GIS Data Request Form (8/14/2014)

The ARAMARK Tower
1101 Market Street
Philadelphia, Pennsylvania 19107-2994
Howard M. Neukrug
Commissioner
GIS Data Request Form Name of Requester: ("Requestor") Company/Organization: Address: Phone Number: Email: Date: Name, Phone Number & Email of the Water Department Contact/Sponsor: Project Name: ("Project") Project Location: ("Data") The Project area is bounded by (give specific details on Project boundaries): Names of all employees at Requester's Organization who will have access to the Data: Layers Requested: SEE BELOW
Anticipated dates/duration of Project: Requester agrees with the following terms and conditions for the use of the Data: 1. Requester acknowledges the following: a. Data contains sensitive information about the City's infrastructure; b. Reproduction, distribution or disclosure of Data is strictly prohibited; and c. Data is exempt from public disclosure under the Pennsylvania Right to Know Law and the Federal Freedom of Information Act. 2. Requester shall use the Data solely in connection with the Project and shall not use the Data or display materials or reports generated from the Data for any other purpose, including demonstrations or promotional use. 3. Requester shall advise all persons in Requester's Organization with access to the Data of, and shall require them to adhere to, these terms and conditions of use. 4. Requester shall notify the City when the Project is complete and the Data is no longer needed. At the completion of the Project, Requester shall permanently delete from any and all electronic storage media in possession of the Requester, Requester's Organization and any employee or agent of the Requester's Organization. 5. The City provides the Data "as‐is" and makes no warranty of the accuracy or completeness of the Data and has no liability arising from any incomplete, incorrect, inaccurate or misleading Data. 6. Requester shall indemnify, defend and hold harmless the City and its officers, employees and agents from and against any and all losses, claims, demands, actions, damages, suites and liabilities that are incurred by or recovered against the City for any reason arising out of or relating to the release of the Data or to any use to which the Requester may use the Data. Name: Title: Date: Signature: Email or fax this form to Larry Szarek, GIS Manager, Philadelphia Water Dept.; [email protected]; fax: (215) 685‐6207 GIS Layers Requested:
1. Water Mainline Pipes
2. Water Service Line Pipes
3. Waste Water Inlets
4. Waste Water Gravity Mains
5. Storm Water Network Inlets
6. Street Centerline
7. Valleys
8. Street Flow Net Junctions
9. Flow Ridges
10. Street Nodes
11. Street Flow
12. 2' Topography 2004
13. Impervious and Sewersheds
14. Green Stormwater Infrastructure Structure
15. Green Stormwater Infrastructure Drainage Area
16. Plan Review Projects
17. CAPIT Projects
18. Parcels
19. Project Opportunity Parcels in CSO
20. Depth to Water
21. Depth to Bedrock
22. Study Area Boundary
PLEASE NOTE: Consultant will need to obtain a 2012 study area aerial from the PASDA database.