HomeMy WebLinkAbout40-09 Thermo Fisher Scientific - Building Addition - Back Creek - BackfileSITE PLAN TRACKING SKEET
Comment Sheets:
r
GIS VDOT
Sanitation Authority Winchester
Inspections Stephens City
Public Works '/ Middleto«-n,
Parks & Rec Y Airport
Health Dept. file
One copy of Site Plan application form
Payment of site plan review fee
`f One reproducible copy of Site Plan
OPEN FILE:
1113 n File Opened
(� Reference Manual updated/number assigned
(3Zo D-base updated
/- ?j.Qo Application Action Summary updated
CLOSE FILE:
0 - Approved (or denied) letter mailed to applicant/copy to file and ce's
d File stamped "approved "denied" or "withdrawn"
Reference Manual updated
Q - D-base updated
Application Action Summary updated
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GREENWAY ENGINEERING
d 151 Windy Hill Lane
Founded in 1971 Winchester, Virginia 22602
TRANSMITTAL
Project Name: Thermo Fisher
File No: 0935G
Date: Thu, Jul 1, 2010
To: Frederick County Planning
107 North Kent St
Winchester, VA 22601
Attn: Mark Cheran
Copied
Delivery: ❑ Fed Ex
❑ Other_
❑ U.S. Mail
From: Jeremy Tweedie/cls
GREENWAY ENGINEERING
Phone: 540-662-4185
Fax: 540-722-9528
FVJ Courier [] Pick Up
❑ Urgent ❑ For Your Review ® As You Requested ❑ Please Comment
CO Y' 0'f'rR +DERICK
Department of Planning and Development
540/ 665-5651
FAX: 540/665-6395
December 8, 2009
Mr. Jeremy Tweedie
Greenway Engineering, Inc.
151 Windy Hill Lane
Winchester, VA 22602
RE: Approval of Site Plan #40-09; Thermo Fisher Scientific
Property Identification Number (PIN): 90-A-58A
Dear Jeremy:
The above -referenced site plan was approved on December 8, 2009. Tile site plan is approved for
the construction of a new 41,600 square foot manUfaClUring building at the existing Thermo
Fisher Scientific site located at 8365 Valley Pike (Route 1 1) in the Opequon Magisterial District.
Required site improvements include the following:
Construction of a parking lot with 18 new parking spaces (including two handicap
accessible), including curb and gutter, striping, handicap access and landscaping (site will
have a total of 274 parking spaces).
A new entrance on Valley Pike (site will have a total of two entrances).
Landscaping as shown on sheet 13 of the site plan.
All requirements of the Frederick County Zoning Ordinance have been met in the approved site
plan, including review agency comments from all relevant review agencies. I am providing you
with six (6) copies of the approved site plan. Please forward these copies to the appropriate
representative(s). Furthermore, advise the owner(s) that a copy should be kept for future
reference, and an approved copy must be kept on the construction site throughout the
development process. Once site development is complete, the owner(s) should contact this office
to schedule an on -site inspection. Do not hesitate to contact me if you have any questions.
Sincerely,
Candice E. Perkins, AICP
Senior Planner
CEP/bad
cc: Bill Ewing, Opequon District Supervisor
Roger Thomas and Brian Madagan, Opequon District Planning Commissioners
Commissioner of the Revenue
Jane Anderson, Real Estate
Patrick Barker, EDC
Thermo Fisher Scientific, 8365 Valley Pike, Middletown, VA 22645
107 North Kent Street, Suite 202 • Winchester, Virginia 22601-5000
•
•
Candice Perkins
From: Joe Wilder
Sent: Wednesday, December 02, 2009 11:51 AM
To: 'Jeremy Tweedie'
Cc: Rhonda Sargent; Candice Perkins
Subject: Thermo -Fisher Site Plan
Jeremy,
Upon review of the revised site plan dated November 10, 2009 for the Thermo -Fisher Scientific project, all of our
previous comments have been addressed. Therefore, we recommend approval of the subject site plan. A formal
approval letter will be sent out in the next couple of days.
Joe C. Wilder
Deputy Director of Public Works
107 N. Kent Street
Winchester, Va. 22601
•
I�ecluest 1401- kite Plan Comments
Frederick County Inspections Depart-nlent
Ala i1 to:
Frederick County hlspections Department
Attn: Building Official
107 North Kent Street
Winchester, VA 22601
(540) 665-5650
Hand deliver- to:
107 North Kent Street
Fourth Floor
Winchester, VA
(540) 665-5650
Please fill out the information as accurately as possible in order to assist the agency with
their review. Please attach one (1) copy of the site p1i111 with this sheet.
Applicant's Name: Greenway Engineering
Address: 151 Windy Hill Lane Winchester Virginia 22602
Phone Number: (540) 662-4185
Name of development and/or description of the request: Thermo Fisher Scientific -
Building Addition
Location of property: 8365 Valley Pike Middletown
Inspections Department's Comments:
15
• 0
Buildings shall comply with The Virginia Uniform Statewide Building Code and Sections 306,
Use Group F (Factory and Industrial) of the International Building Code/2006. Other Code that
applies is ICC/ANSI Al 17.1-03 Accessible and Usable Buildings and Facilities.
Proposed 41,600 sq ft building shall comply with the IBC Table 503 for height and area or
Section 506 for unlimited area building. Full Sprinkler system required. Egress location and
travel distance shall comply with Chapter 10, IBC. All required egress door shall be accessible
and area of rescue can be utilized on the landings at the loading docks provided the exterior wall
is fire rated per section 1007.6 Exterior area for assisted rescue and wall rating per 1007.6.2
Question as to accessible emergency egress
Design Professional licensed in CIA shall seal the structural plans submitted for permit
application and special inspection requirements of Chapter 17 of IBC shall apply to this type of
structure. (soil, concrete, steel etc.)
11/24/09 revised to include Accessible ramp at rear exit. Interior area of refuge is not an
approved accessible exit. Emergency egress shall meet travel distance as required by IBC. An
exterior area of refuge may be required per 1107 IBC. Walls within 10' of landing shall be rated
for one hour & include emergency voice communications. Evaluation of exiting requirement
shall be done at building review stage. ANSI approved ramp shall not exceed 1:12 slope or
exceed 30" rise/30' run with out landing. Ramp appears ok per plan
1 • •
GREENWAY ENGINEERING,IH�.
-��
151 Windy I fill lane
I Winchester, Virginia 22602
1 '
Founded in 1971
November 16, 2009
Frccicricic County
Department of Planning and Developmcnt
107 North Kent Street, Suite 202
Winchester, VA 22601
Attu: Candice Perkins
Re: 'Thermo Fishcr—Site Plan #40-09
Comment Response better
Dear Ms. Perkins:
We arc in receipt of the comments datecl November 4, 2009 and offer the following
responses:
Comments from Frederick County Planning
Colnnnvrl 1: Special Limited Power oFAttorney Toren. Please have The Proper(), owner sign /be
rr/lac•hed .Shecra/ Linlrled Power o1','1//0l71()' I'017n pr101' /o /ia/he'r 12.'Plew 01' (I/)rinua/. 7Gi.r /one should be
nolrn•itier/ rani/ t-Ompleled /o grill/ /he (ppin•all/ Dion) w lh rnr/h0n-lr/loll to 1 [:presell/ /hells /or /bi.r .tile plan/.
Response: SI,110r1 provide as rcyucstcd
Conllnenl 2: Valley Pike. In/itrrle 1/'a RO IV dediia/iou i.r ucc:essaly /ol• Rowe 1 /.
Response: Please sec attached VDOT approval, no r/w recluestecl for the site plan.
Colanlen/ 3: Ordinance References. The ordinance re/i?rwu s on /he t-ovowbeel need /o be nw .red /o
r ir�ler / /he new /bl7nrr/.
Response: Revised as noted. Rcfcr to sheet '1.
Conrnlew 4: Parking Cfllculatlons. The parkiq lwkw/aliolls shown do no/ rcIlva The roll' ed parking
al-/ill(wo" the new ra/tll/a/ion is /.5 .tprn•e.r per emplgee p/n.r alvas o/ of%ice or o/ber 11ses.
Response: Parking calculation has been revised as discussed. Rcfcr to sheet 1.
Colmilen/ 5: Existing Building Labe/ /he exir/ilig bui/r/ilii as "173R, or 111dica/e i/ il i.r being
1 �'Iocalerl.
Response: 1"Xisting building is to be dcmolishcd. Refer to sheet 7.
linginecrs Sunvcyors Planners linviloll nuental scientists
Fdc 110915G/tot
I'elehhonc 540-662-4185 FAX 540-722-9528
1
www.greenwayeng.com
C ,owed G: BRL's. The rear 1310_ needs to be 75 fire/, nol 25 /i�d.
Response: Revised as noted. Refer to sheet 2 & G
C,OnlJnen/ 7: Paged Area, Then, i.r a new lrmwed mea /bal i.r nol labeled; indicale whal /bi.r al -ea will be
al/btiPll /oi:
Response: Loading travel way and Loading clocks labclecl as noted. Refer to sheet G.
C0nrnrenl S. Landscaping. I'l-011i /e /anr/.rrn/urt ccr/cn/al o1is. fiw Me c.tii.r/ink auc/rrnlmsed pai-kind areas
and chirunS laver (inclitdirig evergn,err .rbrirb.r alolig Ron/e
Response: I,anclscaping provided as discussed. Refer to sheet 13.
Coamnenl 9: Lighting., Indicale i/"/benv will be anp packing ar• buildiiig morn led /igblirlg on /be addi/iou.
Response: Building mounted lighting shall be proviclecl. Refer to sheet 14 for location and
specifications.
"Thank you for }lour assistance with this project. Contact us with any questions or need for
additional information.
Sincercly,
Grecmva), Engineering, Inc.
9 /cc, •c-g
Jercmy N. Twcedic, project Manager
I ,nclosures
Cc: John Yenges, Geis Co.
JD Wall, "Thermo Fisher
Pdc fl0935G,/jnt 2
•
A
GREENWAY ENGINEERING
1 . 151 Windy Hill Lane
Founded in 1971 Winchester, Virginia 22602
TRANSMITTAL
Project Name: Thermo Fisher -Building Addition Site Plan
File No: 0935 ,
Date: Tue, Nov 24, 2009
To: FC Planning
Aun: Candice Perkins
Copied
Delivery: ❑ Fed Ex
❑ Other_
❑ Urgent ® For Your Review ❑ As You Requested ® Please Comment
From: Jeremy Tweedie/dlm
GREENWAY ENGINEERING
Phone: 540-662-4185
Fax: 540-722-9528
❑ U.S. Mail
Message
® Courier ❑ Pick Up
Candice,
Attached is the following:
- I - copy pf the Building addition site plan revised per you r comments
SLPOA
-Comment Response Letter
-Approvals from the following agencies
FC Fire Marshal
VDOT
FC Public Works
FCSA
Please not FC Inspection is forth coming, I re -submitted today and will forward approval once recieved.
As always, thank you for your assistance. Call with any questions.
r
Hand Delivery and Pick Ups Only:
h!OV 2 4 2000
Received by: Date: Time:
Please Print Name:
rT
z " 4 r,
r'ii 1; Special Limited Power of Attorney
' County of Frederick, Virginia
Frederick Planning Web Site: www.co.freclerickNa.us
Department of Planning & Development, Comity of Frederick, Virginia,
107 North Kent Street, Suite 202 Winchester, Virginia 22601
Facsimile 540-665-6395 Phone 540-665-5651
Know All Men By These Presents: That I (We)
(Name) Fisher Scientific Company LLC (Phone) (540) 869-8296
(Address) 8365 Valley Pike Middletown. Virginia 22645
the owner(s) of all those tracts or parcels of land ("Property") conveyed to me (us), by deed recorded in the
Clerk's Office of the Circuit Court of the County of Frederick, Virginia, by
Instrument No. Deed Book 492 on Page h and is described as
Parcel: 90 Lot: 58A Block: A Section: Subdivision:
do hereby make, constitute and appoint:
(Name) Greenway Engineering Inc (Phone) (540) 662-4185
(Address) 151 Windy Hill Lane Winchester VA 22602
To act as my true and lawful attorney -in -fact for and in my (our) name, place and stead with full power and
authority I (we) would have if acting personally to file planning application for my (our) above described
Property, including:
❑ Rezoning (Including proffers)
❑ Conditional Use Permit
❑ ltilaster Development Plan (Preliminary and Final)
❑ Subdivision
® Site Plan
❑ Variance or Appeal
❑ Comprehensive Policy Plan Amendment
N,ty attorney -in -fact shall have the authority to offer proffered conditions and to make amendments to
previously approved proffered conditions except as follows:
This authorization shall expire one year from the day it is signed, or until it is otherwise rescinded or
modified.
In witness thereof, I (we) have I\ejeto set my (our) hand and seal this G clay of /VO✓ , 200
Signature(s)
State of Virginia, City/County of To -wit:
1, 7 a Notary Public in and for the jurisdiction aforesaid, certify that the person(s) who
signed t� goir strument and Who I (are) known to me, personally appeared before me and has
acknowledged the same before me in the jurisdiction aforesaid this day of l%�, 200�_.
_ My Commission Expires: 3
Notary Public Registration It: j0 yU/39
Revised 3/17/08 /
BONNIE H. MARKLEY
Public Reg. p 7040139
_ +¢
•�1)�•
Notary •
Commonwealth of Virginia
. -,z Mar 31, 2010
Thermo Fisher -Building AddiJyQn - VDOT Plan Approval Page I of 1
Jeremy Tweedie
From: Funkhouser, Rhonda [Rhonda.Funkhouser@VDOT.Virginia.gov] on behalf of Smith, Matthew, P.E.
[Matthew.Smith @vdot.virginia.gov]
Sent: Thursday, November 05, 2009 10:34 AM
To: Jeremy Tweedie
Cc: Smith, Matthew, P.E.; John.Bishop; Ingram, Lloyd; Hoffman, Gregory; Baker, Philip (Staunton)
Subject: Thermo Fisher -Building Addition - VDOT Plan Approval
We have received your revised site plan dated October 30, 2009 for the referenced project. It
appears all of our earlier review comments have been satisfactorily addressed. Please advise
the owner of our approval. Also please provide four (4) sets of approved construction
plans with signed seal for VDOT distribution.
The appropriate land use permit may now be applied for to cover work within the Route 11
right-of-way. The permit is issued by this office and will require a minimum processing fee,
surety bond coverage, and the salary & expenses of a State assigned Inspector. A copy of
any/all recorded plats of dedication for drainage easements or additional right-of-way required
for implementation of this proposed project should be provided to VDOT prior to issuance of
any land use permits. Dedication should be made to the Commonwealth of Virginia.
Once satisfactory application has been made, a permit will normally take approximately thirty
days to process and issue. Should you have any questions, do not hesitate to call.
<<SCN 20091105103204_001.pdf>>
Matthew I3. Smith, P.E.
Residency Staff Engineer
VDOT - Edinburg Residency
14031 Old Valley Pike
Edinburg, VA 22824
Phone #E (540) 984-5615
Fax ## (540) 984-5607
11/23/2009
Request For Site Plan Comments
Virginia Department of Transportation
Mail to:
Virginia Department of Transportation
Attn: Resident Engineer
14031 Old Valley Pike
Edinburg, Virginia 22824
(540) 994-5600
Hand deliver to:
Virginia Department of Transportation
2275 Northwestern Pike
Winchester, VA 22603
(540)535-1828
Please fill out the information as accuratcly as possible in order to assist the agency with
their review. Please attach five (5) copies of the site plan with traffic generation data
and drainage calculations with this sheet.
Applicant's Name: Greenway Engineering
Address: 151 Windy Hill Lane Winchester Virginia 22602
Phone Number. (540) 662-4185
Name of development and/or description of the request: Thermo Fisher Scientific -
Building Addition
Location of property: 8365 Valley Pike. Middletown
Virginia Department of Transoration Comments: See attached VDOT approval
in e-mail dated November 5, 2009.
' vno i�rse one`^����*�"-�:�{�; a. �?:� . ' :, , ��!_ _���N4: ; . a�� .;• T, �; .
14
Request For Site Plan Comments
Frederick County Sanitation Authority
Mail to: Hand deli%,er to:
Frederick County Sanitation Authority 315 Tasker Road
Attn: Engineer Director Stephens City, VA
P.O. Box 1877 (540) 868-1061
Winchester, VA 22604
(540) 868-1061
Please fill out the information as accurately as possible in order to assist the agency with
their review. Please attach t�I•o (2) copies of the site plan with this sheet.
Applicant's Name: Greenway Engineering
Address: 151 Windy Hill Lane Winchester, Virginia 22602
Phone Number: (540) 662-4185
Name of development and/or description of the request: Thermo Fisher Scientific -
Building Addition
Location of property: 8365 Valley Pike, Middletown
Frederick County Sanitation Authority's Comments:
T�C /,YoT S,EraV11141'
7',d1/ S
Sanitation Authority use only
Date received Date revision received I),itc apprord >
Incomplete Incomplete
Date revie"cd Z "ed
signature and Date
Signature and (revision)
IN
0
•
Frederick County Fire and Rescue
Department
O ice od.the Fire Marshal
Plan Review and Cibimments
Control number Dale received Date reviewed
S PO 9 - 0 0 31 11 /2/2009 11 /2/2009
Project Name Applicant
Thermo Fisher Scientific -Building Addition Greenway Engineering
Address City State Zip
8365 Valley Pike Middletown VA 0
Date Revised
Applicant Phone
540-662-4185
Type Application Tax ID Number Fire District Rescue District
Site Plan 90-A-58A 12 12
Current Zoning Election District
MI Recommendations Back Creek
Automatic Sprinkler System Automatic Fire Alarm System Residential Sprinkler System
Yes Yes No
Other recommendation
Emergency Vehicle Access
Adequate
Siamese Location
Not Identified
Emergency Vehicle Access Comments
Access Comments
Additional Comments
R
2 C �qu:rernents
�..•
Hydrant Location
Adequate
Roadway/Aisleway Width
Adequate
Fire Lane Required
Yes
Special Hazards
No
Plan Approval Recommended
Yes
Reviewed By
J. Neal
Signature
Title
r
E
•
November 4, 2009
Mr. Jeremy Tweedie
Greenway Engineering, Inc.
151 Windy Hill Lane
Winchester, VA 22602
COUNTY of I+ RIEDERICK
Department of Planning and Development
540/665-5651
FAX: 540/ 665-6395
Re: Review Comments for Site Plan 440-09; Thermo Fisher Scientific
Property Identification Number (PIN): 90-A-58A
Dear Jeremy:
Planning Staff has reviewed the above -referenced site plan to determine if administrative
approval can be granted. At this time, administrative approval cannot be granted. This
site plan is denied until the issues in this letter, as well as all issues of the other review
agencies, have been adequately addressed. Please review Staff's comments listed below
and then prepare a revised site plan which adequately addresses each concern.
Review Comments
1. Special Limited Power of Attorney Form. Please have the property owner sign
the attached Special Limited Power of Attorney Form prior to further review or
approval. This form should be notarized and completed to grant the applicant
(you) with authorization to represent them for this site plan.
2. Valley Pike. Indicate if a ROW dedication is necessary for Route 1 1.
3. Ordinance References. The ordinance references on the coversheet need to be
revised to reflect the new format.
4. Parking Calculations. The parking calculation shown does not reflect the
revised parking ordinance; the new calculation is 1.5 spaces per employee plus
areas of office or other uses.
5. Existing Building. Label the existing building as TBR, or indicate if it is being
relocated.
6. BRL's. The rear BRL needs to be 75 feet, not 25 feet.
7. Paved Area. There is a new paved area that is not labeled; indicate what this area
will be utilized for.
8. Landscaping. Provide landscaping calculations for the existing and proposed
parking areas and driving lanes (including evergreen shrubs along Route 1 1).
107 North Dent Street, Suite 202 o Winchester, Virginia 22601-5000
e
Mr. Jeremy Tweedie 0
RE: Site Plan 11-09
November 4, 2009
Page 2
9. Lighting. Indicate if there will be any parking or building mounted lighting on
the addition.
After you have revised the site plan, please resubmit two copies so that I may verify the
information contained on the plan. I will need all approved review agency comment
sheets and at least five copies of the final plan for approval. Comment sheets are
required from the following agencies: the Frederick County Inspections Department, the
Frederick County Depa7'1171el?t of Public 6Vorks (County Fnginee7), the Frederick County
Fire Marshall, and the Virginia Department of Transportation.
Sincerely,
Candice E. Perkins, AICP
Senior Planner
cc: Thermo Fisher Scientific, 8365 Valley Pike, Middletown, VA 22645
CEP/bad
Attachment
•
SITE PLAN APPLICATION
Department of Planning and Development Use Only.
Date application received % �j Application #`�
❑ Complete Date of Acceptance
❑ Incomplete Date of return
1. Project Title:
Thermo Fisher Scientific -Building
Addition
2. Location of Property
8365 Valley Pike, Middletown
(street address)
3. Property Owner:
Fisher Scientific Company, LLC
Address:
8365 Valley Pike
Middletown, VA 22645
Telephone
540-869-8296
4. Applicant/Agent Address
Greenway Engineering, Inc.
151 Windy Hill Lane
Winchester, VA 22602
Telephone
540-662-4185
5. Designer:
Greenway Engineering,_ Inc.
Address:
Same
Telephone:
Same
Contact:
Jeremy Tweedie
6
rj
6. Is this an original or revised site plan?
7a. Total acreage of parcel to be developed:
7b. Total acreage of parcel:
8. Property Information:
a) Property Identification Number:
b) Current Zoning:
c) Present Use:
d) Proposed Use:
e) Adjoining Property Use(s)
f) Adjoining Property Identification Nuinber(s)
g) Magisterial District(s)
Original ❑ Revised
4.9 acres
18.209 acres
90-A-58A
MI
Manufacturing
Manufacturing
Manufacturing, residential,
battlefield
90-A-59A, 90-A-55, 90-A-58,
90-A-5813, 90-A-58C
Back Creek
I have read the material included in this package and understand what is required by the
Frederick County Planning Department. I also understand that all required material will
be complete prior to the submission of my site plan.
Signature: -
Date: /D �/0
7
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•
Request For Site Plan Comments
Department of Planning and Development
Mail to:
Department of Planning and Development
Attn: County Planner
107 North Kent Street
Winchester, VA 22601
(540) 665-5651
Hand deliver- to:
107 North Kent Street
Fourth Floor
Winchester, VA
(540) 665-5651
Please fill out the information as accurately as possible in order to assist the agency with
their review. Please attach two (2) copies of the site plan with this sheet.
Applicant's Name: Greenway Engineering
Address: 151 Windy Hill Lane Winchester, Virginia 22602
Phone Number: (540) 662-4185
Name of development and/or description of the request: Thermo Fisher Scientific -
Building Addition
Location of property: 8365 Valley Pike, Middletown
Planning and Development's Comments:
Planning and Development use only
Date received Date revision received Date approved
Incomplete Incomplete
Date reviewed Date reviewed
Signature and Date
Signature and Date (revision
16
GREENWAY ENGINEERING
151 Windy Hill Lane ( P,
Founded in 1971 Winchester, Virginia 22602
TRANSMITTAL
Project Name: Thermo Fisher -Building Addition Site Plan
File No: 0935G
Date: Tue, Nov 3, 2009
To: FC Planning
Attn: Candice Perkins
Copied
From: Jeremy Tweedie/dlm
GREENWAY ENGINEERING
Phone: 540-662-4185
Fax: 540-722-9528
Delivery: ❑ Fed Ex ❑ U.S. Mail ❑� Courier ❑ Pick Up
❑ Other
❑ Urgent ❑� For Your Review ❑ As You Requested 0 Please Comment
Message
Candice,
Attached is the following:
-Building addition site plan review fee check for $3,480.00
As always, thank you for your assistance. Call with any questions.
t
Hand Delivery and Pick Ups Only:
Received by: Date: Time:
Please Print Name:
•
•
0 GREENWAY ENGINEERING
151 Windy 1-1i11 Lane
Founded ur 1971 Winchester, Virginia 22602
TRANSMITTAL
Project Name: Thermo Fisher -Building Addition Site Plan
File No: 0935G
Date: Fri. Oct 30. 2009
To: FC Planning
Attn: Candice Perkins
Copied
1=r0111: Jeremy Tweedie/dlm
GREENWAY ENGINEERING
Phone: 540-662-4185
Fax: 540-722-9528
Delivery: ❑ Fed Ex ❑ U.S. Mail ❑ Courier ❑ Pick Up
❑ Other
❑ Urgent ❑� For Your Review ❑ As You Requested ❑� Please Comment
_ Message - —
Candice.
Attached is the following for your review:
-Building addition site plan application
-2 copies of the building addition site plan
-Planning comment sheet
We are in the process of obtaining review agency approvals and will forward to your office once we
I receive.
Thank you for your assist; ice. Call with any question.
Hand Delivery and Pick Ups OnIN
Received by:
Please Print Name:
Date: OC�T n�e 0 2009
C. Y-\
•
0
Document Approval Form
PLEASE REVIEW THE ATTACHED DOCUMENT. IF THIS DOCUMENT MEETS YOUR
APPROVAL PLEASE INITIAL AND PROVIDE THE DATE AND TIME OF YOUR
APPROVAL.
IF THIS DOCUMENT DOES NOT MEET YOUR APPROVAL PLEASE PROVIDE
COMMENTS AS TO WHAT YOU WOULD LIKE TO HAVE COMPLETED.
INITIALS DATE & TIME
Candice
Mark �f—
Dana
Eric
Mike
John
COMMENTS:
Received by Clerical Staff (Date & Time): �2 0)
U:\Pam\Common\Document Approval Form.wpd