to dpq@hrsd.com
Connection details and notes are available online at www.hrsd.com/iec.htm
All projects that use these details and notes must still be submitted for HRSD review and approval.
Notice to Applicant:
All application requests will be processed within 3 weeks from submittal date to HRSD.
In order to avoid delays, please ensure the form is fully completed and all pertinent documents are
attached to the request form.
Applications can be email or forwarded by mail to the respective HRSD Interceptor Engineer.
Signature: ____________________________________
Date: ________________