1-Statement of Work.docx

IV. STATEMENT OF WORK

Project Name: Samantha DeGoede New Test Well

Lewis County

A. Project Description

This project is for the installation of a residential drinking water well on fee land. The contractor shall drill the well, consisting of welded steel casing, PVC liner (as needed), sanitary seal, well screen (as needed), well development, test pumping, disinfection, and water quality sampling and testing. The estimated well depth based on existing nearby wells is 400 feet. All appurtenances, including a submersible pump and pressure system, will be contracted separately. Existing well logs from the surrounding area are provided (see Attachments). Further investigation of the site and locating other local well logs is the responsibility of the Contractor. Any permits, including the Department of Ecology Notice of Intent, are the responsibility of the Contractor.

B. Ownership

This project will provide sanitation facilities to a private home owned by a member of the Cowlitz Tribe. Upon completion, the facilities will be transferred to the homeowner. The system will be operated by the homeowner.

C. TERO & Other Fees

TERO fees do not apply.

D. Scope of Work

Work is to be completed on a private home, under the jurisdiction of Lewis County. The contractor must review site conditions and report any concerns or discrepancies to the Contracting Officer’s Representative (COR) in writing prior to beginning construction. The proposed well location is indicated in the drawings. IHS has verified that an adequate 100-foot sanitary control area is available at this spot. In accordance with the Site Plan, the contractor must:

1. Mobilize and Demobilize

2. Drill 6” Well

3. Install 6” Steel Well Casing

4. Place Sanitary Grout

5. Install PVC Well Liner (as needed)

6. Develop Well

7. Test Pump

8. Disinfect and Perform Water Quality Analysis (see Attachments) Optional Items, As Needed:

9. Well Screen (as needed)

10. Abandon Unusable Well

E. Technical Requirements

1. Codes, References, and Standards: Work under this contract must be performed in compliance with the codes, references, and standards listed below. If conflicts exist between these references, consult the Tribe for direction.

i. Washington Administrative Code (WAC Chapter 173-160, MINIMUM STANDARDS FOR CONSTRUCTION AND MAINTENANCE OF WELLS)

ii. Indian Health Service Technical Provisions (See Attachments)

2. Submittals: The Contractor shall provide submittals on the items listed below. Submittal approval is required for variations from equipment and materials specified.

Pre-Construction (5 days before beginning construction)

i. Type of drilling method: If mud rotary, method of mud containment

ii. Well Casing

iii. Well Liner Following drilling, if a screen is found to be necessary, the following submittals are required. The Tribe will make the final determination regarding screen installation:

iv. Well Screen

Post-Construction

i. Water quality analysis results

ii. Pumping test results (form provided in Attachments)

iii. WA DOE Well log

3. Material Specifications: Install materials as specified in sections D & E above. Materials specified may be substituted with equals upon approval from the Tribe.

4. Work Execution Requirements

i. The Contractor shall contact the COR 48 hours prior to mobilization.

ii. The Contractor must attend a pre-construction meeting before beginning work under this contract, unless otherwise explicitly authorized by the Contracting Officer.

iii. The Contractor is responsible for determining the exact location of any and all utilities. The Contractor is responsible for protecting utilities from damage during construction.

iv. All debris generated during construction shall be removed from site.

v. All areas disturbed by construction activities shall be finish-graded.

vi. The contractor must obtain approval from the Contracting Officer prior to installing material quantities in excess of those specified on the bid schedule.

vii. The Contractor must keep the COR notified and advised of all work to be done or work in progress sufficiently in advance so that proper inspection can be performed.

IHS Project Manager and Recommended COR:

Jennifer Toth, Project Manager/Engineering Technician, jennifer.toth@ihs.gov

Project Completion Time:

IV. STATEMENT OF WORK Page 2 of 2

60 calendar days from the notice to Proceed (NTP