Atch 4- HazWasteForm.doc

DOC document 40 KB Posted

Attached to
Repair Various Lift Stations, CCAFS Federal contract opportunity
Solicitation number
FA252120B0009
Issued by
Department of the Air Force Space Command

About this file

This document contains a hazardous waste forecast form and details of a related federal contract solicitation. The hazardous waste forecast form is required from any contractor working on the identified project who must remove or dispose of hazardous materials such as lead or mercury, or who submits materials containing hazards for approval. It requires contractors to specify each process using hazardous materials, describe the material and application method, describe any anticipated waste streams, and estimate waste quantities.

The related federal contract solicitation is for repair work at four lift stations located at Cape Canaveral Air Force Station in Florida. Contractors must provide all labor, materials and equipment for the repairs. The solicitation is posted by the Department of the Air Force Space Command. Review of all attachments posted with the action is required.

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Text version

FORECAST OF CONTRACTOR’S HAZARDOUS WASTE GENERATION

PROJECT #:
DBEH 12-1551
PROJECT TITLE:
Repair Various Lift Station Pumps at Cape Canaveral AFS, FL.

CONTRACTOR:

POINT OF CONTACT:

PHONE:

FAX:

HAZARDOUS MATERIAL:
DESCRIPTION OF PROCESS(ES) INVOLVING MATERIAL

(INCLUDE METHOD OF APPLICATION)

DESCRIPTION OF WASTE:
QUANTITY:

Purpose: The Forecast of Contractor’s Hazardous Waste Generation is required to assist the installation to identify processes using hazardous materials and regulate the generation and disposal of hazardous waste.

Instructions: The Forecast of Contractor’s Hazardous Waste Generation form must be completed by any contractor who:

1) Must remove and dispose of paints, building components, or equipment containing hazardous materials (lead, mercury, etc.)

2) Submits an MSDS for approval of use of a material known to be hazardous.

On multi contractor projects, each contractor (sub-contractor) must specify each process requiring the use of hazardous materials and the potential waste to be generated.

1. Project #: Provide installation project number.

2. Project Title: Provide installation project title.

3. Contractor: Enter complete name of contractor performing process.

4. Point of Contact: Provide name of individual knowledgeable on requirements of materials listed.

5. Phone/Fax: Provide phone and fax numbers for point of contact.

6. Hazardous Material: Provide common name of each hazardous material

7. Description of Process(es) Requiring Material: Describe each process in which the material will be used (Thinning paint, cleaning tools, etc.). Describe methods of application where appropriate (applied to rag, sprayed gun, etc.).

8. Description of Waste: Provide description of anticipated waste stream or enter “none” if no waste is anticipated to be generated.

9. Quantity: Estimate quantity of waste to be generated

10. Sign and date each form at bottom

CONTRACTOR’S SIGNATURE ______________________________________ DATE ________________

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