Atlanta Streetcar Overhead Contact System Deactivation Request
Work within ten feet of the Overhead Contact System requires line deactivation
Minimum Ten-business days notification
Required Information
Company NameApplicant Name and e-mail address /
Office Phone
/Mobile Phone
/Fax (if unable to provide e-mail)
Deactivation Date(s): (mm/dd/yy)
/Mon-Thur Start (from 12:30 AM each night)
/Tue-Fri End (until 4:30 AM each morning)
until /:_m
/:_m
Post-Fri service Start (from 2:30 AM Sat)
/Pre-Sat service End (until 7:00 AM Sat)
/Post-Sat service Start (from 2:30 AM Sun)
:_m
/:_m
/:_m
Pre-Sun service End (until 7:30 AM Sun)
/Sun Start (from 12:30 AM)
/Mon End (until 4:30 AM)
:_m
/:_m
/:_m
Location of Work (Include Address or Affected Street with Proximity in Measured Feet to Nearest Cross Street)
/ Street Use Permit No.Primary Contact Person (Project Manager or Crew Lead, On-Site preferred) / Mobile Phone 24/7
Alternate Contact Person (On-Site Lead Foreman or Second-in-Command) / Mobile Phone 24/7
Purchase or Work Order No. (if applicable) / Billing Address w/”Attn” Person Name
SuppLEMENTAL INFORMATION
Description of work.
▼ Include description in space below – specify if line segment removal is required ▼
Nature of Work
Will work require general-purpose traffic to be detoured?
▼ If “YES” continue below ▼
/(Check one)►
/YES
/NO
Traffic Control Plan (Brief Description of Official Detour Route, UPO posts)
Will work affect Streetcar Station Stops?
▼ If “YES” continue below ▼
/(Check one)►
/YES
/NO
Location of station stop(s) and how affected
Will time range of work conform to allowable OCS outage range? (See chart below)
▼ If “NO” continue below ▼
/(Check one)►
/YES
/NO
Explanation
reference chart for nightly allowable range of A streetcar ocs outageDAY OF OPERATION
/STREETCAR HOURS
/PRE-OP & POST OP BUFFER
/RANGE ALLOWED FOR OCS OUTAGE
MONDAY
/6:00 AM until11:00 PM
/5:00 AM to 6:00 AM and 11:00 PM to 12:30 AM
/12:30 AM Tue– 5:00 AM Tue
TUESDAY
/6:00 AM until11:00 PM
/5:00 AM to 6:00 AM and 11:00 PM to 12:30 AM
/12:30 AM Wed – 5:00 AM Wed
WEDNESDAY
/6:00 AM until11:00 PM
/5:00 AM to 6:00 AM and 11:00 PM to 12:30 AM
/12:30 AM Thu – 5:00 AM Thu
THURSDAY
/6:00 AM until11:00 PM
/5:00 AM to 6:00 AM and 11:00 PM to 12:30 AM
/12:30 AM Fri – 5:00 AM Fri
FRIDAY
/6:00 AM until 1:00 AM
/5:00 AM to 6:00 AM and 1:00AM to 2:30 AM
/2:30 AM Sat – 7:30 AM Sat
SATURDAY
/8:30 AM until 1:00 AM
/7:30 AM to 8:30 AM and 1:00AM to 2:30 AM
/2:30 AM Sun – 8:00 AM Sun
SUNDAY
/9:00 AM until 11:00 PM
/8:00 AM to 9:00 AM and 11:00 PM to 12:30 AM
/12:30 AM Mon – 5:00 AM Mon
HOLIDAY SCHED*
PRECEDING MON-FRI
/9:00 AM until 11:00 PM
/8:00 AM to 9:00 AM and 11:00 PM to 12:30 AM
/12:30 AM Holiday – 5:00 AM Mon-Fri
* May not pertain to all holidays.
Confirmation of request / Form No.FOR DPW/OFFICE OF TRANSPORTATION/STREETCAR OPERATIONS ONLY
Request approved? / Yes No / If “NO” then explanation for denial ►
Streetcar Ops approved? / Yes No / Manager: / Date: / LCC notified? / Yes No
Safety/Security approved? / Yes No / Director: / Date: / Dispatch notified? / Yes No
Request rescinded by DPW or cancelled by submitter? / Yes / Date rescinded or Cancelled
▼ If “YES’ then reason for rescinding or cancelling ▼
Coordinator Name / Date received / Date approved/Rejected
Approved Rejected
Atlanta Streetcar / Phone 404-546-5785 12/15/2014