A05.0 PSNS5090-132 Contractor Hazardous Material Inventory (CHMI)_Attachment One.pdf

955 KB Posted

Attached to
Preventative Maintenance and Calibration plan for GE Type 5203/300 Structurix M-Eco Radiography Film Processors for Puget Sound Naval Shipyard (Bremerton, WA) and Naval Air Station North Island (San Diego, CA)
Solicitation number
N4523A25Q1412
Issued by

About this file

Written by GovTribe AI ·

The Contractor Hazardous Material Inventory (CHMI) is a naval facility document used to track and authorize hazardous materials being transported onto federal property at the Bremerton Naval Complex. The form requires contractors to list all hazardous materials they plan to bring onsite, including detailed information such as trade name, manufacturer, process code number, and container size/type. Key requirements include submitting the most current Safety Data Sheets (SDS) for each product, obtaining approval from Code 106.33 before bringing materials onsite, and using a provided Hazardous Material Process Code Selection Flowchart to determine the appropriate process code for each material. Contractors must certify the accuracy of their submissions and report monthly hazardous material usage by the 5th calendar day of the following month.

View the file

Other files

File Type Posted
A5 PWS Film Processor Maintenance_FinalRev_Redacted.pdf PDF
A5 PWS Film Processor Maintenance_Amended.pdf PDF
C 04.0 Combined+Synopsis-Solicitation-Film Processor_Amended.pdf PDF
C08.0 Questions submitted N4523A25Q1412.pdf PDF
A05 PWS Film Processor Maintenance_Redacted.pdf PDF
C 04.0 Combined+Synopsis-Solicitation-Film Processor_final.pdf PDF
A05.0 Major Maint Checklist Processor_OperatingManual_Attachment Two.pdf PDF
A11 WageDetermination_2015-5525_KitsapWA.pdf PDF
A11 WageDetermination_2015-5635_SanDiegoCA.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

CONTRACTOR HAZARDOUS MATERIAL INVENTORY (CHMI) Document No.

Ref: NAVSEA Standard Items 009-97 and 009-02 NWRMC Local Standard Item 099-04NW.

(1) CONTRACTOR INITIAL REQUEST (Before moving any hazmat onto this Federal facility) **Refer to instructions on last page** Page of PRIME CONTRACTOR (KTR) (POC) SUBCONTRACTOR (If Applicable) PRIME KTR CERTIFICATION SIGNATURE (sign or submit electronically) Print and sign

PHONE

CONTRACT NUMBER (2) PROJECT NAME (3) WORKSITE LOCATION (4) PROJECT EXECUTION START DATE (5) PROJECTED END

ENVIRONMENTAL, SAFETY, AND HEALTH (ESH) GOVERNMENT REPRESENTATIVE

CONTRACT OFFICE AGENCY (e.g., Code 400, AIT) ESH GOVERNMENT REPRESENTATIVE NAME PHONE FAX SUBMITTAL DATE

CODE 106.33 HAZARDOUS MATERIAL PROCESS MANAGEMENT BRANCH

CODE 106.33 NAME AND INITIALS RECEIPT DATE REVIEW DATE

(6) Trade Name

♦Name on product and safety data sheet (SDS) must match

(7) Manufacturer

♦Manufacturer name on product and SDS must match

(8) Process Code Number ♦Use provided flowchart

(9) Container Size and Type

♦Enter size

PSNS&IMF 5090/132 (Rev. 9-2017)

CONTRACTOR HAZARDOUS MATERIAL INVENTORY (CHMI) Document No.

Ref: NAVSEA Standard Items 009-97 and 009-02 NWRMC Local Standard Item 099-04NW.

(1) CONTRACTOR – INITIAL REQUEST (Before moving any hazmat onto this Federal facility) **Refer to instructions on last page** Page of

(6) Trade Name

♦Trade name on product and SDS must match

(7) Manufacturer

♦Manufacturer name on product and SDS must match

(8) Process Code Number ♦Use provided flowchart

(9) Container Size and Type

♦Enter size

PSNS&IMF 5090/132 (Rev. 09-2017)

PSNS&IMF 5090/132 (Rev. 9-2017)

INSTRUCTIONS FOR CONTRACTOR:

Fill out each section per these instructions and footnotes.

− List all hazardous material (HM) that, as the contractor; anticipates transporting off-site onto the Federal property located at the Bremerton Naval Complex (BNC).

− Do not list HM obtained inside the BNC labeled with the facility’s salmon-colored supplemental barcode label.

− Use additional sheets, as necessary, to include all HM anticipated to be transported onsite.

− Provide the most current SDS for each product listed in the CHMI.

− If using a “non-road” engine, submit an O&M plan to Code 106.31 Air Department (PSNSIMF C106.31Air_Asbestos_PCB <BREM_PSNSC106.31@navy.mil>).

− For all marine coatings, provide a volatile organic compound (VOC) certification sheet for each batch. If in possession of a marine coating that is general use and the VOCs are above

340g/l, separate paperwork must be submitted to the Code 106.31 Air Department via a Low-Use Exempt Form.

− All HM must be approved by Code 106.33 before bringing material onsite.

− Upon completion of all contractor-required items, submit the completed CHMI form to your Government Environmental, Safety, and Health representative.

*Prime Contractor Certification Statement: “I hereby certify that the submitted information contained in the attached document(s) is true, complete, and accurate, and all material listed has been approved by Code 106.33.”

Designated Government Environmental, Safety, and Health Representative: Complete the designated Government ESH section. Submit the completed CHMI to Code 106.33 (PSNSIMF C106.34 Hazardous Material Distro <BREM_PSNSC10634HazardousMaterialDistro@navy.mil>) for review and approval.

FOOTNOTES:

1. This form is the initial request for authorization. Use the Receipt & Monthly Usage Form to report monthly HM usage by the 5th calendar day of the following month. If no usage occurred, enter 0 in column 9 and submit the report.

2. Identify the job or project the HM will be used for (e.g., USS Abraham Lincoln, Bldg 435 Seismic Upgrades).

3. Identify worksite location (PSNS & IMF or NAVBASE Kitsap).

4. Enter the date the contractor is to start work on the project.

5. Enter the estimated project completion date.

6. Enter the trade name of the product. Use a separate line for each product and container size. List each kit component on a separate line. The trade name and manufacturer listed must match the SDS and container labels. Please include part numbers in the Trade Name block to expedite processing.

7. The manufacturer listed must match the SDS and container labels.

8. Use the attached Hazardous Material Process Code Selection Flowchart to determine the proper process code number.

9. Report container size in quantifiable units (e.g., 3-lb jar, 16-oz. bottle) and the container type code from Table 1 below.

Table 1 – Container Type Code Table 1 – Container Type Code Table 1 – Container Type Code Table 1 – Container Type Code Above ground tank A Can F Box K Tank wagon P Below ground tank B Carboy G Cylinder L Rail car Q Tank inside building C Silo H Glass bottles or jugs M Other R Steel drum D Fiber drum (cardboard) I Plastic bottles or jugs N Lead Acid Battery S Plastic or non-metallic drum E Bag J Tote bin O − For compressed gas cylinders, report the quantity of gas in cubic feet or units such as pounds (e.g., 150 cu-ft, 100-lb cylinder).

− For bulk material without a specific container size, use the units in which the material is commonly sold to consumers. Use gallons for bulk diesel fuel and pounds for welding rod or wire.

− For kits, list the container size and type for each component per examples:

Trade Name Manufacturer Container Size and Type

SYNDECK BOND COAT Part A (part no. SA1222) EPMAR Corp 0.75 gal F SYNDECK BOND COAT Part B (part no. SB1222) EPMAR Corp 0.25 gal F mailto:BREM_PSNSC106.31@navy.mil mailto:BREM_PSNSC10634HazardousMaterialDistro@navy.mil%3e

PSNS&IMF 5090/132 (Rev. 09-2017)

Follow the chart in sequential order of categories and codes to select the process code number (PCN) which best describes the application for hazardous material (HM) use. Complete Course HM03. (PSNS & IMF Homepage> Apps> Authorized Use List-MSDS> Training)

Correct PCNs are critical to accurately record HM usage and calculate annual air emissions.

Category Process Code Number

Hazardous Material Process Code Selection Flowchart

Gasoline Vehicle SR1093 Diesel Vehicle SR1094 Propane Vehicle SR1097 Fuel Gases ID1100 Arc or Thermal Cutting ID1300 Portable Boilers SR1090 Non-Vehicle Diesel Engine SR1091 Non-Vehicle 2-Cycle Gasoline Engine SR1098 Non-Vehicle 4-Cycle Gasoline Engine SR1099

Abrasive Blasting ID0100 N-Propyl Bromide Degreaser ID0207 Trichloroethylene Degreaser ID0209 Ultrasonic Cleaning ID0301 Solvent Cleaning or Stripping (Organic) ID0206 Metal Cleaning, Etching, Polishing (Inorganic) ID0200 Electroplating Processes and Surface Conversion ID0400

Marine Coating, Dip ID0601 Marine Coating, Brush and Roll ID0603 Marine Coating, Spray Booth ID0604 Marine Coating, Spray (Outdoors or In Drydock) ID0606 Marine Coating, Spray (Indoors or Ship Interior) ID0608 Marine Coating, Spray (Tank Interior) ID0609 Marine Coating, Powder ID0607 Marine Coating, Thinning or Pigment ID0610 Low Use Marine Coatings ID0666

Surface conditioners are applied as a preliminary or final step in preparing a surface for the application of a coating.

Examples: Abrasive blast grit, Buffing Compounds, Cleaning Solvents, Stripping Agents, Degreasers, El t l ti S l ti

NO

Surface coatings include thinners, pigments, and other products (such as dry film lubricants and lagging adhesive when used as a coating) which cure to form a thin, continuous, dry, surface-film.

YES

YES

Architectural Paint ID0599

Non-Marine Coating, Spray ID0502 Non-Marine Coating, Powder ID0504 Non-Marine Coating, Brush and Roll ID0505 Non-Marine Coating, Dip ID0506 Non-Marine Coating, Thinning or Pigment ID0510 Aerosol Painting (sprayed from a can) ID0507

Aerosol Adhesive (sprayed from a can) ID2399 Styrene Adhesive or Sealant ID2320 Non-Aerosol Adhesive ID2313 Welding ID1110 Brazing or Soldering ID1105

Adhesives and sealants include chemical and metallic bonding agents and their primers and fluxes that join two surfaces or fill gaps in a surface or in between surfaces.

NO

NO

NO

Exempt and Consumer Products are subject to Transfer Label requirements of

PSNS&IMFINST 4110.1

when transferred from the original container.

Exempt and Consumer Products are subject to

PSNS&IMFINST 5090.5

for disposal of unused product and empty containers.

Sealed Fluid or Gas System Fill ID2303 Non-Fuel Gases ID1101 Grounds Maintenance and Pest Control SR0500 Process Water Treatment (Includes Waste Water) SR1599 Chemistry Lab ID2400 Routine Maint. of Vehicle, Mobile Equip., and Cranes SR0100 Minor Maint. or Repr. of Non-Mobile Industrial Equip. ID2301 Misc. Industrial and Facilities ID2304

No PCN necessary for purchase or use.

No PCN necessary for purchase or use.

YES YES

NO

Fuel that fits these PCNs:

• Fuel to power vehicles

• Fuel to power non-road equipment, motors, generators, heaters etc.

• Gases used to cut through metal

Examples: Propane, Gasoline, Acetylene

NO

NO

YES

NO

YES

START HERE

Is the HM a fuel?

Is the HM used in surface preparation?

Is the surface part of a ship, submarine, barge, floating crane or other seagoing vessel?

(This includes components that have been removed and will be reinstalled)

Is the surface part of a building?

(This includes walls, floor, ceiling, roof and substructures)

All other coatings and surfaces…

Is the HM used to join or adhere two layers or surfaces together?

-Or to prime a surface for application of an adhesive?

-Or to seal gaps in or between surfaces?

For all other products and processes, check Exempt/ Consumer Products List or the No CHRIMP Tracking List, or both

All other PCNs (including lubricants, terrazzo floor components, etc.)

Abbreviations:

Maint. > maintenance misc. > miscellaneous Equip. > equipment Repr. > repair

Is the HM Exempt from AUL?

Is the HM exempt from tracking?

Is the HM used as a surface coating?

PSNS&IMF 5090/132 (Rev. 9-2017) https://syapps.psns.navy.mil/Community/106Environment/106.31+AirAsbestosContracting/HazMatControlMgmt/Download+Maintenance/Downloads_GetFile.aspx?id=3396 file://Spssvr007/msds/P910CP.pdf file://Spssvr007/msds/P910CP.pdf file://Spssvr007/msds/P910CP.pdf file://Spssvr007/msds/P910NC.pdf file://Spssvr007/msds/P910NC.pdf

**Refer to instructions on last page**
**Refer to instructions on last page**
INSTRUCTIONS FOR CONTRACTOR:
FOOTNOTES:
Trade Name
CONTRACT NUMBER:
CONTRACT OFFICE AGENCY eg Code 400 AIT:
ESH GOVERNMENT REPRESENTATIVE NAME:
PHONE_2:
FAX:
SUBMITTAL DATE:
CODE 10633 NAME AND INITIALS:
RECEIPT DATE:
REVIEW DATE:
6 Trade Name Name on product and safety data sheet SDS must matchRow1:
7 Manufacturer Manufacturer name on product and SDS must matchRow1:
8 Process Code Number Use provided flowchartRow1:
9 Container Size and Type Enter sizeRow1:
6 Trade Name Name on product and safety data sheet SDS must matchRow2:
7 Manufacturer Manufacturer name on product and SDS must matchRow2:
8 Process Code Number Use provided flowchartRow2:
9 Container Size and Type Enter sizeRow2:
6 Trade Name Name on product and safety data sheet SDS must matchRow3:
7 Manufacturer Manufacturer name on product and SDS must matchRow3:
8 Process Code Number Use provided flowchartRow3:
9 Container Size and Type Enter sizeRow3:
6 Trade Name Name on product and safety data sheet SDS must matchRow4:
7 Manufacturer Manufacturer name on product and SDS must matchRow4:
8 Process Code Number Use provided flowchartRow4:
9 Container Size and Type Enter sizeRow4:
6 Trade Name Name on product and safety data sheet SDS must matchRow5:
7 Manufacturer Manufacturer name on product and SDS must matchRow5:
8 Process Code Number Use provided flowchartRow5:
9 Container Size and Type Enter sizeRow5:
6 Trade Name Name on product and safety data sheet SDS must matchRow6:
7 Manufacturer Manufacturer name on product and SDS must matchRow6:
8 Process Code Number Use provided flowchartRow6:
9 Container Size and Type Enter sizeRow6:
6 Trade Name Name on product and safety data sheet SDS must matchRow7:
7 Manufacturer Manufacturer name on product and SDS must matchRow7:
8 Process Code Number Use provided flowchartRow7:
9 Container Size and Type Enter sizeRow7:
6 Trade Name Name on product and safety data sheet SDS must matchRow8:
7 Manufacturer Manufacturer name on product and SDS must matchRow8:
8 Process Code Number Use provided flowchartRow8:
9 Container Size and Type Enter sizeRow8:
Document No_2:
Page of_2:
6 Trade Name Trade name on product and SDS must matchRow1:
7 Manufacturer Manufacturer name on product and SDS must matchRow1_2:
8 Process Code Number Use provided flowchartRow1_2:
9 Container Size Type Enter sizeRow1:
6 Trade Name Trade name on product and SDS must matchRow2:
7 Manufacturer Manufacturer name on product and SDS must matchRow2_2:
8 Process Code Number Use provided flowchartRow2_2:
9 Container Size Type Enter sizeRow2:
6 Trade Name Trade name on product and SDS must matchRow3:
7 Manufacturer Manufacturer name on product and SDS must matchRow3_2:
8 Process Code Number Use provided flowchartRow3_2:
9 Container Size Type Enter sizeRow3:
6 Trade Name Trade name on product and SDS must matchRow4:
7 Manufacturer Manufacturer name on product and SDS must matchRow4_2:
8 Process Code Number Use provided flowchartRow4_2:
9 Container Size Type Enter sizeRow4:
6 Trade Name Trade name on product and SDS must matchRow5:
7 Manufacturer Manufacturer name on product and SDS must matchRow5_2:
8 Process Code Number Use provided flowchartRow5_2:
9 Container Size Type Enter sizeRow5:
6 Trade Name Trade name on product and SDS must matchRow6:
7 Manufacturer Manufacturer name on product and SDS must matchRow6_2:
8 Process Code Number Use provided flowchartRow6_2:
9 Container Size Type Enter sizeRow6:
6 Trade Name Trade name on product and SDS must matchRow7:
7 Manufacturer Manufacturer name on product and SDS must matchRow7_2:
8 Process Code Number Use provided flowchartRow7_2:
9 Container Size Type Enter sizeRow7:
6 Trade Name Trade name on product and SDS must matchRow8:
7 Manufacturer Manufacturer name on product and SDS must matchRow8_2:
8 Process Code Number Use provided flowchartRow8_2:
9 Container Size Type Enter sizeRow8:
6 Trade Name Trade name on product and SDS must matchRow9:
7 Manufacturer Manufacturer name on product and SDS must matchRow9:
8 Process Code Number Use provided flowchartRow9:
9 Container Size Type Enter sizeRow9:
6 Trade Name Trade name on product and SDS must matchRow10:
7 Manufacturer Manufacturer name on product and SDS must matchRow10:
8 Process Code Number Use provided flowchartRow10:
9 Container Size Type Enter sizeRow10:
6 Trade Name Trade name on product and SDS must matchRow11:
7 Manufacturer Manufacturer name on product and SDS must matchRow11:
8 Process Code Number Use provided flowchartRow11:
9 Container Size Type Enter sizeRow11:
6 Trade Name Trade name on product and SDS must matchRow12:
7 Manufacturer Manufacturer name on product and SDS must matchRow12:
8 Process Code Number Use provided flowchartRow12:
9 Container Size Type Enter sizeRow12:
6 Trade Name Trade name on product and SDS must matchRow13:
7 Manufacturer Manufacturer name on product and SDS must matchRow13:
8 Process Code Number Use provided flowchartRow13:
9 Container Size Type Enter sizeRow13:
6 Trade Name Trade name on product and SDS must matchRow14:
7 Manufacturer Manufacturer name on product and SDS must matchRow14:
8 Process Code Number Use provided flowchartRow14:
9 Container Size Type Enter sizeRow14:
Text3:
Clear:
Document No:
PRIME CONTRACTOR KTR POC:
SUBCONTRACTOR If Applicable:
Page of:
Text1:
PHONE:
5 PROJECTED END:
4 PROJECT EXECUTION START DATE:
3 WORKSITE LOCATION:
2 PROJECT NAME:

File details come from the government source that posted it. Updated .