Atch 4 Hazmat Authorization Request.pdf

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AMENDMENT 01 (12 Sep 2025) Maintain and Inspect Radio Towers at 5 Missile Alert Fields and Bldg 3650
Solicitation number
FA461325Q0027
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This document is a Hazardous Materials Authorization Request form for a project at F.E. Warren Air Force Base. The form requires detailed documentation for hazardous materials to be used on-site, with the specific example being Rust-oleum Stops Rust Enamel Top Coat. The product details include a 12 oz aerosol can in gloss black, with a product part number of 7779830, and a projected on-site storage quantity of 35 units. The form mandates that submission must include the manufacturer's Safety Data Sheet (SDS) for each hazardous material requested, with the option to submit SDS documentation in lieu of completing the entire HAZMAT 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:
ProjectContract Number:
Location of Project:
FE Warren AFB POC:
Phone_2:
Construction Mgmt Rep:
Phone_3:
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 .