Atch 5 - Hazmat Auth Form and Tracker.pdf

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Attached to
Active Vehicle Barrier Maintenance at FE Warren AFB, WY AMD01
Solicitation number
FA461324R0005
Issued by

About this file

This document is a Hazardous Materials Authorization Request form for the Active Vehicle Barrier Maintenance contract at F.E. Warren Air Force Base, WY. The form identifies the contractor, project details, and a list of hazardous materials, including the product name, manufacturer, part number, container type/size, and projected quantity to be stored on-site. The contract period is from 1 July 2024 to 30 June 2029. This form must be submitted with the manufacturer's Safety Data Sheets for each hazardous material requested. The related federal contract opportunity is Solicitation Number FA461324R0005 for the Active Vehicle Barrier Maintenance at F.E. Warren AFB, WY. The solicitation requires the contractor to provide all personnel, labor, equipment, supplies, tools, materials, supervision, and other items and services necessary to provide regular periodic inspection, maintenance, and emergency repair for barriers. A site visit is required, with questions due by 11:00 am MST the next business day after the site visit, and proposals due by 26 April 2024 at 2:00 PM MST.

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Text version

Environmental Protection Section 01 57 19.05 32 Page 32

SECTION 01 57 19.05 32

ATTACHMENT 5

HAZARDOUS MATERIALS AUTHORIZATION REQUEST

Contractor Name:

POC: Phone:

Project Name:

Project/Contract Number:

Contract Start Date/period: End Date: _

Phone:

Location of Project:

F.E. Warren AFB POC (CE):

F.E. Warren AFB POC (CONS): 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.

Active Vehicle Barrier Maintenance

1 July 2024 30 June 2029

F.E. Warren AFB, WY 82005

Francisco J. Rodriguez

Liezel C. McIntyre

307-773-6102

307-773-3411

MSN Product ID Noun

CUP -

QIP/SUI

Quantity

Used Max On

3439PHM00000189 Rust-oleum Gas 35 cans 35 cans 35

Hazardous Material Usage Month/Year:

FRANCIS E WARREN AIR FORCE BASE - AFGSC - Mirador Nasco JV -CTSBR - SABER - BUILDING HVAC -Contract Gary Shenefelt Phone 307-365-4609

Atch 2 Hazmat Auth Form
F0025 Sub 04 Hazmat Tracker
materialAuthorizationsInShopSeq

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