007100_Attch1_Airfield Construction Waiver.pdf
PDF 192 KB Posted
- Attached to
- Tinker AFB MAC BOA - WWYK240176 - Replace Industrial Waste Lift Stations 6N & 6S, B62501
- Solicitation number
- FA813726R0043
About this file
This is an Airfield Construction Waiver Application Form used by the U.S. Air Force to request temporary waivers from airfield construction standards outlined in UFC 3-260-01. The form is a template designed for government civil engineering use and contractor coordination related to construction activities at military installations.
Requesters must complete blocks 1, 2, and 4-6, 8, 10, and 11, with "N/A" entered for any non-applicable sections. Key required information includes the project or work order number, contract number, a detailed map depicting the construction location, a description of construction activities, the facility number closest to the work, specific criteria being waived with reference to UFC 3-260-01 chapters and paragraphs, and location/height data including ground elevation, tallest equipment height, and total height calculations. The form requires justification for why the temporary waiver is needed and detailed risk mitigation measures for each violation or waiver, such as special painting, obstruction lighting, barricades, marshallers, flagging, and safety procedures. Point of contact information must include the CEC project manager and contractor details with phone and email. Coordination must be completed with multiple Air Force offices including the Airfield Manager (72 OSS/OSAM), Airfield Operations (72 OSS/OSA), TERPS (HQ AFMC/A3), Flight Safety (72 ABW/SEF), Ground Safety (72 ABW/SEG), Logistics (72 LRS/DD), Communications (72 CS/SCX), and Security Forces (72 SFS/S5S). Final approval authority rests with the Installation Commander, or the Base Civil Engineer in emergency situations per UFC 3-260-01, B1-2.5.4.7.
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Text version
INSTRUCTIONS: Requester MUST complete blocks 1, 2, 4-6, 8,10,11, if not applicable put N/A in the block.
4.
5.
6.
7.
8.
9.
10.
Phone & Email:CEC (THDR, Alutiq,etc.) Project Manager:
Phone & Email:
Construction End Date:
11.
12.
LOGISTICS
COMMUNICATIONS
Installation Commander approval authority. If waiver is an emergency the Base Civil Engineer may approve according to UFC 3-260-01, B1-2.5.4.7.
72 OSS/OSAM
72 OSS/OSA
HQ AFMC/A3
72 ABW/SEF
72 ABW/SEG
72 LRS/DD
72 CS/SCX
AIRFIELD OPERATIONS
TERPS
FLIGHT SAFETY
GROUND SAFETY
Describe risk mitigation measures that will be taken for each violation/waiver. (eg. Special painting, obstruction lighting, barricades, marshallers, flagging, safety plan/recall procedures, etc.)
AIRFIELD MANAGER
COORDINATION COMPLETED (Government Civil Engineering Use Only):
Point of Contact Data:
AIRFIELD CONSTRUCTION WAIVER APPLICATION FORM
N
CRITERIA TO BE WAIVED (Government Use Only- State Chapter, paragraph, table number, etc. from UFC 3-260-01 or other):
Include a map with a detailed depiction of the construction location and submit with this form.
Description of Construction Activity: Include description of construction with notes pertaining to the work that will be done.
Location and Height Data of Construction Activity:
SECURITY FORCES 72 SFS/S5S
Why is the temporary waiver required?
h of construction.
Facility Number (Closest to Construction Activity):
Form Date: April 2018
13. APPROVAL (Government Use Only)
Installation Commander
Contractor (Executing the work):
Construction Start Date:
1. Project or Work Order # 2. Contract # 3.Waiver # (Government Use Only)
Longitude:
Latitude: W
A) Construction Activity Ground Elevation (Average Mean Sea Level):
B) Tallest Construction Equipment Height (Crane Height, etc):
Ft.
Ft.
Total Height (A+B): Ft.
(Base Civil Engineer if Emergency)
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File details come from the government source that posted it. Updated .