Atch 4 Hazmat Auth.pdf

129 KB Posted

Attached to
Removal of Underground Storage Tank at Launch Facility E-10 (Laramie County, WY)
Solicitation number
FA461326R0005
Issued by

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Written by GovTribe AI ·

This is a Hazardous Materials Authorization Request form for a construction project at F.E. Warren Air Force Base. The form is used to request approval for hazardous materials that will be used and stored on-site during contract performance.

The project is titled "Remove UST, TK 101, at LF Echo 10" under contract number GHLN 26-7127, located at E10 on the base. The F.E. Warren AFB point of contact is Fotios Papadopoulos (773-3379), and the Construction Management Representative is Carla Mlinar (773-3574). The contractor must submit this form accompanied by a Safety Data Sheet (SDS) for every hazardous material requested. The form includes a table for documenting hazardous material information including material name, manufacturer, product part number, container type and size, paint color/sheen specifications, and projected quantity stored on-site. The single material listed is Rust-Oleum Stops Rust Enamel Top Coat (product number 7779830), available in 12 oz aerosol cans with a gloss black finish, with 35 units projected to be stored on-site. Contractors may alternatively submit complete SDS documentation in place of completing the hazardous materials information table.

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Environmental Protection Section 01 57 19.05 32 Page 32

SECTION 01 57 19.05 32

ATTACHMENT 1

HAZARDOUS MATERIALS AUTHORIZATION REQUEST

Contractor Name:

POC: Phone:

Project Name:

Project/Contract Number:

Contract Start Date/period: End Date: _

Location of Project:

F.E. Warren AFB POC: Phone:

Construction Mgmt Rep: Phone:

HAZMAT Information

Material Name Manufacturer

P r o d u c t

P a r

C o n t a i n e r

T y p

S i z a i n

C o l o h e o j e c t d

Q u a n t i y o r d

O

S i

Rust-oleum Stops

Rust Enamel Top

Coat

Rust-Oleum 7779830 12 oz

Aerosol

Can

Gloss

Black

Submission of this form must be accompanied by a copy of the

Manufacturer’s SDS for every HAZMAT requested. SDSs including all information requested below may be submitted in lieu of completing the

HAZMAT information table below.

Contractor Name:
POC:
Phone:
Project Name: Remove UST, TK 101, at LF Echo 10
ProjectContract Number: GHLN 26-7127
Location of Project: E10
FE Warren AFB POC: Fotios Papadopoulos
Phone_2: 773-3379
Construction Mgmt Rep: Carla Mlinar
Phone_3: 773-3574
Rustoleum Stops Rust Enamel Top CoatRow1:
RustOleumRow1:
7779830Row1:
12 oz Aerosol CanRow1:
Gloss BlackRow1:
35Row1:
Rustoleum Stops Rust Enamel Top CoatRow2:
RustOleumRow2:
7779830Row2:
12 oz Aerosol CanRow2:
Gloss BlackRow2:
35Row2:
Rustoleum Stops Rust Enamel Top CoatRow3:
RustOleumRow3:
7779830Row3:
12 oz Aerosol CanRow3:
Gloss BlackRow3:
35Row3:
Rustoleum Stops Rust Enamel Top CoatRow4:
RustOleumRow4:
7779830Row4:
12 oz Aerosol CanRow4:
Gloss BlackRow4:
35Row4:
Rustoleum Stops Rust Enamel Top CoatRow5:
RustOleumRow5:
7779830Row5:
12 oz Aerosol CanRow5:
Gloss BlackRow5:
35Row5:
Rustoleum Stops Rust Enamel Top CoatRow6:
RustOleumRow6:
7779830Row6:
12 oz Aerosol CanRow6:
Gloss BlackRow6:
35Row6:
Contract Start Dateperiod:
Contract End Dateperiod:

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