A04_-_19-FS-003_004_Specs.pdf

Station Name/Address:

Project Name:

GENOA NATIONAL FISH HATCHERY

S 5631 State Highway 35, Genoa Wisconsin, 54632

REHABILITATE PONDS 14A AND 14B

Page J - 1

PART III, SECTION J

LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACHMENTS

INDEX

TECHNICAL PROVISIONS/SPECIFICATIONS

DIVISION 1 - GENERAL REQUIREMENTS

SECTION 01100 SUMMARY OF THE WORK

SECTION 01310 PROJECT COORDINATION

SECTION 01330 SUBMITTALS

SECTION 01420 DEFINITIONS AND STANDARDS

SECTION 01770 PROJECT CLOSEOUT

DIVISION 2 - SITE WORK

SECTION 02200 EARTHWORK

SECTION 02230 GRAVEL

SECTION 02270 UNDERLAYMENT FABRIC

SECTION 02280 EPDM POND LINER

DIVISION 15 - MECHANICAL

SECTION 15100 GATES

ATTACHMENTS

SUBMITTAL REGISTER

PRECONSTUCTION SAFETY CHECKLIST

DRAWINGS

Drawing Number Description Sheet

3F-WISC-126-507 Vicinity / Site Map / Index 1 of 2

3F-WISC-126-508 Cross Sections / Anchor Trench Details 2 of 2

DIVISION 1 SECTION 01100

GENERAL REQUIREMENTS SUMMARY OF THE WORK

01100-1

A. General

1. Project Title: Rehabilitation of Pond 14A and 14B.

B. Work Under These Specifications

Measurement and payment shall include but not be limited to furnishing materials, labor, and equipment for the work in the Bidding Schedule below listed below:

1. Schedule I - Rehabilitation of Pond 14 A.

Work in Schedule I includes removing and disposing of the existing polypropylene pond liner in a fish rearing pond as located on the drawings and replacing that liner with new polypropylene liner to the extents shown including unbolting the liner from the existing water control structure walls and re-attaching the new liner to those walls. The work will also include minor excavation work to remove the existing trench liner and replace with new liner to the existing pond bottom drainage grade, leveling work to re-slope the embankment for new liner placement and the replacement of a water control structure gate valve.

Payment for this item shall be made lump sum.

2. Schedule II - Rehabilitation of Pond 14 B.

Work in Schedule I includes removing and disposing of the existing polypropylene pond liner in a fish rearing pond as located on the drawings and replacing that liner with new polypropylene liner to the extents shown including unbolting the liner from the existing water control structure walls and re-attaching the new liner to those walls. The work will also include minor excavation work to remove the existing trench liner and replace with new liner to the existing pond bottom drainage grade, leveling work to re-slope the embankment for new liner placement and the replacement of a water control structure gate valve.

01100-2

Payment for this item shall be made lump sum.

C. Location And Inspection Of Site

1. The site of the work is located at the Genoa National Fish Hatchery near Genoa, Wisconsin. The mailing address is shown on the Solicitation, Offer, and Award (Standard Form 1442) as attached to this Invitation.

The Hatchery Manager may be contacted for further information at the above referenced address or by telephone at (608) 689-2605.

2. All prospective bidders, contractors, subcontractors, and related persons are encouraged to visit the site of the proposed work and to assess the location and extent of the work prior to submitting a proposal. Persons may inspect the work site by contacting the Hatchery Manager.

D. Specifications and Drawings for Construction

1. The successful bidder will be provided, upon request, up to 5 sets of additional full size prints of the contract drawings as necessary for execution of this contract.

These drawings will be provided at no additional cost to the successful bidder/quoter.

2. Exact location of all affected utilities will be the responsibility of the contractor. Drawings may not completely show all utilities. Site verification is required in addition to contacting any local authorities and utility companies to determine exact locations of utilities.

3. In case of difference between drawings and specifications, the specifications shall govern.

E. Work Not Included In This Contract

1. All items indicated "NIC" on drawings or specifications are items not included in this contract.

01100-3

2. Work in place is generally shown as "Existing" on the Contract Drawings.

3. Work to be performed under other contracts and not included as part of this contract is generally shown as "By Others" on the Contract Drawings.

F. Items Provided By The Government

1. Work to be accomplished by the Government or manufactured items to be provided by the Government are generally shown as "By Government" on the Contract Drawings.

a. Unless specifically provided herein, no materials or equipment shall be furnished by the Government under this Contract.

G. Engineering Services

1. N/A

H. Temporary Facilities

1. Maintain and restore all government roads, service areas and utilities used to pre-construction condition.

2. Toilet facilities may be used inside the Genoa NFH

Headquarters, but only as designated and allowed by the facility manager.

I. Site Access and Right of Way

1. The construction access limits on Government property will be established by the Government and the Contractor shall be responsible for complying with these limits and governing all work accordingly. All temporary access roads shall be removed following work completion unless directed otherwise by the Contracting Officer.

2. Requirements for maintenance of traffic in a safe manner such as signs, barricades, lights, watchmen, etc., shall be met as required. Load limits and other restrictions

01100-4 shall be obeyed. All bidders are reminded that they are responsible for contacting the local entity such as township, county, state, etc., having jurisdiction in the project vicinity to insure bidders/quoters are aware of any requirements of the local entity. These requirements are between the entity and the bidder. If the Contractor proposes to cross private property, permission must be obtained from the owner to use private property or roads in the conduct of the work.

3. Work scheduled on Saturdays, Sundays, Federal Holidays or other than normal working hours shall be approved in advance by the Government.

J. Safety - In addition to FAR 52.236-13 Accident Prevention

1. The Contractor’s Safety Plan shall be available on-site.

The Contractor shall provide Material Safety Data Sheets (MSDS) for all hazardous materials brought on-site. MSDS shall be made available in a conspicuous location.

2. All equipment and work activities shall comply with OSHA

Regulations and all accidents incidental to work performed under this contract shall be reported in accordance with OSHA reporting requirements.

Additionally a copy of the accident report shall be provided to the Contracting Officer.

3. The Contractor shall provide and install barricades, signs, or other warning devices to delineate the construction area and restrict public access to the construction site.

4. Provide at least one non-freezing-type fire extinguisher in each workshop and shed used for storage of materials on the premises. Place in location readily accessible to workers.

5. Provide at least one non-freezing-type fire extinguisher of the appropriate class for each group of workers performing flammable procedures.

01100-5

6. Provide and maintain a basic first aid kit for use of workers.

(a) Provide first aid supply commensurate with size of project with items necessary for first aid treatment of all injuries. Include first aid items identified on MSDS for applicable items, in applicable locations.

(b) Advise all workers of the location of first aid supplies.

(c) Post telephone numbers of nearest hospital or ambulance service and fire station in conspicuous location. Advise all workers of location of telephone numbers.

7. Provide necessary Personnel Protective Equipment (PPE) as identified by MSDS. Provide documentation, workers have been trained in use of PPE prior to individual use.

8. Provide a safety officer to ensure a safe work site. The safety officer shall perform daily work site inspections to assure compliance with all safety regulations and standards.

(END OF SECTION 01100)

DIVISION 1 SECTION 01310

GENERAL REQUIREMENTS PROJECT COORDINATION

01310-1

A. Jobsite Administration - Superintendence, Subcontract administration and Quality Control, is the responsibility of the Contractor.

1. Final decisions relative to items in conflict shall be made by the Contracting Officer.

2. The Government shall have the authority to temporarily suspend the work for such time as necessary because of the failure on the part of the Contractor to perform any of the provisions of the contract, and no extension of contract performance time will be allowed for such suspensions. Resumption of work will not be permitted until the Government determines that the defi-ciencies in performance, which caused the temporary suspension, have been corrected.

3. The Contractor shall notify the Engineer at least ten

(10) days prior to the anticipated date of completion of all work specified herein. Upon completion of the work, the Engineer shall proceed with the final inspection which shall be completed as promptly as practicable.

The time required for such inspection and for performing any corrective work shall be included in the contract performance time.

B. Modification/Change Order procedures

1. In the event of the need for a change order, the Contractor will receive a letter requesting a price quote for proposed changes to the contract.

2. For evaluation purposes, the Contractor's quote shall be broken down to show the costs of labor and materials for each proposed category of work included with the change, along with the total cost for Contractor's overhead, profit, and bond for the proposed changes.

DIVISION 1 SECTION 01310

GENERAL REQUIREMENTS PROJECT COORDINATION

01310-2

3. All contract time extensions required as a result of a proposed change must be justified and supported in detail at the time of the proposal.

C. Preconstruction Conference

1. Soon after award of the Contract and prior to commencing construction, the Contractor and any subcontractors shall attend a preconstruction conference with representatives of the Government. Timely notification of the meeting will be given to the Contractor. Time, date, and place of the conference will be determined by the Contracting Officer. Requirements pertaining to con-tract administration, construction operations and the project schedule will be discussed. The project schedule shall be in accordance with Section 01330.

D. Progress Meetings

1. Periodic general project meetings will be conducted with a representative of the Contractor at the project site or by telephone by the Government's representative for the purpose of coordinating, expediting, and assessing the work progress.

2. The Contractor shall provide reports of progress on the project, discuss the work schedule for the coming period and present all conflicts, discrepancies or other difficulties for resolution. A record of discussions and decisions will be prepared by the Government and distributed to those attending and others affected.

(END OF SECTION 01310)

DIVISION 1 SECTION 01330

GENERAL REQUIREMENTS SUBMITTALS

01330-1

A. General:

1. Refer to submittal register or technical specifications for all submittals required.

2. When specifically requested by the Government representative, the Contractor shall provide copies of manufacturer's literature containing detailed specifications and performance data or shop drawings fully describing the items and written installation instructions and/or recommendations for review and approval prior to accomplishing equipment installation.

B. Submittal Register:

1. A submittal register, listing all items requiring submittals under this solicitation, is provided as an attachment to this document. The Contractor shall provide all required submittals to the Engineer within 21 days of award except for items noted otherwise on the submittal register.

2. Furnish four copies of all required submittals. Three copies will be retained by the Government. One copy will be returned to the Contractor.

3. The approval of submittals shall not relieve the contractor to comply with the terms and conditions of the contract drawings and specifications. The contractor shall be responsible to determine correct dimension, design, connection, detail and satisfactory construction of all work.

C. Project Schedule: Contractor shall provide as required by

Federal Acquisition Regulation (FAR) clauses. *

D. Price Breakdown - Lump Sum Items: Contractor shall provide as required by FAR clauses. *

E. Subcontractor's List

DIVISION 1 SECTION 01330

GENERAL REQUIREMENTS SUBMITTALS

01330-2

Submit a list of subcontractors who will be working on the project.

F. Submittal of Progress Payment Certificate: Contractor shall provide as required by FAR clauses. *

G. Guarantees, Warranties And Certificates -Refer to Section

01770.

H. Delivery Tickets

1. The Contractor shall submit to the Government's on site representative, one legible copy of each delivery ticket for all material delivered to the construction site.

2. The delivery ticket shall show brand name, catalog number, and number of items received.

* The applicable FAR clauses will be provided in full text to the resultant contractor at the pre-construction conference.

(END OF SECTION 01330)

DIVISION 1 SECTION 01420

GENERAL REQUIREMENTS DEFINITIONS AND STANDARDS

01420-1

A. Regulatory Requirements

1. All work shall be accomplished in strict accordance with the regulations, codes, and laws in effect at the time the work is performed for the location where it is to be performed.

B. Means and Methods

1. Means and methods used in the performance of this contract must be in accordance with all applicable Federal Acquisition Regulations in addition to OSHA regulations, 29 Code of Federal Regulations, acceptable industry practices as recognized by societies, associations, building codes, manufacturers’ specifications and any applicable state safety and health requirements.

(END OF SECTION 01420)

DIVISION 1 SECTION 01770

GENERAL REQUIREMENTS PROJECT CLOSEOUT

01770-1

A. Final Inspection

1. The Contractor shall request a final inspection in writing at least ten (10) days prior to the anticipated date of completion.

2. Work will not be considered ready for final inspection until all the work has been completed and the Contractor has certified that all items are in strict compliance with all contract terms and conditions.

3. The Contractor or the project supervisor shall be at the job site during the final inspection.

C. Tests

1. Complete all tests required to prove actual operating performance of equipment and systems incorporated into the project.

2. Submit reports of all tests to the Contracting Officer prior to final payment.

D. Record Drawings

The Contractor shall provide and maintain in proper order and in good, clean condition, in the field or the Hatchery office or at the project site, one (1) complete set of full size prints of all drawings. On this set, with red pencil or ink, the Contractor will neatly inscribe all changes in work. At time of final acceptance, and prior to final payment, these corrected prints will be presented to the Engineer. The Contractor will note all data and changes on these record drawings in sufficient detail and clarity to provide information necessary for preparation of "as built" drawings by the Government.

E. Guarantees, Warranties and Certificates

1. The Contractor will submit all guarantees, warranties and certificates to the government prior to final payment.

DIVISION 1 SECTION 01770

GENERAL REQUIREMENTS PROJECT CLOSEOUT

01770-2

2. The Government requires a 100% warranty for a period of one full year after final acceptance. Items of work found defective during the warranty period will be replaced at no cost to the Government and the warranty for that particular part of the work shall automatically extend for one full year beyond the completion date of repairs.

3. If a manufacturer or supplier offers a guarantee in excess of the one year requirement outlined herein, then the longer guarantee period will apply for those particular items.

(END OF SECTION 01770)

DIVISION 2 SECTION 02200

SITEWORK EARTHWORK

02200-1

1. The requirements of this section shall include the trench excavation required for pond liner removal and new liner placement. It shall also include the minor grading needed to provide a consistent embankment slope prior to pond underlayment liner and HPDM Liner placement.

2. The Hatchery shall drain the ponds prior to construction activities. It will be the Contractor's responsibility to dewater the sites and keep the ponds free of water.

Notify the Contracting Officer's Representative / Engineer if this condition cannot be met.

B. Execution

1. Have utility owners field mark utility locations and verify location of existing utilities prior to pond excavations.

2. Dewater if necessary the trench areas to the extent necessary to perform existing liner removal and new liner replacement

3. Cut pond liner into manageable sizes and remove from site. Pond liner material shall be removed from the site and become property of the Contractor.

4. Reuse existing gravel material to the extent possible in trench areas. After liner is laid in trench add new gravel as needed to restore to existing grades to allow pond drainage.

(END OF SECTION 02200)

DIVISION 2 SECTION 02230

SITEWORK GRAVEL

02230-1

1. Work under this section includes the furnishing, transporting, spreading and compacting of gravel that may be needed to replenish gravel disturbed in the trench areas during liner removal operations.

2. The Contractor shall provide all labor, tools, materials and equipment necessary to install gravel of similar size in the existing trenches shown on the contract drawings.

3. The equipment used in the work shall be of sufficient size and in such mechanical condition as to meet the requirements specified herein and shall be capable of providing a satisfactory quality of work. All equipment shall be ready for immediate use when required or directed by the Engineer. The Engineer may order the immediate removal and replacement of any unsatisfactory piece of equipment which will not, in his opinion, produce finished work of acceptable quality.

5. Any equipment which drips fuel, grease, oil or any other substance which, in the opinion of the Engineer, is detrimental to the quality of the finished product shall not be permitted on the job site until such drips are adequately repaired.

6. Submittals:

a. Certification that gravel materials meet these specifications shall be submitted for approval prior to delivery of any materials to the job site.

Weight tickets shall be collected by the Government Inspector at the job site.

B. Materials

1. The material mix used for replenishing trench liner gravel shall be 3/4 " diameter screened clear stone with no fines.

DIVISION 2 SECTION 02230

SITEWORK GRAVEL

02230-2

C. Execution

1. Subgrade Preparation: Subgrade preparation shall include grading the trench bottom and laying a geotextile membrane. Subgrade compaction shall meet requirements specified in Section 02200 A.3.

2. Gravel Placement and Compaction: After removal of the existing liner the trench bottom gravel shall be laid similar to existing gravel in maximum (6) inch layers over the new geotextile underlayment and HPDM liner.

The gravel shall be graded and smoothed and be free of depressions or lumps. The gravel shall be compacted using appropriately sized equipment to fit in the trench area or deemed practicable by the contractor.

3. The surface shall be smooth and uniform. It shall be restored to the existing pond bottom drainage grade to allow drainage to the water control structure.

(END OF SECTION 02230)

DIVISION 2 SECTION 02270

SITEWORK UNDERLAYMENT FABRIC

02270-1

1. The requirements of this section shall govern the work necessary to place the underlayment fabric.

Underlayment fabric shall be placed under all pond liner fabric placed.

2. Submittal: The brand filter fabric to be used shall be accepted on the following basis: The Contractor shall furnish the Engineer a mill certificate or affidavit signed by a legally authorized official from the company manufacturing the fabric. The mill certificate or affidavit shall attest that the fabric meets the requirements stated in these specifications.

B. Material

The underlayment fabric shall be pervious sheet, non-woven, resistant to deterioration in soil construction applications.

The underlayment fabric shall contain stabilizers and/or inhibitors to make the filaments resistant to deterioration due to ultra-violet and heat exposure. The filter fabric shall provide an Equivalent Opening Size (EOS) no finer than U.S. Standard Sieve No. 100 and no coarser than U.S. Standard Sieve No. 70. EOS shall be measured in accordance with CW- 02215 (Corps of Engineers, November, 1977). The fabric Grab Tensile Strength (ASTM D-1682) shall exceed 250 pounds in any principal direction. The fabric puncture Strength (ASTM D-

751) shall exceed 120 psi. The burst strength (ASTM D-751) shall exceed 400 psi.

1. The Contractor shall provide that during all periods of shipment and storage the underlayment fabric material shall be protected from the direct sunlight, ultra-violet rays, temperature greater than 140°F and any mud, debris, or damaging material. Any defective fabric not acceptable to the Engineer shall not be used. The fabric shall remain in a heavy duty protective covering prior to installation.

DIVISION 2 SECTION 02270

SITEWORK UNDERLAYMENT FABRIC

02270-2

2. Fabric shall be laid as shown on the Contract Drawings.

Fabric strips shall be placed to provide a minimum overlap of three (3) feet. The fabric shall be protected at all times during installation and construction. Damaged fabric shall be replaced, except that holes or tears of not larger than two (2) feet in any direction and not closer than two (2) feet to an edge may be covered with a patch two (2) feet larger than the hole. The fabric shall be covered within 4 days.

(END OF SECTION 02270)

DIVISION 2 SECTION 02280

SITEWORK EPDM POND LINER

02280-1

1. The requirements of this section shall govern the work necessary to place the EPDM pond liner on Pond 14A and Pond 14B. Liner shall be placed as shown on the Contract Drawings.

2. Submittal: Submit all manufacturer’s product data relating to the EPDM Pond Liner including the Minimum specifications listed below and installation instructions. Product Warranty shall be now less than 20 years.

B. EPDM Material

1. Specific Gravity ASTM D792 1.1

2. Unit Wt. ASTM D751 .28

3. Thickness (Min Ave.) ASTM D5199 .045

4. Break Strength ASTM D882 50

5. Break Elongation ASTM D882 500%

6. Tear Resistance ASTM D1004 9

7. Puncture Resistance ASTM D4833 35

8. Shore A Durometer ASTM D2240 65-10

9. Resistance to Ozone

Days/100@150 Degrees ASTM D1149 No Cracks

10. Multiaxial Elongation ASTM D5617 100%

11. Brittleness Temp. ASTM D746 -49 F

12. Water Resistance ASTM D471 +8, -2

13. Dimensional Stability ASTM D1204 .075%

14. Chronic Toxicity ASTM E729 Passes EPA/600/4-89-001 Passes

1. The Contractor shall follow the manufacturer’s installation instructions for installing the EPDM liner including any instructions listed in conjunction with underlayment liners. Any defective pond liner not

DIVISION 2 SECTION 02280

SITEWORK EPDM POND LINER

02280-2 acceptable to the COR/Engineer shall not be used. The fabric shall remain in a heavy duty protective covering prior to installation.

(END OF SECTION 02280)

DIVISION 15 SECTION 15100

MECHANICAL GATES

15100-1

1. This section shall govern the work necessary to furnish and install the water control structure gates, stem, and accessories as specified herein complete with all necessary appurtenances.

2. Shop Drawings

a. The Contractor shall submit shop drawings and pertinent descriptive data describing the equipment which is proposed for installation. This equipment will be subject to review and approval by the Engineer prior to installation.

b. Shop drawings shall show all pertinent dimensions, materials, configurations, and related information.

B. Materials

1. The gate shall be medium duty, flatback frame, cast iron, self-contained, flushbottom, non-rising stem type. The gate shall have a minimum seating head of twenty (10) feet and a minimum unseating head of ten (10) feet. The gate shall include bronze seats and lift nut with adjustable wedging devices which will provide a watertight seal in accordance with AWWA 501; galvanized structural steel rails and yoke; stainless steel stem;

and galvanized mounting hardware. The operator shall be a handwheel type with a threaded bronze lift nut to match the stem. An arrow shall be cast on the handwheel to indicate the direction of rotation to open the gate.

Paint shall be gate manufacturer's standard finish.

2. Expansion anchor bolts shall be furnished by the gate manufacturer and shall be sized to adequately secure the gates against the design unseating head. For design purposes, it can be assumed that the structure contains concrete with a compressive strength of 4,000 psi.

Intermediate frame anchor bolts shall be provided if

DIVISION 15 SECTION 15100

MECHANICAL GATES

15100-2 recommended by the gate manufacturer.

3. Available manufacturers offering sluice gates which may be incorporated into the work include, but are not limited to, the following:

a. Hydro Gate Corp., Commerce City, Colorado.

b. Waterman Industries Inc., Exeter, California.

c. Rodney Hunt Company, Orange, California.

1. The contractor shall unbolt and remove the existing control gates on Pond 14 A and 14 B from the existing control structure wall. The gates shall be removed from the site and become property of the Contractor.

2. The Contractor shall repair the concrete walls by filling bolt connection holes with grout or by any means necessary to provide a surface which will provide a wall structurally capable to allow connection of the new control structure gate frame, gate, and stem.

3. The gate shall be installed and adjusted in accordance with the manufacturer's recommendations. The finished installation shall be watertight and shall operate smoothly from the fully closed to the fully open position. The gate shall be lubricated in accordance with the manufacturer's recommendations.

(END OF SECTION 15100)

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PRECONSTRUCTION SAFETY CHECKLIST

PROJECT LOCATION:

PRECONSTRUCTION MEETING

DATE:

NAME AND ADDRESS OF

CO NT RACT OR :

NAME OF CONTRACTOR

SU PER INT EN DE NT /FO RE M AN

NAME OF SERVICE

CONTRACTING OFFICER:

NAM E O F C ON TR ACT OR ’S

COM PETEN T PERSO N (PER 29

CFR

PROPOSED CONSTRUCTION

STAR T D ATE:

PROJECT T ITLE: CONTRACT NUMBER:

The Fish and Wildlife Service (FWS) places safety and health as a top priority at all Service contracted construction sites (360 FW 4). The contractor has ultimate responsibility for safety during construction until final completion and acceptance of the project by FWS.

This checklist serves as an assurance tool/guide in assessing safety program preparations of the contractor, and is not all-inclusive. As tasks change and new risks and hazards are introduced, you may need to address additional safeguards and corrective measures.

The contractor and subcontractor(s) must comply with all Occupational Safety and Health Administration (OSHA) regulations applicable to the construction project, including requirements set forth w ithin solicitation provisions and contract clauses (e.g., FAR 52.236-13 “Accident Prevention” with Alternate I and Special Provisions). It is the responsibility of the contractor/subcontractor(s) to adhere to regulations found at 29 CFR 1910, 1926, and 1928. (See page 5 for Table of Contents of OSHA Construction Safety Standards.) Each contractor/subcontractor must initiate and maintain an effective safety program that provides adequate systematic policies, procedures, and practices to protect their employees from, and allow them to recognize, job-related safety and health hazards. The program must include provisions for the systematic identification, evaluation, and prevention/control of general work s ite hazards, specific job hazards, and potential hazards that may arise from foreseeable conditions, as well as providing a competent person to conduct frequent and regular inspections. The contractor must instruct each employee to recognize and avoid unsafe conditions and the regulations applicable to the work environm ent.

The contractor may use at its option the latest edition of the “Bureau of Reclamation Safety and Health Standards” manual and appedixes as a safety program implem entation guide for the duration of the contract. .

The contractor will address the following items prior to and/or during the Preconstruction Conference (the Contracting

Officer/Contracting Officer’s Representative will record these items):

1.

FAR 52.236-13, Accident Prevention, Alternate I and applicable safety provisions?

The contractor has read and understands his/her re spo nsibilities for compliance with contractual safety language -

NO ___YES ___

2. Has contractor prepared a Safety Plan that analyzes anticipated hazards of the project and indicates how the hazards will be controlled?

use, scaffolding, excavat

Contractor must identify specific procedures for controlling hazardous operations such as crane

NO ___ion/trenching, hot work/welding, etc,. ES ___ Y N/A

FWS Form 3-2199 09/01 Page 1 of 5

3. How will contractor/subcontractor address the four leading hazards of construction work: falls, struck by, caught in/between, and electr ical?

4. The “Designated Competent Person” (responsible for the pro ject’s safety and health performance) is knowledgeable corrective measures?

in applicable OSHA regulations and capable of identifying existing/predictable hazards, and has the authority to prompt

YES ___ NO ___

5.

haza

Do contractor and subcon tractor em ployees know wha t to do in the event of an em erge ncy (e.g., injury, fire, accident, ESYrdous material spill, etc.) with regard to the following actions? NO

a. Notification of Departm ent, FW S Facility Manager, CO, COR, CI, etc.

b. Means of com munication with contact numbers (e.g., radio, cellular, pager, etc.).

c. Availability of first-aid/medically-trained contractor personnel with appropriate medical supplies.

d. Personnel (including subcontractors) knowledge of location for imm ediate aid (e.g., first-aid, etc.).

e. Evacuation routes, signals, and procedures are provided to all on-site personnel.

f. Safety and health information disseminated to all site personnel (e.g., contractor and subcontractor employees).

6.

(If no, skip to # 7)

a. Location and type of trailer (office or equipment).

b. Telephone hook-up.

c. Electrical hook-up.

d.

W ill a contractor/s ubc ontra ctor tra iler be broug ht on site and its hook-up/p lacem ent coord inated with COR /CI?

e. Propane used for heating?

f. Serve as first-aid station? YES

Vehicle parking arrang em ent (adequate space).

YES ___

___NO ___

NO ___

7. Is contractor aware that he/she must ensure construction area is clearly delineated and posted with appropriate warning signs (e .g., “Hard Hat Area”, “Construction Site – CLOSED”, rea C losed to Public”, etc.), and that instructional signs (e.g., designated parking area, etc.) and flagmen or barriers may be required? Yes No

Housekeeping - Is contractor/subcontractor aware that they must ensure that following acceptable housekeeping

NO

“A

8.

standards are practiced from project’s start to finish?

YES

a. Form/scrap lumber with protruding nails and all other debris shall be kept clear from work areas.

b. Combustible scrap and debris shall be removed at regular/frequent intervals.

c. Materials shall be stored with regard to their fire characteristics with effective fire protection and prevention measures used.

d. An enclosed chute shall be used whenever materials are dropped more than 20 feet to an exterior point of a building.

e. Aisles, exits, and passageways shall be kept clear and in good repair.

9.

Is contractor aware of following Environmental and Personal Controls standards? YES NO

a. Potable water provided.

b. Restroom facilities provided.

c. W ashing facility provided for employees engaged in operations involving harmful substances.

d. Intoxicating beverages, controlled substances, and/or firearms are not permitted under any circumstances on the construction site.

e. All activities in or around water bodies must be in compliance with regulations for worker safety, including personal flotation devices or buoyant work vests, lifelines, ring buoys and guardrails while working over or adjacent to water hazards, and from barges, boats, and/or launches.

FWS Form 3-2199 09/01 Page 2 of 5

10.

a. Confined Space.

b. Scaffolding.

c. Fall Protection.

d. Hazard Comm unication.

e. Lockout/Tagout.

f. Respiratory Protection.

g. First Aid.

Is contractor/subcontactor aware that following employee training considerations may need to be addressed?

YES NO

11. Contractor/subcontractor is responsible for requiring the wearing of appropriate personal protective equipment in all operations where there is an exposure to hazardous conditions or where the need is indicated for using such equipment to reduce the hazard to their employee(s). The contractor/subcontractor is also responsible for ensuring equipment may include the following: Discussed with contractor?

that personnel using protective equipment shall be trained and medically qualified to do so. Such personal protective

a. Eye and face protection (safety goggles, safety glasses, welding goggles, face shields, etc.).

b. Protective footwear (safety shoes, boots).

c. Protective gloves (leather, rubber, insulated).

d. Respirators (dust, half-face, full-face, etc.).

e. Hearing protection (ear plugs, muffs, etc.).

f. Coast Guard-approved PFD/buoyant vest.

g. Fall protection equipm ent.

12. Tools (hand, electric, pneumatic) Standards: Discussed with contractor?

a. Hand tools, power tools, and jacks are maintained in safe operating condition and used only for the purpose for which they were designed.

b. Electric power-operated tools must be either approved double-insulated, or be properly grounded (see Item

#13 “Electrical” for additional considerations).

13. Electrical Standards:

a. Ground Fault Circuit Interrupters (GFCIs) or an assured equipment-grounding conductor program must be used to protect employees from ground-fault hazards.

b. Electrical cords/insulation must be in good condition (not frayed or damaged).

c. All ground plugs must be on electrical cords, if so designed by the manufacturer.

d. W orkspace, walkways, and similar locations shall be kept clear of electrical cords.

e.

f.

All electrical extension cords must be of the three-wire type.

Contractor/subcontractor must determine need and implem ent an appropriate Lock-out/Tag-out program.

14. W ill motor vehicles, cranes, and/or heavy equipment be used? YES NO __ (If no, skip to #15)

a. Crane and derrick use must comply with applicable standards.

b. Rollover protection as required.

c. Back-up alarms or observer signals as required.

d. No crawler type vehicles are allowed on an improved road.

e. All utilities must be located prior to excavating soil.

15. Excavating and Trenching work? YES ___ NO ___ (If no, skip to #16)

a. All excavating/trenching must be in accordance with applicable safety standards.

b. All utilities must be located prior to excavating.

FWS Form 3-2199 09/01 Page 3 of 5

16. Elevated W ork? YES ___ NO ___ (If no, skip to #17) a.

Ladders and their use must conform to standards.

b. Aerial lift usage must meet applicable requirements.

c. Fall protection needs must be assessed per standards.

d. Scaffold work must conform to standards.

e. Stair design, construction, and use must meet applicable requirements.

f. Toeboards, when used to protect workers from falling objects, must be erected along the edge of the overhead walking/working surface.

g. Safety net use must comply with standards.

h. Railing must conform to standards.

17.

construction.

Contractor is aware of and understands the need to incorporate app licable requirem ents for concrete and m asonry

YES ___ NO ___ N/A ___

18. Contractor is aware of and understands the need to incorporate welding and cutting operations that com ply with etc.).

applicable safe ty requirem ents (e.g., compressed gas cylinders are protected from vehicle traffic, valve caps secured, 19.

paint

Contrac tor is aw are o f and understands the need to m anage hazard ous m aterials/waste appro priately (e.g., YES N/A

N/A ___ s, solvents, fuels, etc.) including the following: NO ___

a. Use and storage of flammable/combustible liquids.

b. Aboveground fuel storage tanks properly managed/contained.

c. Com pressed gases and cylinders managed correctly (e.g., secured and protected from damage, etc.).

d. Procedures for managing use, storage, and disposal of hazardous materials properly established.

e. Excess/waste product(s) and containers properly disposed of per environmental regulations.

f. Hazards of product use and the need for protective measures (e .g., personal protective equipment, etc.)

conveyed to employees.

g. Asbestos work conform s to applicable standards.

h. Exposure to toxic gases, vapors, fum es, dusts , and m ists managed correctly.

i. Lead, laser, and any other hazardous components managed per the applicable standard.

j. Contract employees must conduct hazardous waste operations work within the parameters of a written safety

& health plan.

20. Comments, notes, additional requirements:

The contractor has the ultimate responsibility for safety on the project site at all times until final completion and acceptance of the project.

The contractor’s signature below indicates the above information was discussed and understood.

Contractor signature: _________________________________________ Date: __________________________

Date: __________________________

Contracting Officer/Contracting Officer’s Representative

FWS Form 3-2199 09/01 Page 4 of 5

OSHA CONSTRUCTION SAFETY STANDARDS - 29 CFR 1926:

(Following standards can be accessed at http://www.osha.gov):

Subpart A (1926.1 - 1926.5) - General

Subpart B (1926.10 - 1926.16) - General Interpretations

Subpart C (1926.20 - 1926.35) - General Safety and Health Provisions

Subpart D (1926.50 - 1926.66) - Occupational Health and Environm ental Controls

Subpart E (1926.95 - 1926.107) - Personal Protective and Life Saving Equipment

Subpart F (1926.150 - 1926.155) - Fire Protection and Prevention

Subpart G (1926.200 - 1926.203) - Signs, Signals and Barricades

Subpart H (1926.250 - 1926.252) - Materials Handling, Storage, Use and Disposal

Subpart I (1926.300 - 1926.307) - Tools - Hand and Power

Subpart J (1926.350 - 1926.354) - W elding and Cutting

Subpart K (1926.400 - 1926.449) - Electrical

Subpart L (1926.450 - 1926.454) - Scaffolds

Subpart M (1926.500 - 1926.503) - Fall Protection

Subpart N (1926.550 - 1926.555) - Cranes, Derricks, Hoists, Elevators and Conveyors

Subpart O (1926. 600 - 1926.606) - Motor Vehicles, Mechanized Equipment and Marine Operations

Subpart P (1926.650 - 1926.652) - Excavations

Subpart Q ( 1926.700 - 1926.706) - Concrete and Masonry Construction

Subpart R (1926.750 - 1926.752) - Steel Erection

Subpart S (1926.800 - 1926.804) - Underground Construction, Caissons, Cofferdam s and Compressed Air

Subpart T (1926.850 - 1926.860) - Demolition

Subpart U (1926.900 - 1926.914) - Blasting and the Use of Explosives

Subpart V (1926.950 - 1926.960) - Power Transmission and Distribution

Subpart W (1926.1000-1926.1003)- Rollover Protective Structures; Overhead Protection

Subpart X (1926.1050 -1926.1060)- Stairways and Ladders

Subpart Y (1926.1071 -1926.1092)- Diving

Subpart Z (1926.1100 -1926.1152)- Toxic and Hazardous Substances

FWS Form 3-2199 09/01 Page 5 of 5