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SECTION J
DOCUMENTS, EXHIBITS, AND OTHER ATTACHMENTS TABLE OF CONTENTS
ATTACHMENT
ATTACHMENT TITLE
| 0200000 |
| Management and Administration |
| J-0200000-01 |
| Definitions and Acronyms |
| J-0200000-02 |
| Wage Determinations |
| J-0200000-03 |
| Directives, Instructions, and References |
| J-0200000-04 A |
| Contractor Incident Report System (CIRS) |
| J-0200000-04 B |
| Monthly On-Site Labor Reporting |
| J-0200000-04 C |
| EPCRA Report and Contractor Hazardous Material Log |
| J-0200000-04 D |
| Approved AC PAS ID Form, SECNAV 5512 1 11 78 7 |
| J-0200000-04 E |
| Expected Visitor Form, NSASP 5512/17V(Rev04-11) |
| J-0200000-04 F |
| Crane Operating Checklist for Critical Lifts |
| J-0200000-04 G |
| Crane and Rigging Gear Near Miss Report |
| J-0200000-05 |
| Recurring ELINs |
| J-0200000-06 |
| Non-Recurring ELINs |
| 1502000 |
| Facility Investment |
| J-1502000-01 |
| References and Technical Documents |
| J-1502000-02 |
| HVAC Chemical Treatment Inventory |
J-0200000-01 DEFINITIONS AND ACRONYMS
| Administrative Contracting Officer (ACO) |
| The individual designated by the Contracting Officer to administer the contract. Throughout this contract, the term ACO will be used to refer to the individual designated to administer the contract or his/her designated representative. |
| Assessment |
| A general term referring to either a survey or inspection of a facility to determine condition. |
| Asset |
| A general term used to refer to an item, such as a component, system, building or facility, which is managed by an automated data management program. |
| Competent Person |
| A person who has the professional experience and training necessary to identify existing and predictable hazards at a work or service environment, and who has the authority to take prompt and corrective action to eliminate or remove dangers from the environment. |
| Confined Work Space |
| A space that is large enough and so configured that a person may bodily enter a space (such as in tanks, vessels, silos, storage bins, hoppers, vaults, pits, and like spaces where there is limited means of entry) and is hindered or restricted from escaping during an emergency. |
| Contracting Officer (KO) |
| That individual with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority as delegated by the Contracting Officer. |
| Contractor |
| That entity or its representative responsible for the delivery of the services or materials specified in this contract, as designated by contract award. The term Contractor as used herein refers to both the prime Contractor and any subcontractors. The prime Contractor shall insure that subcontractors comply with the provision of this contract. |
| Contractor Representative |
| That individual appointed by the Contractor, either orally or in writing, who has been assigned responsibility for executing the requirements of this contract. |
| Crane, Category 1 |
| Portal cranes, Hammerhead cranes, Locomotive cranes, Derricks, Floating cranes (YD), Tower cranes, Container cranes, Mobile cranes (except those indicated as category 4), including truck, cruiser, crawler, warehouse/industrial cranes, and cranes used for dragline, pile driving, clamshell, magnet, bucket work, and Aircraft crash cranes. |
| Crane, Category 2 & 3 |
| Cranes with rated capacities of 20,000 pounds or greater are category 2. Examples are Overhead traveling cranes, Gantry cranes (rail mounted), Wall cranes, Jib cranes, Pillar cranes, Pillar jib cranes, Monorails and associated hoists, Fixed hoists, and including chain falls. |
Pedestal mounted commercial boom assemblies (fixed length, telescoping, and articulating types) attached to stake trucks, trailers, flatbeds, or railcars, or stationary mounted to piers, etc., with OEM rated capacities less than 2,000 pounds.
| Crane, Category 4 |
| Commercial truck mounted cranes, Truck mounted articulating boom cranes, Pedestal mounted commercial boom assemblies (fixed length, telescoping, and articulating types) attached to stake trucks, trailers, flatbeds, or railcars, or stationary mounted to piers, etc., with OEM rated capacities of 2,000 pounds and greater. Commercial truck mounted cranes and truck mounted articulating boom cranes with OEM capacities of 2,000 pounds and greater require a licensed operator even if the cranes are down rated below 2,000 pounds capacity for administrative purposes. |
| Direct Material Costs |
| The actual vendor invoice charges for materials used for performance of work under this contract. Direct material costs shall include transportation charges when such charges are included on the invoice by the vendor, as well as any discounts allowed for prompt payment and discounts or rebates for core value or salvage value that accrue to the Contractor. When questions arise concerning the cost of materials, material costs will be based on the lowest of quotes provided by the Contractor from at least three different commercial vendors for the direct material cost. The Government retains the right to obtain additional quotes in questionable situations. The lowest price will be used. |
| Equipment |
| Tangible asset that is functionally complete for its intended purpose, durable, and non- expendable. |
| Equipment, Collateral |
| Encompasses built-in and large substantially affixed equipment/property that is normally acquired and installed as part of a facility project. |
J-0200000-01 DEFINITIONS AND ACRONYMS
| Equipment, Installed |
| Encompasses building-type equipment, built-in equipment, and large, substantially affixed equipment/property, and is normally acquired and installed as part of a facility project. |
Installed equipment is normally required to make a facility useful and operable. Removing such equipment would impair the usefulness, safety, or environment of the facility or the facility restoration work required after its removal, is substantial.
| Equipment, Personal Property |
| Personal property equipment includes all equipment other than collateral equipment. Such equipment, when acquired and used in a facility or a test apparatus, can be severed and removed aster erection or installation without substantial loss of value or damage thereto or to the premises where installed. |
| Facility |
| A building or structure designed and created to serve a particular function. |
| Facilities Life Cycle |
| A facilities life cycle is divided into four stages, requirements (planning and design), acquisition (construction and acceptance), stewardship (operations, maintenance and repair), and disposal. |
| Facilities Maintenance Management |
| The planning, prioritizing, organizing, controlling, reporting, evaluating, and adjusting of facilities maintenance operations to support the CNO/NAVFAC facilities policy and objectives and satisfy customers’ facility needs. Defined by the International Facility Management Association as “the practice of coordinating the physical workplace with the people and work of the organization.” |
| Frequency Of Service |
| Daily (D5). Services performed once each calendar day, Monday through Friday, including holidays unless otherwise noted. |
Daily (D6). Services performed once each calendar day, Monday through Saturday, including holidays unless otherwise noted.
Daily (D7). Services performed once each calendar day, seven days per week, including weekends and holidays.
Monthly (M). Services performed 12 times during each 12-month period of the contract at intervals of 28 to 31 calendar days.
Quarterly (Q). Services performed four times during each 12-month period of the contract at intervals of 80 to 100 calendar days.
Semiannual (SA). Services performed twice during each 12-month period of the contract at intervals of 160 to 200 calendar days.
Semimonthly (SM). Services performed 24 times during each 12-month period of the contract at intervals of 14 to 16 calendar days.
Three times weekly (3W). Services performed three times a week, such as Monday, Wednesday, and Friday.
Twice weekly (2W). Services performed twice a week, such as Monday and Thursday or Tuesday and Friday.
Weekly (W). Services performed 52 times during each 12-month period of the contract at intervals of six to eight calendar days.
Yearly (Y). Services performed once during each 12-month period of the contract at intervals of 335 to 395 days.
| Government Furnished Property (GFP) |
| Property in the possession of, or directly acquired by, the Government and subsequently furnished to the contractor for performance of a contract. Government furnished property includes, but is not limited to, spares and property furnished for repairs, maintenance, overhaul, or modification. Government furnished property also includes contractor acquired property if the contractor acquired property is a deliverable under a cost contract when accepted by the Government for continued use under the contract. |
| Hazardous Material (HM) |
| Any material designated by the Department of Transportation (DOT) as posing a potential threat while being transported. Hazardous materials are listed in 49 CFR Part 172. |
| Hazardous Waste (HW) |
| Any discarded solid waste (liquid, semi-solid, solid, or gaseous) that meets the definition of a hazardous waste by USEPA, state authorities, or the Navy. In accordance with RCRA, a solid waste is a listed hazardous waste if it is specifically listed, or it is a characteristic hazardous waste if it exhibits the characteristics of ignitability, corrosivity, reactivity, or toxicity. |
| Inspection |
| A rigorous, detailed assessment of the condition of a facility performed to generate a fundable scope and cost estimate for prioritization and funding of maintenance and repair. |
J-0200000-01 DEFINITIONS AND ACRONYMS
| Integrated Maintenance Program (IMP) |
| IMP is a recurring state-of-the-art, reliability-centered inspection, testing, maintenance and repair program that determines best practices for managing the functions and consequences of failures of facilities equipment and system components. IMP encompasses accepted commercial practices, including reactive, preventive, predictive and proactive maintenance, into one optimal program. The IMP approach gives the Contractor full responsibility to maintain systems and equipment and perform repairs whenever necessary to ensure equipment and systems are operational and remain in a constant state of readiness. Service calls will not be issued for accomplishment of repairs on systems and equipment maintained under IMP. |
| Life-Cycle Costs |
| A form of economic analysis that considers the total cost of owning, operating, and maintaining a building or system over its useful life. |
| Maintenance And Repair |
| The preservation or restoration of a piece of equipment, system, or facility to such condition that it may be effectively used for its designated purposes. Maintenance/repair may be adjustment, overhaul, reprocessing, or replacement of constituent parts or materials that are missing or have deteriorated by action of the elements or usage, or replacement of the entire unit or system if beyond economical repair. |
| Maintenance, Preventive |
| Maintenance designed to increase the availability of the facilities/equipment by reducing the number of unexpected breakdowns or service interruptions. It is any planned maintenance activity that improves equipment life and avoid any unplanned maintenance requirements. |
| Monthly On-Site Labor Report |
| A compilation of all Contractor and subcontractor employee-hours involved in delivering contract services on a Government property. |
| Performance Assessment |
| A method used by the Government to provide some measure of control over the quality of purchased goods and services received. |
| Performance Assessment Representative (PAR) |
| That individual designated by the KO to be responsible for the monitoring of Contractor performance. |
| Pre-Expended Bin Materials And Supplies |
| The minor materials and supplies that are incidental to the job, for which the total direct cost of any one material line item shown on the material estimate is $10.00 or less. Examples of pre- expended bin materials and supplies include, but are not limited to, solder, lead, flux, electrical connectors, electrical tape, fuses, nails, screws, bolts, nuts, washers, spacers, masking tape, sand paper, solvent, cleaners, lubricants, grease, oil, rags, mops, glue, epoxy, spackling compound, joint tape, plumbers tape and compound, clips, welding rods, and touch up paint. |
| Property Administrator |
| An authorized representative of the Contracting Officer who is responsible for administering contract property requirements, terms and conditions of the contract |
| Property Management Program |
| A Government program established for the purpose of reviewing and approving the Contractor’s Property Management Plan and System through performance of a system analysis whenever government property is in the possession of the Contractor. |
| Quality Assurance (QA) |
| The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled. |
| Quality Control (QC) |
| The observation techniques and activities used to fulfill requirements for quality. |
| R. S. Means | |
| A data collection and organization system developed by R. S. Means Company which can be used to prepare accurate, dependable construction estimates and budgets in a variety of ways. The Contractor shall use the latest edition. Material prices are based on a national average and computed labor costs are based on a 30-city national average. | An estimate prepared using this data is called a "Means estimate"; data may simply be referred to as "Means". |
| Repair |
| Repair is the restoration of facilities or equipment to such a condition that it may be effectively utilized for its designated purposes by overhaul, reconstruction, or replacement of constituent parts or materials which have deteriorated by action of the elements or usage, and which have not been corrected through maintenance. This term also applies to replacement of the entire unit or system if beyond economical repair. The intent of repair is to have the equipment at normal working condition. |
J-0200000-01 DEFINITIONS AND ACRONYMS
| Replacement |
| Replacement, as a distinct work element, is confined to a program of planned replacement of a facility or its components. It may be further limited to major components such as air conditioning compressors, furnaces or hot water heaters. Replacement is performed when the equipment has reached the end of its useful life; when it no longer can perform due to degradation of its internal components and repair is no longer cost effective. Included under the replacement would be the major rebuilding of any component, since rebuilding also restores performance. |
| Response Time |
| The time allowed the Contractor after initial notification of a work requirement to be physically on the premises at the work site with appropriate personnel, tools, equipment, and materials, ready to perform the work required. |
| Restoration |
| Restoration of real property to such a condition that it can be used for its intended purpose. Includes repair or replacement work to restore facilities damaged by inadequate sustainment, excessive age, natural disaster, fire, accident or other causes. |
| Sustainment |
| Maintenance and repair activities necessary to keep a typical inventory of facilities in “normal working condition”. Sustainment includes regularly scheduled maintenance as well as cyclical major repairs or replacement of components that occur periodically over the expected service life of the facilities. |
| Spillage |
| Refuse dislodged from Any containers and/or solid waste collecting equipment in the course of collection and disposal. |
| Unit Priced Labor (UPL) Hour |
| The unit price bid by the Contractor to perform one hour of work-in-place. With the exception of direct material and construction equipment costs, the unit price includes all indirect and direct costs associated with performing work. The price includes the Contractor’s hourly composite trade wage, adjusted to allow for workforce productivity; costs for pre-expended bin materials, union agreements, crew sizes, hand tools, payroll burdens and fringes, overtime, job (field) overhead (including clerical support, supervision, inspection, fees, taxes, licenses, permits, and insurance), general and administrative (home office) overhead, and profit. |
Additionally, time for job preparation, safety standby personnel, and similar indirect labor elements are included.
| Weight Handling Equipment (WHE) |
| Weight handling equipment consists of cranes (e.g., portal cranes, jib cranes), rigging gear (e.g., slings, shackles), and associated equipment (e.g., portable hoists, dynamometers). For purposes of this technical sub-annex, WHE does not include mobile or transportable truck, crawler, and railway mounted locomotive cranes covered in 1700000 BSVE. |
J-0200000-01 DEFINITIONS AND ACRONYMS
| ACO |
| Administrative Contracting Officer |
| CDR |
| Contract Discrepancy Report |
| CIA |
| Controlled Industrial Area |
| CIMU |
| Component Inventory Management Unit |
| CMMS |
| Computerized Maintenance Management System |
| COR |
| Contracting Officer Representative |
| COR |
| Condition of Readiness |
| DBH |
| Diameter at Breast Height |
| DCR |
| Direct Condition Rating |
| DoD |
| Department of Defense |
| DRMO |
| Defense Reutilization Management Office |
| EPA |
| Environmental Protection Agency |
| EPCRA |
| Emergency Planning and Community Right-to-Know Act |
| FAR |
| Federal Acquisition Regulation |
| FIFRA |
| Federal Insecticide, Fungicide, and Rodenticide Act |
| FSC |
| Facility Support Contract |
| GIS |
| Geospatial Information System |
| GFE |
| Government-furnished Equipment |
| GFF |
| Government-furnished Facilities |
| GFM |
| Government-furnished Materials |
| HCA |
| Head Contracting Agency |
| HVAC |
| Heating, Ventilation, and Air Conditioning |
| ICAP |
| Infrastructure Condition Assessment Program |
| ICP |
| Integrated Contingency Plan |
| iNFADS |
| Internet Navy Facilities Asst Data Store |
| IMP |
| Integrated Maintenance Program |
| IPM |
| Integrated Pest Management |
| IPMIS |
| Integrated Pest Management Information System |
| IPMP |
| Integrated Pest Management Plan |
| MAP |
| Maintenance Action Plan |
| MDI |
| Mission Dependency Index |
| MEP |
| Mechanical, Electrical and Plumbing |
| MRI |
| Mission Readiness Index |
| MSDS |
| Material Safety Data Sheets |
| NAVFAC |
| Naval Facilities Engineering Command |
| NMCI |
| Navy Marine Corps Intranet |
| NOSC |
| Navy-On-Scene Coordinator |
| PAP |
| Performance Assessment Plan |
| PAR |
| Performance Assessment Representative |
| PAW |
| Performance Assessment Worksheet |
| PEO |
| Program Executive Officer |
| PM |
| Planned Maintenance or Preventative Maintenance |
| PRCSP |
| Permit Required Confined Space Program |
| PWS |
| Performance Work Statement |
| RPIE |
| Real Property Inventory Equipment |
| RSL |
| Remaining Service Life |
J-0200000-01
DEFINITIONS AND ACRONYMS
| SPAR |
| Senior Performance Assessment Representative |
| SRM |
| Sustainment, Restoration and Modernization |
| VIQ |
| Variation in Quantity |
| WBS |
| Work Breakdown Structure |
J-0200000-02
WAGE DETERMINATIONS
J-0200000-03
DIRECTIVES, INSTRUCTIONS, AND REFERENCES
| EM 385-1 |
| Safety and Health Requirements Manual |
| E.O. 13514 |
| Installation Water Conservation Program |
| E.O. 13423 |
| Installation Energy Management Program |
| FAR Clause 52.223-2 |
| Affirmative Procurement of Bio-based Products Under Service and Construction Contracts |
| FAR Clause 52.223-3 |
| Hazardous Material Identification and Material Safety Data |
| FAR Clause 52.228-5 |
| Insurance- Work on a Government Installation |
| FAR Clause 52.245 |
| Government Property |
| FAR Clause 52.246-4 |
| Inspection of Services- Fixed Price |
| Public Law 91-596 |
| Occupational Safety and Health Act |
NAVFAC Clause 5252.245- Government-Furnished Property, Materials, and Services
| NAVFAC P-307 |
| Management of Weight Handling Equipment |
| 29 CFR 1910 |
| Occupational Safety and Health Standards |
| 29 CFR 1926 |
| Safety and Health Regulations for Construction |
| 40 CFR 82 |
| Protection of Stratospheric Ozone |
| 40 CFR 247 |
| Comprehensive Procurement Guidelines for Products Containing Recovered Materials |
Attachment J-0200000-04 Forms
J-0200000-04 A
J-0200000-04 B
| Prime Contractor: |
| Contract # |
| Description: |
Monthly Work Hours
Month
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sep.
Oct.
Nov.
Dec.
Total MH Per Month
0.00
0.00
0.00
0.00
0.00
0.00
Total Per Year
| Sub Contractor #1: |
| Contract # |
| Description: |
May
0.00
0.00
0.00
0.00
0.00
| Sub Contractor #2: |
| Contract # |
| Description: |
May.
0.00
0.00
0.00
0.00
0.00
J-0200000-04 C
J-0200000-04 D
J-020000-04 E
EXPECTED VISITOR(S)
Can Only Be Submitted By Authorized Personnel PassID.NSASP@navy.mil
General Information (POC provide this form to Person Authorized by your command to submit it)
MARK ONLY ONE
Persons without one of the following, MUST fill out Vetting Form SECNAV 5512/1 Form
Date(s) of Visit Visitor Last Name Visitor First Name & Middle Initial
| Citizen-ship |
| Representing Company |
| Visit Bldg # |
| Restricted Area / Admin Area |
CAC
In
JPAS
GOV
PIV
Date vetting completed
POC
POC Phone #
NSASP 5512/17V
Revision January 2022
J-0200000-04 F
ATTACHMENT "A"
| CONTRACTOR CRANE OPERATING CHECKLIST FOR CRITICAL LIFTS |
| YES |
| NO |
| 1 |
| Does the operator know the weight of the load to be lifted? |
| 2 |
| Is the load to be lifted within the crane manufacturer's rated capacity in its present configuration? |
| 3 |
| Is the crane level and on firm ground? |
| 4 |
| Are outriggers required? |
| 5 |
| If so, are outriggers fully extended and down, and the load off the wheels? |
| 6 |
| If blocking is required, is the entire surface of the outrigger pad supported, and is the blocking material of sufficient strength to safely support the loaded outrigger pad? |
| 7 |
| If outriggers are not used, is the crane rated for on-rubber lifts by the manufacturer's load chart? |
| 8 |
| Is the swing radius of the crane counterweight clear of people and obstructions and accessible areas within the swing area barricaded to prevent injury, damage and unplanned encroachment? |
| 9 |
| Has the hook been centered over the load in such a manner to prevent swing (deflection, side loading, load-moment)? |
| 10 |
| Is the load well secured and balanced in the sling or lifting device before it is lifted (free and clear) more than a few inches? |
| 11 |
| Is the lift swing path clear of obstructions? |
| 12 |
| If rotation of the load being lifted is hazardous, is tag line or restraint line being used? |
| 13 |
| Are personnel prevented from standing or passing under a suspended load? |
| 14 |
| Are personnel prevented from entering the load fall zone? |
| 15 |
| Is the crane operator's attention diverted? |
| 16 |
| Are proper signals being used at all times? |
| 17 |
| If radio communications are used is the frequency isolated to the crane team? |
| 18 |
| Do the operations ensure that side and tip loading is prohibited? |
| 19 |
| Are start and stop motions in a smooth fluid motion (no sudden acceleration or deceleration)? |
| 20 |
| If operating near electric power lines, are the rules and guidelines understood and adhered to as specified in NAVFAC P-307? |
| 21 |
| Is the lift a critical lift? |
| 22 |
| If so, are critical lift regulations understood, check-off sheets initialed and signed off, and was there an interactive brief conducted with associated personnel? |
| 23 |
| Is Attachment "A" current, filled out completely, and posted in the crane? |
Contractor Name (Print Legibly):
Contractor Name (Signature):
J-0200000-04 G
CRANE AND RIGGING GEAR ACCIDENT REPORT
Accident Category: |_| Crane Accident |_| Rigging Gear Accident
From:
UIC:
Bldg. 491 NNSY Portsmouth, VA 23709 Fax: 757-967-3808
Activity:
Report No:
Crane No:
Category:
Accident Date:
Time: hrs:
| Category of Service: | |_| SPS | |_| GPS |
| Crane Type: | | |
Crane Manufacturer:
| Was Crane/Rigging Gear Being Used in SPS: |_| Yes |_| No |
| Was Crane/Rigging Gear Being Used in a Complex Lift/Critical Non-Crane Rigging Operation: |_| Yes |_| No |
Location:
Weather:
Crane Capacity:
Hook Capacity:
Weight of Load on hook:
Fatality or Permanent Disability? |_| Yes |_| No
Material/Property Cost Estimate:
| Reported to NAVSAFECEN? |_| Yes | |_| No |
| Accident Type: | | |
| |_| Personal Injury | |_| Overload | |_| Derail | |_| Damaged Rigging Gear |
|_| Load Collision |_| Two Blocked |_| Dropped Load |_| Damaged Crane
| |_| Crane Collision | |_| Damaged Load | |_| Other: Specify |
| Cause of Accident: | |
| |_| Improper Operation | |_| Equipment Failure | |_| Inadequate Visibility |
|_| Improper Rigging |_| Switch Alignment |_| inadequate Communication
| |_| Track Condition | |_| Procedural Failure | |_| Other: Specify |
| Chargeable to: |
| |_| Crane Walker |_| Rigger | |_| Operator |
| |_| Maintenance | |_| Management/Supervision | |_| Other: Specify |
| Crane Function: | | | | | |
| |_| Travel | |_| Hoist | |_| Rotate | |_| Luffing | |_| Telescoping | |_| Other | |_| N/A |
Is this accident indicative of a recurring problem? |_| Yes |_| No
| If yes, list Accident Report Nos.: |
ATTACH COMPLETE AND CONCISE SITUATION DESCRIPTION AND CORRECTIVE/PREVENTIVE ACTIONS TAKEN AS ENCLOSURE (1). Include probable cause and contributing factors. Assess damages and define responsibility. For equipment malfunction or failure, include specific description of the component and the resulting effect or problem caused by the malfunction or failure. List immediate and long term corrective/preventive actions assigned and respective codes.
Preparer:
Phone:
E-mail:
Code:
Date:
Concurrences: (Include Code, Signature and Date)
Code:
Date:
Code:
Date:
Certifying Official (Crane Accident Only):
Code:
Date:
CRANE AND RIGGING GEAR ACCIDENT REPORT INSTRUCTIONS
This form is designed for fax transmission without a cover page or by e-mail and, with enclosures and signatures, shall be the official document. Electronic submission will be accepted without signatures but the names of the preparer, concurring personnel, and certifying official (for crane accidents only) shall be filled in. The e-mail address is m_nfsh_ncc_accident@navy.mil. The fax number is (757) 967-3808.
1. Accident Category: Indicate either crane accident or rigging gear accident.
2. From: The naval activity that is responsible for reporting the accident and UIC number.
3. Activity: The naval activity where the accident took place.
4. Report No.: The activity assigned accident number (e.g., 95-001).
5. Crane No.: The activity assigned crane number (e.g., PC-5), if applicable.
6. Category: Identify category of crane (i.e., 1, 2, 3, or 4), if applicable.
7. Accident Date: The date the accident occurred.
8. Time: The time (24 hour clock) the accident occurred (e.g., 1300).
9. Category of Service: Check the applicable service (SPS as defined by NAVSEA 0989-030-7000).
10. Crane Type: The type of crane involved in the accident (e.g., mobile, bridge), if applicable.
11. Crane Manufacturer: The manufacturer of the crane (e.g., Dravo, Grove, P&H), if applicable.
12. SPS: Was the crane or rigging gear being used in an SPS lift?
13. Complex lift: Was the crane or rigging gear being used in a complex lift?
14. Location: The detailed location where the accident took place (e.g., building 213, dry dock 5).
15. Weather: The weather conditions at time of accident (e.g., wind, rain, cold).
16. Crane Capacity: The certified capacity of the crane (e.g., 120,000 pounds), if applicable.
17. Hook Capacity: The capacity of the hook involved in the accident at the max radius of the operation, if applicable.
18. Weight of Load on Hook: If applicable, the weight of the load on the hook.
19. Fatality or Permanent Disability?: Check yes or no.
20. Material/Property Cost Estimate: Estimate total cost of damage resulting from the accident.
21. Reported to NAVSAFECEN?: Self-explanatory.
22. Accident Type: Check all that apply.
23. Cause of Accident: Check all that apply.
24. Chargeable to: Check all that apply.
25. Crane Function: Check all functions in operation at time of accident. Check N/A if a rigging gear accident.
26. Is this a recurring problem?: Check yes or no. Identify any other similar accidents.
27. Situation Description/Corrective Actions: Self-explanatory.
28. Preparer: Self-explanatory.
29. Concurrences: Self-explanatory.
30. Certifying Official (Crane Accidents Only): Self-explanatory.
31. Brief Description: No more than one paragraph summarizing the resultant incident.
32. Background and Detailed Description: Provide the relevant background in a descriptive timeline of preconditions leading up to the event, as well as a detailed description of the event.
33. Corrective Actions: List all short term and long term corrective actions that are taken to prevent recurrence of the incident. Short Term Corrective Actions are those actions taken that will allow return to work in short time frame. Long Term actions are more ‘programmatic’ in nature and typically include: process revision, changes in training, ‘mistake proofing’, etc.
J-0200000-05 Recurring ELIN
J-0200000-06 Non-Recurring ELIN
J-1502000-01
REFERENCES AND TECHNICAL DOCUMENTS
| EM 385-1 |
| Safety and Health Requirements Manual |
| E.O. 13514 |
| Installation Water Conservation Program |
| E.O. 13423 |
| Installation Energy Management Program |
| FAR Clause 52.223-2 |
| Affirmative Procurement of Bio-based Products Under Service and Construction |
Contracts
| FAR Clause 52.223-3 |
| Hazardous Material Identification and Material Safety Data |
| FAR Clause 52.228-5 |
| Insurance- Work on a Government Installation |
| FAR Clause 52.245 |
| Government Property |
| FAR Clause 52.246-4 |
| Inspection of Services- Fixed Price |
| Public Law 91-596 |
| Occupational Safety and Health Act |
NAVFAC Clause 5252.245- Government-Furnished Property, Materials, and Services
| NAVFAC P-307 |
| Management of Weight Handling Equipment |
| 29 CFR 1910 |
| Occupational Safety and Health Standards |
| 29 CFR 1926 |
| Safety and Health Regulations for Construction |
| 40 CFR 82 |
| Protection of Stratospheric Ozone |
| 40 CFR 247 |
| Comprehensive Procurement Guidelines for Products Containing Recovered |
Materials
J-1502000-02 HVAC Chemical Testing & Treatment Inventory
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