Atch 7 HAZWST Form.doc

DOC document 39 KB Posted

Attached to
Replace Street Light Poles and Fixtures, Various Federal contract opportunity
Solicitation number
FA252120B0010
Issued by
Department of the Air Force Space Command

About this file

This document contains a hazardous waste forecast form and details of a federal contract opportunity to replace street light poles and fixtures at Patrick Air Force Base. The hazardous waste forecast form requires contractors to identify any hazardous materials that will be used in the project and estimate the type and quantity of hazardous wastes that will be generated. The federal contract opportunity is solicitation number FA252120B0010 to remove and replace existing concrete light poles and fixtures throughout Patrick AFB in accordance with contract specifications and applicable laws. The work will provide all labor, materials, equipment, transportation, and supervision necessary to accomplish the technical requirements. The Department of the Air Force Space Command is the contracting agency.

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Text version

FORECAST OF CONTRACTOR’S HAZARDOUS WASTE GENERATION

PROJECT #:

PROJECT TITLE:

DELIVERY ORDER
SXHT 13-1232

FA2521-20-B-0010

Replace Street Light Poles and Fixtures, Various

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 equiptment 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 knowledgable 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 .