Attachment 1_Schedule B_ SOW Code Inspection Services.pdf

DocuSign Envelope ID: 16C1CAC8-EF0F-4259-A250-B19F5A4D88F2

STATEMENT OF WORK

FOR

Code Inspection Services CAT: Exempt per QAPD B.5

UNIQUE IDENTIFIER: FAC-010010.3.4

PREPARED BY:

Cognizant Individual (COG) Allison Nichols for Jermain Lewis

REVIEWED BY:

Responsible Engineer (RE) Craig Shaw

ES&H- Jon LaCarrubba

Quality Assurance- Andres Castaneda

APPROVED BY:

Project Manager (PM) David Carle

PRINCETON PLASMA PHYSICS

LABORATORY

P.O. BOX 451

PRINCETON, N.J. 08543

609-243-2000

1.0 INTRODUCTION & SCOPE

(a) INTRODUCTION PPPL requires Plumbing, Electric, Fire and Building code inspection and consulting services for construction projects and existing conditions. This scope of work is requesting services for building and facility code inspections of construction installations for compliance and code review/research to help Authorities Having Jurisdiction, (AHJ) review existing construction conditions. The intent is to ensure construction, maintenance installations, or existing conditions meet current building code and DOE regulations, and/or contract specific code requirements.

Under the general direction of PPPL AHJs and Princeton Technical Representatives (PTRs), inspectors will be requested to review construction, maintenance or existing construction work installed by PPPL employees or subcontractors in accordance with basis of design codes identified on signed and sealed plans and or site enforced codes and regulations identified in this document.

The inspector shall be required to provide a written report intended to assist PPPL AHJ’s and/or DOE AHJs in confirming code compliant installations and or existing building and facility construction conditions.

This scope will require research and review of current and past building codes, DOE site specific standards, and DOE site specific building regulations imposed on our site by The Department of Energy. This scope will include development and establishment of plan review flowchart identified in attachment #4 of this document. This scope will require review of plans and specifications prior to work commencing to allow inspectors to understand the work being installed and to confirm the code inspections required for each job order.

Code inspectors must be qualified ISC or HHS licensed as indicated in attachment #3 “Inspector License Qualification Requirements” of this document.

(b) SCOPE

(i) Plan Review

1) Inspection agent shall conduct plan review 30 consecutive days prior to project or task commencement in accordance with NJDCA plan review instruction checklist see attachment #5.

2) Provide a plan review report in accordance with attachment #4 under the guidance of attachment #5

a) Any code questions to Architect, Engineer, ESH, AHJ for guidance

b) Any code clarifications to Architect, Engineer, AHJ, ESH, PTR for awareness

3) Provide an inspection plan that is similar or equal to attachment 12

(ii) Inspections

1) Provide code required inspections for maintenance and construction installations upon request in writing.

2) Provide code required inspections for existing construction assemblies upon request in writing and contract issued by PPPL procurement team.

3) Create Inspection reports for each project that is similar or equal to attachment #6

4) Inspects the construction site for code compliance in accordance with Design codes and/or site enforced codes and standards for the following disciplines:

a) Underground Inspections

i) Gas

ii) Water

iii) Sanitary

iv) Storm Water

v) Electric

v) Grounding

b) Building: Rough and Final Inspections

i) Building

ii) Plumbing

iii) Fire

iv) Mechanical

v) Electric

vi) Elevator

(iii) Reporting

1) Provide inspection log of all inspections performed as indicated in sample attachment #6

2) Provide inspection approval sticker formatted in alignment UCC format See attachment #7 for clarification on expectations

3) Provide certificate of approval or equal acceptable document for AHJ to sign. See attachment #9 as a document example.

4) Provide code hazard report to PTR and AHJ citing code trade, chapter, and subparagraph as indicated on sample form in attachment #8

(iv) Compliance

1) Inspect in accordance with current approved building codes, unless otherwise noted in

a) This SOW,

b) A signed and sealed design document (Drawings and or specifications)

c) A contract job order.

2.0 APPLICABLE Standards and Codes

Inspection shall be performed by a qualified agent or agency as identified in this SOW and in accordance with the most current codes, standards and regulations indicated below but not limited to:

(a) Applicable Codes, Standards, and Associations

(i) IBC, International Building Code

(ii) IMC, International Mechanical Code

(iii) IFC, International Fire Code

(iv) NFPA, National Fire Protection Association

(v) NSPC, National Standard Plumbing Code

(vi) NEC, National Electric Code

(vii) ASME- American Society of Mechanical Engineers

(viii) ANSI- American National Standards Institute

(ix) ASCE-American Society of Civil Engineers

(x) Occupational Safety and Health. Standards Code of Federal Regulation 29 CFR 1910,

(xi) Occupational Safety and Health. Standards Code of Federal Regulation 29 CFR 1926,

(xii) OSHA, Occupational Safety and Health Act

(xiii) CGA, Compress Gas Association

(xiv) ICC, International Code Council

(xv) DOE 420 Facility Safety

(xvi) DOE 1066 Fire Protection technical Standard

(xvii) CFR 851 Worker Safety and Health Program (Specifically Building with the intention of Hazard Abatement in accordance with 851.22)

(xviii) Division 010010 General Requirements Site Specification The above codes are applicable unless otherwise noted in job order, this SOW, or signed and sealed design documents.

3.0 APPLICABLE DRAWINGS

(a) Drawings created by

(i) Engineer of record (EOR)

(ii) PPPL drafting department.

4.0 RESPONSIBILITIES

(a) PRINCETON PLASMA PHYSICS LABORATORY

(i) PPPL designated contact shall be identified in executed PPPL contract or purchase order.

(ii) PPPL or competent responsible person in charge of work installation must notify agent or agency when work is ready for any required inspections specified below. Requests for inspections must be made at least 24 hours prior to the time the inspection is desired.

Inspections will be performed within three business days of the time for which they are requested. The work must not proceed in a manner which will preclude the inspection until it has been made and approval given.

(iii) All communications on technical matters shall be directed to the assigned PPPL Princeton Technical Representative or designated contact.

(iv) All communications on administrative matters shall be directed to the PPPL Procurement Representative or designated contact.

(v) PPPL permits all employees to issue a “STOP WORK” Order if unsafe work practices are observed.

(b) INSPECTION AGENT/AGENCY This inspection agency,

(i) Shall Coordinate with Princeton Technical Representative or designated contact to minimize.

(ii) downtime and shall not have any negative impact on experimental operations.

(iii) Shall provide a single point of contact for any communication between PPPL and the testing and inspection agency.

(iv) Shall Stop work, due to unsafe conditions or other emergency related conditions.

(v) Shall notify the Princeton Technical Representative or PPPL designated contact, immediately.

See “Notification Requirements Off-Normal Events and Issues” See Attachment #1.

(vi) Shall provide all labor, materials, equipment, and supervision services necessary to complete inspection request in accordance with this Scope of work, drawings, technical specifications, or job work order requirements.

1) Where there is a conflict between any project’s documents the more stringent or difficult to perform shall apply for the testing and inspection agency to perform as a bases of quoting and pricing a job order.

(vii) Shall provide working planning and coordination of means and methods to complete Scope of Work prior to arriving on site to perform inspections that require square special equipment or access.

(viii) Shall verify and confirm the scope outlined in this Scope of Work, job order, or signed and seal drawings and specification

1) All questions regarding the scope of work shall be received prior to start of work.

(ix) Identify any facility changes, modifications, or obstructions to be mitigated in order to safely and efficiently perform work.

(x) Perform work in accordance with OSHA requirements.

(xi) Shall complete work during normal working hours of 7:00 AM to 4:00PM, Monday through Friday.

(xii) Shall not perform inspections on designated Lab closure Holidays indicated in div spec 010010.1.16

(xiii) Provide and attend periodic status meetings with PPPL representatives as outlined designated contact.

1) Projects or tasks that last more than one day shall be required to have daily meetings, unless otherwise agreed upon by the PPPL designated contact.

2) Meeting Notes delineating all action items shall be included in the inspections agency’s Field inspection report and distributed to PPPL designated contact or PPPL Facility representative prior to leaving the site.

(xiv) Shall provide a government issued Photo ID as required for the agent or agency to gain access to PPPL Site.

(xv) Shall Notify and obtain PPPL written approval for any lower-tier vendors/consultants proposed for this project, prior to their arrival on site.

(xvi) Shall Protect all infrastructure within the project limits to prevent damage during inspection activities.

(xvii) Shall provide field inspection results promptly, prior to leaving site the day of inspection.

(xviii) Shall provide violations notifications immediately, within 30 mins from identification.

1) violations shall be issued in written form

2) shall cite code installation or existing construction condition violates.

(xix) Shall report all inspections indicate compliance or noncompliance with the approved project plans and specifications. The reports shall be complete and factual, citing code chapter and subparagraph at minimum

5.0 REQUIREMENTS

(a) Inspect in accordance with the following for existing construction and maintenance repair work:

(i) Building – IBC 2018

(ii) Electric – NEC 2015/NFPA 70E

(iii) Plumbing – NSPC 2020

(iv) Fire- (NFPA 101 101A 101B)

(v) Mechanical – IMC 2018

(vi) Elevator – (ASME A17.1 A18.1, A90.1)

(vii) DOE Standard 1066 Fire Protection

(viii) DOE Standard 420

(b) Inspect in accordance with the most current edition of the following codes and regulations, or as indicated on sign and sealed drawings and specification, for New Construction:

(i) Building – IBC

(ii) Electric – NEC

(iii) NFPA 70E

(iv) Plumbing – NSPC

(v) Fire- IFC

(vi) NFPA 101

(vii) NFPA 101A

(viii) NFPA 101B

(ix) DOE Standard 1066 Fire Protection

(x) Mechanical – IMC

(xi) Elevator – ASME A17.1 A18.1, A90.1

(xii) DOE Standard 420

(c) EQUIPMENT, DESIGN DEFINITION

(i) SPECIFICATIONS AND STANDARDS

1) As specified within this SOW, job order and the design drawings and specifications

(ii) GENERAL DESIGN FEATURES

1) As specified with in this SOW, job order and the design drawings and specifications

(iii) MATERIALS

1) As specified with in this SOW, job order and the design drawings and specifications

(iv) ELECTROMAGNETIC INTERFERENCE AND SUSCEPTIBILITY

1) If inspecting within LTX, Flare, NSTXU lab space and vicinity be sure to coordinate with PTR.

(v) IDENTIFICATION AND MARKING

1) As specified within SOW, job order and the design drawings and specifications (vi)

REPORT METHODS

1) As specified within SOW, job order and the design drawings and specifications

6.0 INSPECTION REQUIREMENTS

(a) PERFORMANCE TESTS

(i) N/A

(b) ACCEPTANCE TESTS

(i) N/A

(c) SUPPLIER HOLD POINTS (Inspections Required)

(i) Inspections required, but not limited to the following code inspections

1) Building Rough Inspection

a) Footing Inspections

i) Footing bottom report review (third party report)

ii) Rebar spacing report review (third party report)

iii) Concrete break report review (third party report) iv) bonding /grounding steel (third party report)

b) Steel Inspection

i) Steel Plumb inspection (third party report)

ii) Steel Column anchor bolt inspection (third party report)

iii) Steel Bolt torque inspection (third party report)

iv) Moment Weld inspections (third party report)

c) Walls

i) Framing exterior

a. spacing

b. Connection/fastener details

c. Framing gauge per specs

d. Expansion joint connection details

ii) Framing interior

a. spacing

b. Connection/fastener details

c. Framing gauge per specs

d. Expansion joint connection details

iii) Inspect framed Elevator shafts

a. spacing

b. Connection/fastener details

c. Framing gauge per specs

d. Expansion joint connection details

iv) Exterior Insulation inspection

a. Wall insulation

i. Vapor barrier inspection (third party inspection)

ii. Flashing inspection (third party inspection)

b. Ceiling or Roof insulation

d) Above Ceiling

i) Inspect to confirm Independent supported ceiling framing

ii) Inspect to confirm Wall Fire Rating labeling above ceiling

iii) Inspect to confirm nothing is being supported by the ceiling framing.

2) Building Final inspection

a) Walls

i) Inspect Doors and hardware and installed for positive latching

ii) Inspect Signage is up for room identification

a. Braille signage is in place

b) Above Ceiling

i) Penetration inspections.

c) Egress

i) Inspect All lighting is in and functional

ii) Emergency lighting is in place

iii) Perform a power outage to confirm Emergency lights work

a. 1 foot candle are maintained through egress paths with emergency lighting in the event of a power outage for min 1.5 hours (NFPA 101 section 7.9)

b. illuminated exit signs are in place

iv) Inspect All Egress stairs are in place

a. Inspect Evacuation plans are in place

d) Building Tightness

i) Report confirming building pressure is being maintained at 0 to a positive .1 in. w.c.

e) Other inspections

i) All other inspections have been completed prior to building final (Plumbing, Fire, Electric, Mechanical) ii) Window

Inspection- leak test

iii) Complete Energy Report iv) Lightning protection master certification

3) Rough Plumbing Inspection

a) Underground within foot print of building

i) potable water

ii) Underground sanitary

iii) Underground storm

b) Wall inspections

c) Above ceiling inspections

d) Gas Pressure test- in accordance with design

e) Sanitary stack head test

f) Potable water pressure test in accordance with design

g) Sanitary vent size and location

4) Final Plumbing inspection

a) Labeling

b) Hot water temp inspection 105-degree max limit

c) Insulation under ADA sinks

d) Bonding on gas

e) Bonding on water

f) Backflow preventor inspection

5) Rough Fire inspection

a) Spray Fireproofing

b) Rated Deck Penetrations

c) Rated Wall penetrations

6) Final Fire inspection

a) Labeling

b) Inspect for Sprinkler spacing and trim

c) Inspect paths of egress

d) Inspect to confirm annunciator for fire alarm is in the lobby or entrance area

e) Ring the bells and smoke.

f) Inspect audible and visual alarm works.

g) Read dbs. of horn when activated.

h) Confirm HVAC shutdown takes place.

i) Confirm the elevator recalls to the correct floor.

j) Inspect elevator dial out for emergency.

k) Test Fire Mashal key control

l) Collect Program print out and confirm the trouble or supervisory came in and the annunciator panel.

m) Inspect Elevator shaft for sprinkler and heat head installation.

n) Inspect elevator shaft for penetration details.

o) Fire smoke damper flashing details at rated walls and floors

7) Mechanical Rough Inspection

a) Grounding

b) Bonding

c) Surge Protection

d) Disconnect Locations

e) Equipment Service outlet location

8) Mechanical Final Inspection

a) Labeling

b) Manufacture Start up report

c) Testing and Balancing Report

i) Short Circuit Study

ii) Air and water balance report

d) Commissioning Report

i) Energy Report -Includes Energy Calculations (Bases of Design)

ii) Inspect building pressure (Commission)

iii) Inspect confirmed air changes (Commission) iv) Inspect power consumption

(Commission)

v) Inspect water consumption (Commission)

9) Electric Rough Inspection

a) Underground

i) Duct banks (Utility Inspection required)

ii) Grounding

b) Wall inspections

i) Proper rated cables

ii) Box termination

iii) Grounding and bonding

c) Above ceiling inspections

i) Independently hung back to structure

ii) Fixtures independently supported back to structure

d) Panel inspections

i) Feeder Termination points

ii) Circuit termination points

iii) Panel clearances

e) Equipment inspections

i) Disconnect visible to unit

ii) Service 120V outlet at unit iii) Feeder Termination points iv) Grounding and bonding

f) Building Grounding bus bar

i) Proper size

ii) Termination points

11) Final Electrical Inspection

a) Labeling (Breakers and panel number)

b) Arc flash labeling

c) Cover plates are installed

d) All electric panel covers are on

e) Labeling is completed

12) Lightening Protection

a) Master certification

13) Elevator Rough Inspection – (State involvement may be required)

a) Case sleeve and piston Inspection

b) Shaft inspection

i) Fire Alarm

ii) Sprinkler

iii) Fire Penetration

14) Elevator Final (State involvement may be required)

a) Controls and Safeties

i) Fire Recall (Fire Alarm)

ii) Dial out (Phone line)

iii) Cab and Breaks

7.0 QUALIFICATIONS

(a) INSPECTOR REQUIREMENTS

(i) All inspections covered by SOW and associated contract documents must be performed by a qualified agent and/or agency.

(ii) The following requirements must be satisfied by the agency when are being provided under this SOW :

1) Provide New Jersey qualified ICS or HSS inspectors for the following disciplines

a) Building ICC 1B, 4B or HHS 1C

b) Electric ICC 2B or HHS 2C

c) Plumbing ICC 4B, M2 or HHS 5C

d) Fire ICC 3B, HHS 3C

e) Mechanical ICC 4B, HHS M2

f) Elevator HSS 6B

2) Capable or drafting code review reports

3) Perform code compliant review of design documents

4) Prior to award, the agent or agency shall provide executed “PPPL Facility Testing and Inspection Qualifications Check List”, See Attachment #2.

a) If the agent or agency has worked with the installing contractor in less than 24 months, or is currently working with contractor, the inspection agency will not be able to perform work outlined in this SOW unless there is a written approval from PPPL Facilities and Procurement departments.

b) The inspection agent and agency shall have no contract or immediate business relationship with the contractor responsible for the work being inspected.

5) The inspection agent and agency shall have adequate equipment to perform the required inspections.

6) The inspection agency shall provide a copy of their quality control or quality assurance program for review and record by PPPL

8.0 ENVIRONMENT, SAFETY, AND HEALTH

(a) All work shall comply with PPPL ESHD 5008. The manual is available on the internet at:

http://www.pppl.gov/eshis/ESHD_MANUAL/sm.html .

(b) The agent and/or agency must issue a copy of their written Safety Program to PPPL prior to arriving on site.

(i) The agent and/or agency must designate the individual(s) responsible for implementation of inspections.

(c) The agent and/or agency shall provide testing and inspection technicians properly trained to observe and work safety. Safety qualifications or certifications shall be including in personnel resume to be included in PPPL Testing and Inspection Agent or Agency Qualification. See attachment #2.

(d) The agent and/or agency must comply with:

(i) this SOW

(ii) All applicable Federal, State, and local laws, regulations and requirements whether they are specifically listed in the Statement of Work or subcontract.

(iii) The inspection agency shall comply with all OSHA, DOE and PPPL safety requirements.

1) Care shall be taken to protect personnel, employees and surrounding property.

(iv) The agent and/or agency safety record will be considered in the bid evaluations.

(v) Agent and/or agency personnel working on-site at PPPL for more than 40 hours will be required to successfully complete PPPL’s General Employee (safety) Training and receive a PPPL Identification Badge. PPPL Identification Badges are to be returned to PPPL upon completion of subcontract.

(vi) The agency shall ensure workers are aware of foreseeable hazards and the protective measures as defined by JHAs and require that workers acknowledge being so informed. This policy shall be included within the submitted safety plan.

(vii) The agent and/or agency shall ensure that workers not following safe work practices are subject to the agent and/or agency’s disciplinary process. This policy shall be included within the submitted safety plan.

(viii) The agent and/or agency shall maintain a designated representative onsite during inspection activities that is knowledgeable of the associated hazards and has the authority to act on behalf of the testing agency.

1) This designated person can also be one of the people required to perform the required inspection or testing task.

2) The agent and/or agency shall be informed by PPPL, where the emergency muster point is for each job upon the contractor’s arrival at the site.

(ix) All vehicles and equipment owned or rented by the agent and/or agent must be in good working order with no leaks of any kind. Any spills must be reported immediately to PPPL, and work stopped until the spill is addressed. The agent and/or agency is responsible for remediation costs caused by negligence and or faulty equipment. PPPL Environmental Services will determine the proper method of remediation.

(x) PPPL has safety programs that include the following areas: Confined Space Permits, Digging Permits, Penetration and Fire Seal permits, Flame permits, Radiation Work permits, Lockout/Tag out of energy sources, and restrictions on working alone. The

(xi) , agent and/or agency, must confirm with their PPPL contact person that all prerequisites have been met before initiating any activity that involves these areas.

(xii) All requirements of this Statement of Work apply to all sub-tier vendors.

(xiii) The inspections agency must have their employees trained and provide PPPL with their qualification prior to performing this work. PPPL ES&H training courses that are more specific to the agent and/or agency's laboratory work scope may also be required. If PPPL determines that training of agent and/or agency employees is inadequate, PPPL reserves the right to require the agent and/or agency to obtain certified training.

9.0 QUALITY ASSURANCE REQUIREMENTS

(a) Provide a copy of the company quality assurance plan.

(b) Inspection agencies shall have sufficient personnel having the necessary education, training, technical knowledge, certification as appropriate, and experience for their assigned functions.

(c) PPPL’s review and/or approval of and inspections agency documents shall not relieve the agent and/or agency from providing full compliance with standards and codes recognized nationally, regionally and/or locally.

10.0 SHIPPING STORAGE AND HANDLING

(a) Not Applicable

11.0 WARRANTY

(b) 11.1. Not Applicable

12.0 ATTACHMENTS

(a) Attachment #1 – Notification Requirements Off-Normal Events and Issues

(b) Attachment #2 - Testing and Inspection Qualifications

(c) Attachment #3- NJ Inspector requirements

(d) Attachment #4-Plan Review Workflow

(e) Attachment #5- Plan Review Check List

(f) Attachment #6- Inspection Log Example forms

(g) Attachment #7- Inspection Notice Forms

(h) Attachment #8- Inspection Hazard Notice Example forms

(i) Attachment #9- Certificate of Approval Example forms

(j) Attachment #10- Elevator Inspection Checklist

(k) Attachment #11- Electric or Equipment Cut in Card

(l) Attachment #12 Inspection Plan Log Example form

13.0 DOCUMENTATION & DELIVERABLES

(a) Deliverables List

PO / Subcontract / BOA / BPA #:

Physical Deliverables Required

When Deliverable Is Required

Deliverabl e Received

1 Field Inspection Within 24 hours of request (verbal or written) Exceptions (Add justification for any missing physical deliverables that will not be received):

Special Testing Requirements, Weather, Lead-time for equipment for commissioning 1/14/20

Document Deliverables Required

When

Deliverable Is Required

Deliverable format (paper, electronic etc.)

Storage Location for

Received (✔)

1 Plan Review report PS E Procore- Submittal

2 Code Inspections Plan Log PS E Procore-

3 Inspectors and License Qualification Report

PS E Procore-

4 Rough Inspection Approval/NonApproval

D P,E Procore Daily Report

5 Final Inspection Approval/NonApproval

D P,E Procore Daily Report

6 Certificate of Approval/Occupancy Form for AHJ Approval

C P,E Procore Corresponde nce

Exceptions (Add justification for any missing document deliverables that will not be received):

*Legend N = Notice to Proceed Requirement PS = Prior to Start of Construction D = During Construction/As Required for Facility Operations related tasks or Job Order (Non-construction) C = Project Completion P, E = Paper or Electronic Princeton Technical Representative/COG: _____________________________ (Sign-off and provide to the Operations Center when job is completed and deliverables are dispositioned and placed/filed in Operations Center (or other Project, Department or Division designated file center)

Attachment #1 Notification Requirements Off-Normal Events and Issues

Notification Requirements Off-Normal Events and Issues

Note: Contacting the PPPL Emergency Services Unit at X3333 to obtain emergency assistance and taking immediate actions to protect workers, guests and visitors takes precedence over the notification requirements described herein.

The testing and inspection agency shall notify PPPL within 15 minutes of becoming aware of off-normal events and issues; off-normal events and issues include:

Personnel injuries of any kind

Near misses that could have resulted in significant (recordable injury or worse) worker injuries

Uncontrolled or unforeseen personnel exposure to chemical, biological or physical hazards (e.g., noise, laser, ultraviolet light, heat, etc.)

Fire emergency of any kind

Any unexpected discovery of an uncontrolled hazardous energy source (e.g., live electrical power circuit, etc.) not including discoveries made by zero-energy checks and other precautionary investigations made before work is authorized to begin

Any failure to follow a prescribed hazardous energy control process (e.g., lockout/tag out)

Damage of any kind to Laboratory property

Damage of any kind to personal property owned by PPPL employees, guests and visitors

Any spills of chemicals, fuels, lubricants, etc.

Other off-normal events and issues deemed by the testing and inspection agency to require notification

In the event of an off-normal event or issue, the testing and inspection agent or agency and its lower-tier contractors/vendors SHALL:

Notify PPPL Emergency Services Unit at X3333 for emergency response, if required

Take immediate action to evacuate and post affected area, if required

Cease related work or work in affected area

Take actions to post and safe-off affected area

Within 15 minutes: Contact The testing and inspection agency Site Supervisor, PPPL designated contact, ESH Construction Safety Engineer and ESH Head

Regarding these off-normal events or issues, no recovery actions (other than those immediately required to preserve life safety) or repairs are to take place until they are reviewed by the testing and inspection agency and PPPL, and specifically authorized by the PPPL designated contact or ESH Department Head. Resumption of work that has been stopped by PPPL due to off-normal events and issues must follow the provisions of PPPL Policy P- 012.

Attachment #2 Inspection Agent or Agency Qualification Check List

TESTING AND INSPECTION QUALIFICATION CHECK LIST

1) ADDRESS AND PRINCIPAL CONTACT

DATE:

FIRM NAME/BUSINESS ADDRESS:

County:

Principal Contact: Phone: ( )

Year Firm Established: Staff Size: Fax: ( ) (Staff size should include full-time licensed & technical staff in this office only.)

E-Mail Address:

2) ORGANIZATION CHART (Project Team and Connection to Company Principal or owner)

3) BRIEF RESUME OF ALL PRINCIPALS AND KEY PERSONNEL THAT MAY WORK AT PPPL SITE

A. NAME AND TITLE

B. YEARS EXPERIENCE: THIS FIRM: OTHER FIRMS:

C. ACTIVE REGISTRATION:

DISCIPLINE N.J. LICENSE NO.

D. BRIEF RESUME:

ATTACH AS MANY OF THESE PAGES OF RESUMES AS NECESSARY

4) Additional Personnel or Organization Qualifications not listed above

INSTRUCTIONS:

1. Fill out Lab Qualification in Column F

2. Fill out Lab Accreditation and Certification in Column G

3. Fill out Technical Staff Qualification/License/Accreditation/Certification in Column D

4. Fill out expiration date in Column H for lab and Personnel certification

A

SPEC

Section

CSI

B

SPECIALTY/DISCIPLINE

C.

CERTIFYING

AUTHORITY

D

PROFESSIONAL/TECHNICAL

Qualification (Example Industrial Hygienist or

Concrete Testing Technician)

E

Staff License or

Certification Number

F

Education and Training

G

Lab

Qualification

H Lab

Accreditation/Certification

I Expiration

Date

Attachment #3 Inspector License Qualification Requirements

Attachment #4

Plan Review Work Flow

Attachment #5 Plan Review Check List ocuSign Envelope ID

: 16C 1C

AC

8-EF0F-4259-A250-B19F5A4D

88F2

: 16C 1C

AC

8-EF0F-4259-A250-B19F5 A4D

: 16C 1C

AC

Attachment #6 Inspection Log Example forms

Attachment #7 Inspection Notice Forms

*See Cut-pin Card Example Attachment #11

*See Elevator Checklist Attachment #10

Attachment #8 Inspection Hazard Notice Example forms

: 16C 1C

AC

: 16C 1C

AC

Attachment #9 Certificate of Approval Example forms

Attachment #10 Elevator Inspection Checklist

: 16C 1C

AC

: 16C 1C

AC

Attachment #11 Electric or Equipment Cut in Card

Attachment #12

Inspection Plan Log Example form