Attachment 10A - SAR Request.pdf

3 MB Posted

Attached to
Wake Island (WI) B. 1120 Restoration
Solicitation number
FA521525R0009
Issued by

About this file

Written by GovTribe AI ·

This document is a PACAF Regional Support Center Site Arrival Request form designed to capture detailed travel and support requirements for personnel visiting a military installation. The form requires comprehensive information including traveler details, aircraft specifications, support needs, and access requirements. Key sections include travel logistics (location, dates, purpose, transportation method), aircraft details (type, call sign, tail number), support requirements (third-party support hours, transportation, permits, equipment), and restricted area access. The form is marked as Controlled Unclassified Information/Personal-Identifiable Information and is version dated January 2024, with the approval authority being the 611th Air Support Squadron Mission Support Flight. The traveler information section allows for tracking up to 20 individuals, with each traveler designated as "unescorted" and with a "CTR" (contractor) status and "NONE" clearance level.

View the file

Other files

File Type Posted
25 AUG 25- RENO Questions.pdf PDF
25 AUG 25- RENO Questions.xlsx XLSX spreadsheet
Bldg B_C_1120 1963.pdf PDF
1120 (C 520) Air Conditioning.pdf PDF
20170412 Wake Island Assessment Pre-Final Report 2017.pdf PDF
1118 and 1120 Structural Assessment and Repairs 2022.pdf PDF
Questions Answered Reno.xlsx XLSX spreadsheet
c_520_1120_Mechanical 1967.pdf PDF
Electrial Site Plan.PDF PDF
1120 Photo Log.pdf PDF
Wake Island Concrete and Masonry Structures Feb 2020.pdf PDF
Utilities.pdf PDF
A_All Buildings 1963 (C_520_1120).pdf PDF
B1120 floorplan draft V3_Redacted Update.pdf PDF
Location Map c_1120.PDF PDF
Amendment 01 - Question Set 1.docx DOCX document
Solicitation - FA521525R0009.pdf PDF
Attachment 1 - WI Restor Building 1120 SOW.pdf PDF
Attachment 2B - AF 103 Template.pdf PDF
Attachment 4 - eSSS PRSC Commercial Satellite Terminal Policy Memorandum.pdf PDF
Attachment 8 - AF FORM 813 B1120.pdf PDF
Attachment 3 - 11 AF Satellite and Ground Terminal Request (Fillable).pdf PDF
Attachment 5 - 611th Tank Inventory Template.docx DOCX document
Attachment 6 - AF3000-3064-3065.pdf PDF
Attachment 9 - B1120 floorplan.pdf PDF
Attachment 10B - Wake Island Cargo Processing Guide.pdf PDF
Attachment 10C - WI Base Support Letter.pdf PDF
Attachment 12A - B1120 Exterior photos portfilio.pdf PDF
Attachment 2A - 611 CES Dig Permit Process 2024.pdf PDF
Attachment 7 - DD Form 1354.pdf PDF
Attachment 11 - WI Master Plan and Design Guide.pdf PDF
Attachment 12B - B1120 Interior photos portfolio.pdf PDF
Attachment 13 - Wage Determination.pdf PDF
Show all 33

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

PACAF REGIONAL SUPPORT CENTER SITE ARRIVAL REQUEST

CONTROLLED UNCLASSIFIED INFORMATION/PERSONAL-IDENTIFIABLE INFORMATION DOCUMENT WHEN COMPLETED

NAME:

ADDRESS:

PHONE:

EMAIL:

3. TRAVEL:

A. LOCATION:

B. DATE/TIME ARRIVAL:

C. DATE/TIME DEPARTURE:

ARR/DEP COMMENTS:

D. PURPOSE:

E. MEANS OF TRAVEL: C-12 AMC CHARTER MIL-AIR OTHER SPECIFY:

4. AIRCRAFT PPR INFORMATION:

A. AIRCRAFT TYPE: B. CALL SIGN: C. TAIL NUMBER: D. DATE/TIME ARR. (Z): E. DATE/TIME DEP. (Z):

F. DEP LOCATION: G. DESTINATION: H. HANGAR J. TOWBAR J. HAZ TYPE:

K. GPU L. FUEL (J-8) AMOUNT: M. IN-FLIGHT MEALS QUANTITY:

5. SUPPORT REQUIRED:

A. 3RD PARTY SUPPORT HOURS: B. TRANSPORTATION TO/FROM PORT C. PERMIT: SELECT OR ENTER PERMIT TYPE:

D. EQUIP: TYPE: E. SUPPLIES: TYPE: F. VEHICLE: DOD: CTR: QTY: TYPE:

G. NON-AIRCRAFT FUEL: DIESEL AMOUNT: MO-GAS AMOUNT: H. RADAR DOWNTIME:

J. RESTRICTED AREA ACCESS: MET IDT COBRA DANE POWER PLANT TER MAR TOWER CLASSIFIED ACCESS:

I. FIREARM(S): QTY:

MAKE: TYPE: SERIAL #: CALIBER: # OF RDS:

YES NO DEVICE MAKE AND MODEL: DEVICE SERIAL #

LOCATION (S):

K. INSTALLLATION PHOTOGRAPHY:

CONTENT:

L. OTHER SUPPORT:

1. REQUESTOR:

A. FIRST AND LAST NAME: B. PHONE NUMBER: DSN COMM

C. EMAIL: D. ORGANIZATION: E. SITE POC:

2. FINANCE: BILLING POC:

A. WAKE ISLAND TRAVELER(S) B. EARECKSON AIR STATION TRAVELER(S) C. KING SALMON TRAVELER(S)

D. ALL NON- PACAF REGIONAL SUPPORT CENTER (PRSC) TRAVELER(S) E. PRSC TRAVELER(S) ONLY

Base PASS REQ: YES NO

F.

SUPPORT AGENCY

REMOVABLE MEDIA: DEVICE MAKE AND MODEL: DEVICE SERIAL #:

COMPLETE ATTACHED DD FORM 2760 & AF FORM 1314 & ADD ADDITIONAL WEAPONS IN BLOCK 6.

Attachment 10A

7. TRAVELER INFORMATION:

# LAST NAME, FIRST NAME, MI RESTRICTED ACCESS RANK SEX DOB: ORGANIZATION SSN # DOD ID/DL# DL STATE CLEARANCE

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

6. ADDITIONAL INFORMATION: (PM/SAR ADMIN ONLY) CHARGE TRAVELERS FOR: MEALS LODGING MAN DAYS

Approval Authority: COPA # Approved By: 611th AIR SUPPORT SQUADRON Mission Support Flight Site Arrival Operations

DSN: 317-552-5781

COMM: 907-552-5781

COPA INSTRUCTIONS:

FORM VERSION JAN 2024 OLDER VERSIONS ARE OBSOLETE

CONTROLLED UNCLASSIFIED INFORMATION/PERSONAL-IDENTIFIABLE INFORMATION DOCUMENT WHEN COMPLETED

EX. 20240815

Untitled
Untitled
F SITE POC:
A WAKE ISLAND TRAVELERS B EARECKSON AIR STATION TRAVELERS C KING SALMON TRAVELERS D ALL NONPACAF REGIONAL SUPPORT CENTER PRSC TRAVELERS E PRSC TRAVELERS ONLYRow1:
NAME ADDRESS PHONE EMAIL:
B DATETIME ARRIVAL:
C DATETIME DEPARTURE:
D PURPOSE:
A AIRCRAFT TYPE:
B CALL SIGN:
C TAIL NUMBER:
D DATETIME ARR Z:
E DATETIME DEP Z:
F DEP LOCATION:
G DESTINATION:
H HANGAR J TOWBAR J HAZ TYPE:
K INSTALLLATION PHOTOGRAPHY YES NO DEVICE MAKE AND MODEL DEVICE SERIAL CONTENT LOCATION S L OTHER SUPPORT:
PMSAR ADMIN ONLY CHARGE TRAVELERS FOR MEALS:
LAST NAME FIRST NAME MI1:
SEX1:
ORGANIZATION1:
SSN 1:
DOD IDDL1:
DL STATE1:
LAST NAME FIRST NAME MI2:
SEX2:
ORGANIZATION2:
SSN 2:
DOD IDDL2:
DL STATE2:
LAST NAME FIRST NAME MI3:
SEX3:
ORGANIZATION3:
SSN 3:
DOD IDDL3:
DL STATE3:
LAST NAME FIRST NAME MI4:
SEX4:
ORGANIZATION4:
SSN 4:
DOD IDDL4:
DL STATE4:
LAST NAME FIRST NAME MI5:
SEX5:
ORGANIZATION5:
SSN 5:
DOD IDDL5:
DL STATE5:
LAST NAME FIRST NAME MI6:
SEX6:
ORGANIZATION6:
SSN 6:
DOD IDDL6:
DL STATE6:
LAST NAME FIRST NAME MI7:
SEX7:
ORGANIZATION7:
SSN 7:
DOD IDDL7:
DL STATE7:
LAST NAME FIRST NAME MI8:
SEX8:
ORGANIZATION8:
SSN 8:
DOD IDDL8:
DL STATE8:
LAST NAME FIRST NAME MI9:
SEX9:
ORGANIZATION9:
SSN 9:
DOD IDDL9:
DL STATE9:
LAST NAME FIRST NAME MI10:
SEX10:
ORGANIZATION10:
SSN 10:
DOD IDDL10:
DL STATE10:
LAST NAME FIRST NAME MI11:
SEX11:
ORGANIZATION11:
SSN 11:
DOD IDDL11:
DL STATE11:
LAST NAME FIRST NAME MI12:
SEX12:
ORGANIZATION12:
SSN 12:
DOD IDDL12:
DL STATE12:
LAST NAME FIRST NAME MI13:
SEX13:
ORGANIZATION13:
SSN 13:
DOD IDDL13:
DL STATE13:
LAST NAME FIRST NAME MI14:
SEX14:
ORGANIZATION14:
SSN 14:
DOD IDDL14:
DL STATE14:
LAST NAME FIRST NAME MI15:
SEX15:
ORGANIZATION15:
SSN 15:
DOD IDDL15:
DL STATE15:
LAST NAME FIRST NAME MI16:
SEX16:
ORGANIZATION16:
SSN 16:
DOD IDDL16:
DL STATE16:
LAST NAME FIRST NAME MI17:
SEX17:
ORGANIZATION17:
SSN 17:
DOD IDDL17:
DL STATE17:
LAST NAME FIRST NAME MI18:
SEX18:
ORGANIZATION18:
SSN 18:
DOD IDDL18:
DL STATE18:
LAST NAME FIRST NAME MI19:
SEX19:
ORGANIZATION19:
SSN 19:
DOD IDDL19:
DL STATE19:
LAST NAME FIRST NAME MI20:
SEX20:
ORGANIZATION20:
SSN 20:
DOD IDDL20:
DL STATE20:
A FIRST AND LAST NAME:
C EMAIL:
ORG:
DSN: Off
COMM: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box8: Off
Check Box9: Off
PAYMENT: [MIPR/FUNDING DOCUMENT NUMBER]
PHONE NUMBER:
AGENCY:
YES: Off
NO: Off
LOCATION: [ ]
ARR/DEP COMMENTS:
C12: Off
AMC: Off
CHARTER: Off
MIL AIR: Off
GPU: Off
FUEL: Off
Check Box26: Off
Text27:
Text28:
Check Box29: Off
Text30:
Check Box31: Off
Check Box32: Off
Check Box33: Off
SUPT: Off
Text35:
TO/FROM: Off
Check Box37: Off
Text38:
EQUIP: Off
Text40:
SUPPLIES: Off
Text42:
Check Box43: Off
Check Box44: Off
Text46:
Check Box47: Off
Text50:
Check Box51: Off
Text53:
Check Box54: Off
Text56:
Check Box58: Off
Check Box59: Off
Check Box60: Off
Check Box61: Off
Check Box62: Off
Check Box64: Off
Check Box65: Off
Check Box66: Off
Text67:
Text68:
Text69:
Text70:
Check Box71: Off
Check Box72: Off
Check Box73: Off
Text45:
Text76:
Text77:
Text81:
CARRIER NAME:
GPU1: [N/A]
Check Box2: Off
Check Box3: Off
RESET:
REMOVE PII:
CLEARANCE1: [NONE]
CLEARANCE2: [NONE]
CLEARANCE3: [NONE]
CLEARANCE4: [NONE]
CLEARANCE5: [NONE]
CLEARANCE6: [NONE]
CLEARANCE7: [NONE]
CLEARANCE8: [NONE]
CLEARANCE9: [NONE]
CLEARANCE10: [NONE]
CLEARANCE11: [NONE]
CLEARANCE12: [NONE]
CLEARANCE14: [NONE]
CLEARANCE13: [NONE]
CLEARANCE15: [NONE]
CLEARANCE16: [NONE]
CLEARANCE17: [NONE]
CLEARANCE18: [NONE]
CLEARANCE19: [NONE]
CLEARANCE20: [NONE]
RANK20: [CTR]
RANK19: [CTR]
RANK18: [CTR]
RANK17: [CTR]
RANK16: [CTR]
RANK15: [CTR]
RANK14: [CTR]
RANK13: [CTR]
RANK12: [CTR]
RANK11: [CTR]
RANK10: [CTR]
RANK9: [CTR]
RANK8: [CTR]
RANK7: [CTR]
RANK6: [CTR]
RANK5: [CTR]
RANK3: [CTR]
RANK4: [CTR]
RANK2: [CTR]
RANK1: [CTR]
DATE1:
DATE2:
DATE3:
DATE4:
DATE5:
DATE6:
DATE7:
DATE8:
DATE9:
DATE10:
DATE11:
DATE12:
DATE13:
DATE14:
DATE15:
DATE16:
DATE17:
DATE18:
DATE19:
DATE20:
weapon type: [N/A]
RESTRICTED ACCES1: [UNESCORTED]
RESTRICTED ACCES2: [UNESCORTED]
RESTRICTED ACCES3: [UNESCORTED]
RESTRICTED ACCES4: [UNESCORTED]
RESTRICTED ACCES6: [UNESCORTED]
RESTRICTED ACCES5: [UNESCORTED]
RESTRICTED ACCES7: [UNESCORTED]
RESTRICTED ACCES8: [UNESCORTED]
RESTRICTED ACCES9: [UNESCORTED]
RESTRICTED ACCES10: [UNESCORTED]
RESTRICTED ACCES11: [UNESCORTED]
RESTRICTED ACCES12: [UNESCORTED]
RESTRICTED ACCES13: [UNESCORTED]
RESTRICTED ACCES14: [UNESCORTED]
RESTRICTED ACCES15: [UNESCORTED]
RESTRICTED ACCES16: [UNESCORTED]
RESTRICTED ACCES17: [UNESCORTED]
RESTRICTED ACCES18: [UNESCORTED]
RESTRICTED ACCES19: [UNESCORTED]
RESTRICTED ACCES20: [UNESCORTED]
Text58:
Text57:
Text59:
Text60:
Text51:
Text52:
Text54:

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