5. CAFB IMT Form 3624 Facilities Outage Request.pdf
PDF 556 KB Posted
- Attached to
- Building 60 Renovation Federal contract opportunity
- Solicitation number
- FA485521B0002
About this file
This document is a utility outage request form used by Cannon Air Force Base to coordinate planned utility outages with relevant base organizations. The form requires requestors to provide details of the proposed outage such as the date, affected facilities, estimated start and stop times, requesting official contact information, and type of outage for services such as power, gas, water, HVAC, or road closures. The process outlined in the form instructions and reverse side requires the requestor to notify the appropriate base shops and obtain approvals from supervising officials and leadership. It also specifies the requestor must notify all affected facility managers as well as organizations such as AAFES, Ambulatory Services, SOSFS, the fire department, and others depending on the scope and facilities involved. The form is to be submitted to the responsible CE shops no later than one day before the planned outage date.
The related federal contract opportunity is a solicitation for the Building 60 Renovation project at Cannon Air Force Base. The pre-bid site visit will be held on July 9th at 1:00PM MDT. The solicitation was issued by the Department of the Air Force Special Operations Command for renovation services involving Building 60. No further details are provided in the document excerpt.
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Text version
BASE CIVIL ENGINEERING OUTAGE CLEARANCE REQUEST
(Completed at least 21 days prior to outage. Form must be completed IN ORDER)
DATE PREPARED
1. Outage is requested to proceed with work at on Work Order No.
4. LIST OF FACILITIES INVOLVED
5. START/STOP DATES OUTAGE/CLOSURE REQUIRED 6. ESTIMATED START/STOP TIMES OF OUTAGE/CLOSURE
7. NAME OF REQUESTING OFFICIAL 8. TELEPHONE NO. 9. ORGANIZATION
ORGANIZATION REMARKS (Use Reverse for additional comments) REVIEWER'S NAME AND INITIALS 10.
B A S E
C I V I L
E N G I N E E R I N
G
A. ELECTRICAL DISTRIBUTION
B. ELECTRICAL SUPERINTENDENT
C. POWER PRO
D. ALARMS SHOP
E. INFRASTRUCTURE SUPERINTENDENT
F. HVAC
G. WFSM SHOP
H. CUSTOMER SERVICE
I. EMAIL CUSTOMERS/FACILITY MANAGERS
J. CEO
11.
12.
13.
14.
15.
16.
19. OTHER, see block 6 on reverse (Specify)
20. REQUESTED CLEARANCE APPROVED DISAPPROVED
21. TYPED NAME AND SIGNATURE OF APPROVING OFFICIAL 21a. DATE SIGNED
CAFB IMT 3624, Utility Outage Request Log V5, 16 July 19 PREVIOUS EDITIONS ARE OBSOLETE.
784-4371-Drafted 269 completed by an authorized issuer
784-2940-Does Facility have a Generator or need one staged?
784-1129-Notified if affected
784-2001-Obtain Facility Manager list
784-6742-Notified if affected
784-6451-Notified if affected
Contact 784-2578 with outage details
784-1132-Electrical, Fire Alarms, EMCS and Power Pro
784-4357-Approved by Operations Chief
DS MESSAGE
If outage is larger than four facilities or affects critical facilities then a notification by requester must be sent out 14 days prior
COMMANDER NOTIFICATION
SLIDE CREATED
If outage is larger than four facilities then a notification by requester must be sent out 14 days prior
784-4368-Water, Fuels, HVAC
27 SOSFS NOTIFICATION
Obtain facility manager's concurrence by e-mail (statement of concurrence, voting buttons etc.). This must be provided with completed form to CEO. Include e-mails to AAFES at stephensontr@aafes.com, hortondl@aafes.com, and SweetenburgJ@aafes.com
FIRE DEPARTMENT NOTIFICATION
COMM FOCAL POINT NOTIFICATION
Send completed DS Message and Slide to the Commander, work with the Commander's secretary to meet to explain the outage as necesary
Contact 784-4111 with outage details.
2. Type of outage POWER/ALARMS GAS WATER/SEWER HVAC
Contact 784-8501 with outage details
ROAD CLOSURE
17. ROC NOTIFICATION (if 123, 600, 777 or 4618 are affected
Contact 904-6791 with outage details
3. CONTRACTOR'S OUTAGE PLAN ATTACHED Yes No N/A Comments:
18. AMBULATORY SERVICES Contact 904-3979 with outage details
1157440345C Line
1157440345C Line
1157440345C Line
1157440345C Line
1157440345C Line
1157440345C Line
1157440345C Line
1157440345C Line
1157440345C Line mailto:27SOSFS.S3@us.af.mil; 27SOSFS.S5@us.af.mil?subject=HOT: Outage Request mailto:27SOCESCEFFACC@us.af.mil?subject=HOT: Outage Request mailto:27socs.scos@us.af.mil?subject=HOT: Outage Request 1157440345C Line
1157440345C Line mailto:stephensontr@aafes.com; hortondl@aafes.com; SweetenburgJ@aafes.com?subject=HOT: Outage request that may affect AAFES facilities
INSTRUCTIONS
The outage clearance request is used for any work (contract or in-house) that may disrupt utility or vehicular traffic flow, base utility services, protection provided by fire and intrusion alarm system, or routine activities of the installation. This form is used to coordinate the required work with key base activities and keep customer inconvenience to a minimum. It is also used to identify potentially hazardous work conditions in an attempt to prevent accidents. The utility outage request does not alleviate the responsibility to complete a current version CAFB AF103, work clearance request prior to any work.
The requestor is responsible for notification to the shops. The requestor's leadership chain is the final approval authority (the requestor's leadership determines if all applicable blocks are satiesfactorily completed.) Completed copies of this form are to be turned in to the CE shop's responsible for executing the outage NLT 1 day prior to the outage request date.
**Step 11 needs to happen 14 days prior to the date of the outage. Allow ample time to complete steps 1-10.
1. Requester liaises with appropriate shop/customer to plan the outage. Dates must be negotiated between the customer and CE's respective mission and every effort must be made to schedule outages during normal duty hours.
2. Requester notifies all shops involved, in order on section 10A-G. Sections must be completed in order
3. Requester gets outage approved by appropriate superintendent.
3a. Requester creates a DS Message (as needed) to be approved by the appropriate superintendent. DS messages originate at the Commander/Vice Commantder level.
a. Slide 1: Title of project size 40 font in black, centered on the slide Briefer’s name and office symbol, bottom right hand corner in size 24, blue
b. Slide 2: Purpose in size 24, sub-bullets in size 20, sub-sub-bullets in size 16. All in blue
c. Slide 3: Time and dates of outage. Main bullets, size 24, sub-bullets in size 20 etc.
d. Slide 4: Scope of outage (i.e. single building, sections of a building, multiple building lists etc.)
Main bullets, size 24, sub-bullets in size 20 etc. Outage mitigation factors (i.e. generator support, temporary systems etc.)
e. Slide 5: Visual slide: a visual map using GEO-Base on the attached Wing Slide, color coding the facilities affected.
f. Slide 6: “Questions?” centered on sheet in blue, size 40 font.
4. Once reviewed by the appropriate Superintendent and a DS message is drafted as needed it's presented to Requestor's leadership for approval.
5. Requester presents proposed outage to the approving official in their chain of command.
6. After leadership approval the requester will contact the following explaining the extent of the outage:
- All of the primary and alternate facility managers
- AAFES Personnel
- Ambulatory Services stephensontr@aafes.com, hortondl@aafes.com, and SweetenburgJ@aafes.com
Call for POC 904-3979
27SOCES.CustServ@cannon.af.mil X-2001
X-4111
X-4111
X-2578
- CE Customer Service
- SOSFS (S5)
- SOSFS (S3)
- Fire Department
- Comm Focal Point
27SOSFS.S5@cannon.af.mil
27SOSFS.S3@cannon.af.mil
27SOCESCEFFACC@us.af.mil
27socs.scos@cannon.af.mil X-2666
-If any of the facilities that are affected by the outage are on the airfield, Airfield Management (MSgt Rose X-7936)
(REVERSE)
Air Commandos, As part of our on-going efforts to continue to improve Cannon Air Force Base, we will be having a scheduled outage affecting buildings .
This outage is scheduled from until on .
The purpose of this outage is to .
We apologize for any inconvenience. If there are any questions, please contact CE Customer service at 784-2001.
3b. Requester creates a CoD slide (as needed) to be approved by the appropriate superintendent. Slides originate to the Wing at the Commander/ Vice Commantder level. Slide example is on the next page.
7. Steps 14, 15 and 16 must be completed for all outages, whether or not a DS Message and Slide is created.
8. Step 17 must be completed if building 123, building 600, building 777 or building 4618 are affected, whether or not a DS Message and Slide is created.
CAFB IMT 3624, Utility Outage Request Log V5, 16 July 19
“Air Commandos” 4
27th SOCES
| DATE PREPARED: |
| 1 Outage is requested to proceed with work at: |
| on Work Order No: |
| 3 DATE CLEARANCE REQUIRED: |
| 4 DATE OF CLEARANCE: |
| 5 SIGNATURE OF REQUESTING OFFICIAL: |
| 6 TELEPHONE NO: |
| 7 ORGANIZATION: |
| 17 TYPED NAME AND SIGNATURE OF APPROVING OFFICER Chief of Operations Flight or Chief of Engineering Flight: |
| 17a DATE SIGNED: |
| Check Box17: Off |
| Check Box18: Off |
| Check Box19: Off |
| Check Box20: Off |
| Text23: |
| Text24: |
| Check Box25: Off |
| Check Box26: Off |
| Button28: |
| Button29: |
| Check Box2: Off |
| Text1: |
| Button27: |
| Button30: |
| Text22: |
| Outage plan Yes: Off |
| Outage Plan No: Off |
| Outage Plan N/A: Off |
| Text5: |
File details come from the government source that posted it. Updated .