NR L2 Civ 003 Formc

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NR/L2/CIV/003/FormC Issue 2, March 2022
NR/L2/CIV/003/FormC:
Certificate of Design and Check for temporary works.
Document reference Revision

Date
Project Title
Project Nr
Remit / Technical Work Revision & date
Scope (TWS) Nr
Requirements Revision & date
documents reference
Nr
CR-T Reference Nr Revision & date
Other design and check Insert document reference and name of related design
certificates associated and check certificates (building services, architectural &
with this submission layout, permanent way, ancillary civils etc) and other
documents associated with this submission
PART 1: DESIGNERS SUBMISSION; DESIGN AND DETAILS

1.1 Brief Description of existing conditions
The designer is to advise current conditions as background for proposed
changes
1.2 Proposed works, scope of Design and assets affected.

As set out in the Contracts Requirement Technical (CR-T), and Requirements
documents, this submission relates to the Design of the following temporary works
Temporary works 1
Description
Location
ELR Mileage
Asset Nr OS grid ref
Proposed Design Check (insert, I, II or III)
temporary works Category
Proposed works description
Note; repeat above as necessary.

Provide details for each design by completing the above boxed heading for each
temporary works and the remainder of Part 1. Designer to list each design and
proposed design check category
Unless this submission warrants a more onerous requirement (for example, due to a
change in anticipated complexity; see Guidance Note) the Categories are to align
with the requirements of this Standard.
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1.3 Construction Methodology
The designer is to confirm the temporary works methodology accords with that
envisaged by the Permanent Works Designer in the Form A, else list any variation
here with reasoning.
1.4 Temporary works
The Temporary Works Designer is to describe temporary works needed to facilitate
compliance with the DIA, such as the provision of temporary footbridges, hoardings,
alternative means of escape, phasing, and such like, where applicable.
The Temporary Works Designer is to consider impact from other disciplines on the
provision for temporary works, e.g., for services and other equipment supported on
temporary works.
The Temporary Works Designer is to review permanent works designs to ensure that
the Permanent Works Designer’s requirements for temporary works construction
methodology and sequencing have been accommodated, where applicable.
The Temporary Works Designer shall be satisfied that all temporary works designs
have been adequately designed and checked for stability at all times, so as not to
import risk of collapse during erection, use or deconstruction. This shall be
demonstrated to the satisfaction of the PE (B&C) and DPE.
1.5 Proposals for the staging of the Design and Design Check submissions
The designer is to confirm the temporary works staging accords with that envisaged
by the Permanent Works Designer in the FormA, else list any variation here with
reasoning.
1.6 Design criteria and design statement
1.6.1 General
The methodology that is to be adopted in the Design is to be stated here including
the proposed methods of analysis. Where relevant, reference is to be made to
NR/L2/CIV/003/F1990 to NR/L2/CIV/003/F1994 & NR/L2/CIV/003/F1997 and
decisions on the options/choices recorded.
1.6.2 Geotechnical Design and Considerations

For designs including geotechnical aspects, this Form is to either include, have
appended or refer to, a Geotechnical Design Report (GDR). (NB for Design Check
Category III works, the Geotechnical Design Report is not to be included in this Form
(to maintain independence of Design Check) but is to be provided separately.
Where ground investigations have been undertaken, this Form is to either have
appended or refer to, a Ground Investigation Report (GIR).
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Take account of mining risks with the potential to affect the works, including
reference to mining documentation identified in NR/L2/CIV/191/MOD05.
State proposed (BS EN 1997-1) Geotechnical Category (1, 2 or 3) and rationale.
1.6.3 Design Criteria
The designer is to state the following:
 Design Life in accordance with NR/L2/CIV/003/F1990
 Operational requirements
 Loading requirements
 Fire resistance and escape times
 Diversity and Inclusion requirements arising from a DIA
 Station pedestrian capacity assessment
 Environmental requirements
1.7 Standards to be used in the Design
1.7.1 Date of standards freeze

Normally this would be the date that this form has been signed off, unless that date
has been amended in the CR-T.
1.7.2 List of Design standards

Attach a list of applicable Design standards is to be provided as part of the detailed
design, where this is a requirement of the CR T- Principal standards are to be listed
in this AIP.
1.8 Variations to standards
Details of all variations to all standards are to be provided with this submission, with
justification. If there are none, state not applicable.
Provide demonstration that such variations have been applied for and agreed in
accordance with NR standard NR/L2/CSG/STP001/04
1.9 Requirements for operation, inspection, maintenance, repair, renewal or

removal including special access arrangements
Provide any further relevant information, such as:
Hidden/partially hidden parts/elements for the purposes of examination/inspection
1.10 Matters to be considered in the Design

The following matters have been considered during the temporary works Design:
The matters that do not apply to the works to meet the particular CR-T and
Requirements documents are to be struck out by the Contractor’s Responsible
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Engineer appointed for the relevant Design phase
1. So far as is reasonably practicable, the Asset affected will be safe in use when
used in accordance with its intended purpose.
2. Hazards are managed in accordance with requirements of the CDM Regulations
and CSM Regulations. Residual risks are documented in a Risk Register. Risks
to both (a) health and safety during construction, maintenance, use, railway
operations and (b) occupational health and safety, are as low as reasonably
practicable or better.
3. The provisions for examination, maintenance and eventual renewal/removal are
included in the design and are satisfactory.
4. The overall Design concept and the appearance of the infrastructure are
appropriate for their purpose, location and site conditions.
5. Where the proposal includes the strengthening, partial renewal or removal of
structures, the stability of the whole structure and all its parts/elements at all
stages of the works are addressed, including the long-term adequacy of the
remaining parts/elements of the structure and supporting soil.
6. The effects of the proposals on existing infrastructure are adequately considered.
7. Arrangements for liaison and consultation with external bodies (such as Local
Authorities, statutory undertakers, the British Transport Police, the Environmental
Regulators and landowners) are satisfactory and the likely effects of the proposals
on external organisations are addressed. Required Permissions/Approvals have
been obtained to support the proposals.
8. The impact of the proposals on services and service routes is adequately
investigated and appropriate mitigation measures have been agreed with the
relevant Authority and incorporated into the Design.
9. The effects on other rail engineering disciplines including track, gauging, signalling
(including signal sighting), telecommunications, electrification, lighting, GSM-R
directional signal strength and other operational electrical and mechanical
equipment have been satisfactorily considered.
10. Mining related risks have been assessed in the development of the design and are
considered acceptable.
11. The requirements/recommendations of Railway Group Standards, Network Rail
standards and Department for Transport Design Standards for Accessible Railway
Stations have been addressed and proposed departures from these standards are
identified and justified.
12. The requirements of the Building Regulations and any planning conditions have
been met in full where applicable
13. The proposed Design loadings are appropriate, and any non-standard accidental
loadings are correctly identified.
14. The requirements of NR/L2/CIV/003/F1990 to NR/L2/CIV/003/F1994 and
NR/L2/CIV/003/F1997 have been considered and the selected options/choice
recorded in Appendix A1.3 of this certificate, where Eurocodes have been used for
the temporary works design.
15. The proposed Design standards and methods of Design are suitable and in
accordance with NR requirements, standards and legislation, with a list of
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standards provided in Appendix A1.2 of this certificate.
16. A Geotechnical Design Report, which meets the requirements of BS EN 1997 and
NR/L3/CIV/071 is available. This Report justifies the selection of the Geotechnical
Design parameters and outlines any further work required for implementation.
Assumptions have been verified or measures for verification of assumptions have
been incorporated in the detailed design.
17. A plan of geotechnical related construction supervision and monitoring (including
details of items to be checked during construction or requiring maintenance or
monitoring) have been incorporated in the detailed design and meet the
requirements of BS EN 1997.
18. The Design complies with structure clearance and platform stepping distance
requirements.
19. Important Design matters not covered by standards are identified.
20. The proposals are economical and sustainable
21. The proposals have considered requirements for environmental and sustainable
development. The design has adequately considered the results and actions
required from the Environmental and Social Appraisal and the Environmental and
Social Management Plan, where required by NR/L2/ENV/015.
22. The proposed works will not compromise the structural robustness of any existing
structures.
development.
24. All materials specified in the design of structures are compatible with the intended
application and environment. This includes, but is not limited to:
 fixing metallic structures to masonry with studs bonded with resin, grout or
other chemical bonding products
 fixing design is to current standards and guidance
 design and installation comply with manufacturer’s requirements, are
compatible with substrate and includes appropriate verification testing
 building fabric design and associated fixings are appropriate for the
security risk and associated requirements
 suitable and sufficient investigation, as far as reasonably practical, has
been carried out to determine that materials to be used will be compatible.
25. Design calculations have been completed where applicable and checked in
accordance with the Design Check Category(s) agreed in this submission
26. Design and design check calculations will be provided for incorporation into the
Project Health and Safety File.
development.
28. The selection of post-installed anchors in concrete and masonry meet the
requirements of BS 8539.
29. A completed IDC certificate has been provided with this design to comply with
NR/L2/RSE/02009 clause 15.3
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30. A Designers Risk Assessment has been provided with this design.
31. The design has been fully co-ordinated with the permanent works design and all
interfaces have been reviewed and confirmed as satisfactory.
32. The provision of new assets has taken account of the effects on existing assets,
such as effects on cuttings, embankments, other structures or GSM-R.
33. The design has adequately considered pedestrian flow, fire risk, means of escape,
emergency access and escape routes and security requirements.
34. The temporary works have been assessed for frequency of inspection and an
inspection and test plan has been developed and agreed with the designer, based
on a specification of workmanship and materials.
35. The Temporary Works are designed and checked to be stable at all times during
construction, use and deconstruction, with all requirements for achieving stability
clearly stated on drawings and sequencing.
I confirm that the criteria specified in NR/L2/CIV/003 have been considered and
certify that reasonable professional skill and care have been used with the objective
of checking that this temporary works Design:-
(a) is submitted on behalf of
insert name and address of the organisation responsible for the Design,
(b) Meets with the indicative temporary works requirements described in the FormA
reference …………………………..
signed by
………………………………………………………..on……………………where
applicable
Insert name of Project Engineer and date
(c) complies with the Design standards, codes and methods stated in this
Certificate
A list of all applicable Design standards are to be provided with this detailed
design submission, in Appendix A1.2.
A list of all requirements for NR/L2/CIV/003/F1990 to F1997 have been
considered and the selected options/choice recorded on this detailed
design submission, in Appendix A1.3
(d) unless identified in 1.3 and 1.8, (i) the Design complies with all relevant standards
and is delivered in accordance with the CR-T, Requirements documents and (ii) the
deliverables identified within the CR-T/Requirements documents will be completed
and submitted in support of this submission.
(e) Where variations to NR and other standards are necessary, applications to
NR/L2/CSG/STP001/04 have been made and accepted by NR.
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(f) the design is accurately described by the following drawings, models,
schedules, performance, materials and workmanship specifications and other
documents that have been prepared for issue as Approved For Construction
pending the completion of all PARTS of this submission and incorporating
all feedback from Network Rail on the submission.
List the relevant documents, each of which has to be uniquely identified by a
reference, number or otherwise (for example, by their title and date of issue).
Drawing numbers are to include revision letters.
(g) all criteria in Part 1 of this submission have been agreed in advance of the
submission in correspondence with the DPE/PE B&C
(h) The CREc / Principal Contractor’s Temporary Works Coordinator has coordinated
the design with other parties and IDC has been undertaken.
Signed Title
Name (print) Date
To be signed by the Contractor’s Responsible Engineer appointed for the
relevant Design phase
PART 2: CHECK
Checking organisation………….……………………..........................................................
I certify that reasonable professional skill and care have been used in checking the
Design identified in PART 1 of this Certificate, with the objective of checking that the
Design
(a) complies with Part 1 and Appendix A of this certificate
(a) complies with the Design standards, codes and methods stated in this
submission (including any stated variations) and with any additions stated in
PART 1 of this Certificate: the justification given for these additions is
acceptable.
I confirm that the Design was checked as stated below and that the Design Check
has been carried out with the level of independence specified in NR/L2/CIV/003 as
listed below.
Description of associated Description of Design Check
permanent works asset proposed temporary Category
works
Signed Title
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Name (print) Date
To be signed by the Checker
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PART 3: CONSTRUCTION ORGANISATION’S ACKNOWLEDGEMENT OF

SUBMISSION BY A SUB-CONTRACT DESIGNER
The Design organisation named in PART 1 is engaged as a sub-contractor to the
organisation stated below. I formally acknowledge the submission of this Certificate
to Network Rail in support of our contract*/sub-contract* delete as applicable
obligation for provision of the Design on behalf of insert name and address of
organisation responsible for construction works.
Further acknowledgement section(s) are to be completed where there is more than
one layer of sub-contract relationship. Insert ‘not required’ where there is a direct
contract with Network Rail.
Where formal Alliancing contracts are in place the wording of Part 3 of this form may
be adjusted to suit, with agreement of wording by the DPE.
Signed Title
Name (print) Date
To be signed by the Contractor’s Responsible Engineer appointed for the
Construction phase
PART 4: ACCEPTANCE ON BEHALF OF NETWORK RAIL

I accept that, so far as can reasonably be ascertained from the information
submitted, the relevant procedures for the Design and Design Check as specified in
NR/L2/CIV/003 have been followed properly.
I have considered the Design Check statement provided in accordance with clause
15 of NR/L2/CIV/003 and confirm that the stated method of checking was suitable.
I have reviewed the submission and my comments on the submission are as follows:
Signed Title
Name (print) Date
To be signed by the Project Engineer (Building and Civil Engineering)
Signed Title
Name (print) Date
To be signed by other responsible person (if applicable)
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NR/L2/CIV/003/Form C Issue 1
Page ... of ...
GRIP Stage Date
PART 5: ASSET MANAGER’S APPROVAL

(Part 5 is optional and only required where the temporary works will be in place such
that other assets are affects as part of a permanent works scheme, such as
temporary bridges supporting pedestrians as part of revised means of escape during
staged works where the AM has an interest; See NR/L2/CIV/003 clause 13)
I have considered the submission and confirm that the proposed variations to the
Requirements documents/CR-T (delete as appropriate) are acceptable subject to
any comments listed below being addressed prior to proceeding to Approved for
Construction (AFC) Design as defined in NR/L2/RSE/02009..
(Statement to be struck out where variation from the Project Requirements is not
being sought).
I have considered the associated permanent works design submission FormB and
confirm that this is approved subject to the comments given below being addressed
prior to proceeding to Approved for Construction (AfC) Design as defined in
NR/L2/RSE/02009.
Signed Title
Name (Print) Date
To be signed by the Asset Manager (Structures)
Signed Title
Name (Print) Date
To be signed by the Asset Manager (Geotechnical)
Signed Title
Name (Print) Date
To be signed by the Asset Manager (Drainage)
Signed Title
Name (Print) Date
To be signed by the Asset Manager (Buildings)
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GRIP Stage Date
APPENDIX A
A1.1 LIST OF BUILDINGS AND CIVILS ENGINEERING ASSETS AFFECTED BY THE
TEMPORARY WORKS
1. Asset No 1 (add description, ELR and mileage)
Provide details for each asset (or group of assets where applicable) by completing
the following boxed heading and A1.1 to A1.4.
Asset No 1
Description
Location
ELR Mileage
Asset Nr OS grid ref
A1.2 – List of standards used for the development of this design

Designer to list the standards used in the design.
A1.3- NR/L2/CIV/003/F1990 to NR/L2/CIV/003/F1994 and NR/L2/CIV/003/F1997.
Designer to record all aspects of Forms NR/L2/CIV/003/F1990 to

NR/L2/CIV/003/F1994 and NR/L2/CIV/003/F1997, where design decisions have
been made in accordance with the requirements of the forms, where applicable to
temporary works.
A1.4 DETAILED DESIGN DRAWINGS AND MODELS OF PROPOSALS

List the relevant documents, each of which has to be uniquely identified by a
reference, number or otherwise (for example, by their title, date of issue and revision
numbers).
.
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GRIP Stage Date
A1.5 – GEOTECHNICAL CONSIDERATION (IF APPLICABLE)
Provide reports for all geotechnical investigation used to justify the design, including
the proposals for the verification on parameters used in the design whilst
undertaking execution of the works.
A1.6 - ACCOMPANYING DRAWINGS AND OTHER DOCUMENTS

These are to include revision numbers.
A1.7 Certificate of IDC

An IDC certificate is a mandatory requirement of NR/L2/RSE/02009 and is to be
provided with each temporary works submission.
A1.8 Designers Risk Assessment

A designer's risk assessment is required for each submission. This may be as a
standalone document or appropriate notes on drawings and is to make clear residual
risks which a competent contractor needs to be aware of.
Page 12 of 12

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NR/L2/CIV/003/FormC Issue 2, March 2022

Document reference Revision

PART 1: DESIGNERS SUBMISSION; DESIGN AND DETAILS

1.2 Proposed works, scope of Design and assets affected.

Note; repeat above as necessary.

Document reference Revision

1.6.2 Geotechnical Design and Considerations

Document reference Revision

1.7 Standards to be used in the Design

1.7.1 Date of standards freeze

1.7.2 List of Design standards

1.9 Requirements for operation, inspection, maintenance, repair, renewal or

Hidden/partially hidden parts/elements for the purposes of examination/inspection

1.10 Matters to be considered in the Design

Document reference Revision

Document reference Revision

Document reference Revision

Document reference Revision

Document reference Revision

Document reference Revision

PART 3: CONSTRUCTION ORGANISATION’S ACKNOWLEDGEMENT OF

PART 4: ACCEPTANCE ON BEHALF OF NETWORK RAIL

PART 5: ASSET MANAGER’S APPROVAL

A1.2 – List of standards used for the development of this design

A1.3- NR/L2/CIV/003/F1990 to NR/L2/CIV/003/F1994 and NR/L2/CIV/003/F1997.

Designer to record all aspects of Forms NR/L2/CIV/003/F1990 to

A1.4 DETAILED DESIGN DRAWINGS AND MODELS OF PROPOSALS

A1.5 – GEOTECHNICAL CONSIDERATION (IF APPLICABLE)

A1.6 - ACCOMPANYING DRAWINGS AND OTHER DOCUMENTS

A1.7 Certificate of IDC

A1.8 Designers Risk Assessment

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