Attachment 15a-MacDill Appendix and Forms.pdf

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APPENDIX 15

REQUIREMENTS FOR REFRIGERANTS FORM

Reference: Ozone Depleting Regulations (40 CFR Part 82 Subpart F)

Contractor Name Contractor Address City State Zip Code Contractor Phone Number

Full Name Supervisor Manager Training Provider Level of

Certification

Form(s) Attached

(Y/N)

Yes _______ No ___________

Submittal (e): If the answer to Submittal Question (d) is “Yes” provide the following:

Facility Name Building # Appliance Manufacturer Appliance Model # Applaince Serial # Type of Appliance

Type of Refrigerant

Date Full Charge

Determined

i. The date any and all service was performed; Date:

ii. The date each leak was discovered; Date:

iii. A complete detailed description of all repair work done (if repairs were not conducted, state the reasons);

Submittal (a): a. Provide the name, address, and phone number of any contractor/subcontractor contracted by MacDill AFB/USACE/Others to service, maintain, repair and/or dispose of any appliance containing a refrigerant.

Submittal (b). Provide the name of each technician, including supervisors and managers, performing any service, maintenance, repair and/or disposal of any appliance containing a refrigerant.

Submittal (c). Provide a copy of each technician's certification indicating training in refrigerant recycling by an EPA approved training program, including the date of certification for each technician and the level of certification.

Contractor

Submittal (d): Did the appliance(s) the contractor installed, serviced, maintained, repaired and/or disposed of, located within the jurisdiction of MacDill AFB, contain or use an ODS class I, class II refrigerant?

Submittal (f): If the answer to Submittal (d) is “Yes”, provide copies of any and all work logs, service tickets, invoices and any other documents maintained by the MacDill AFB or contractor relating to the following:

APPENDIX 15

REQUIREMENTS FOR REFRIGERANTS FORM

Reference: Ozone Depleting Regulations (40 CFR Part 82 Subpart F)

Submittal f (Cont'd) iv The date each repair was conducted; Date:

v. The amount of refrigerant added at the completion of each repair; Lbs =

vi. The name of the technician who performed the work; and Full Name: Company:

vii. Any documentation associated with leak rate calculations, and the calculated leak rate.

viii. Identify each of the above by the following:

Facility Name Building # Serial #

Amount of Refrigerant Recovered (lb)

Type of Refrigerant (e.g. R11, R12, R22, R123 )

Amount of

Reclaimed(lb)

Amount of Reclaimed

Returned to MacDill AFB (lb) Date Returned

Disposition of recovered / reclaimed refrigerant NOT returned to MacDill AFB

Name of Reclamation Facility Phone Number City State

Submittal (h). Provide the name and complete business address of the refrigerant reclamation facility used to process recovered or used refrigerant. Provide any documentation and/or invoices from the recovery/recycling facility.

Provide the amount and type of all refrigerant recovered from all appliances and the amount of refrigerant reclaimed and returned to MacDill AFB and date returned.

Submittal (g). Please describe all methods utilized by the contractor on MacDill AFB to remove refrigerants or substitutes from appliances.

Street Address

Submittal Requirements Form

Atch 1 (1 of 10)

LED TECHNOLOGY TECHNICAL SPECIFICATION INFORMATION

PART 1 GENERAL

Note: The electrical designer must edit the bracketed information within this attachment for the requirements of the project.

1-1 REFERENCES

The publications listed below form a part of this specification to the extent referenced.

Publications are referenced within the text by their basic designation only.

AMERICAN NATIONAL STANDARDS INSTITUTE (ANSI)

ANSI C62.41.1-2002 IEEE Guide on the Surge Environment in Low-Voltage (1000 V and less) AC Power Circuits

ANSI C62.41.2-2002 IEEE Recommended Practice on Characterization of Surges in Low-Voltage (1000 V and less) AC Power Circuits

ANSI C78.377-2008 Specifications for the Chromaticity of Solid State Lighting Products for Electric Lamps

ANSI C136.31-2010 Roadway and Area Lighting Equipment – Luminaire Vibration

ANSI C136.3-2005 (R2009) Roadway and Area Lighting Equipment – Luminaire Attachments

AMERICAN SOCIETY FOR TESTING AND MATERIALS INTERNATIONAL (ASTM)

ASTM B117-09 Standard Practice for Operating Salt Spray (Fog) Apparatus

ASTM G154 Standard Practice for Operating Fluorescent Light Apparatus for UV Exposure of Nonmetallic Materials

DEPARTMENT OF DEFENSE (DoD) Air Force ETL 11-1 Civil Engineer Industrial Control System Information

Assurance Compliance ETL 12-15 Light-Emitting Diode (LED) Fixture Design and

Installation Criteria for Interior and Exterior Lighting Applications

Joint Service UFGS 26 56 00 Exterior Lighting

(2 of 10)

FEDERAL COMMUNICATIONS COMMISSION (FCC)

(FCC) Title 47, Class B Non-consumer Emission Limits for Electronic Subpart B, Section 15 Noise

ILLUMINATING ENGINEERING SOCIETY OF NORTH AMERICA (IESNA)

HB-10-11 IES Lighting Handbook LM-79-08 Electrical and Photometric Measurements of Solid-State

Lighting Products LM-80-08 Measuring Lumen Maintenance of LED Light Sources RP-8 Roadway Lighting ANSI Approved TM 15-07 Luminaire Classification System for Outdoor Luminaires TM-21-11 Projecting Long Term Lumen Maintenance of LED Light

Sources

INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS (IEEE)

IEEE STDSPCD1155 IEEE Standards Dictionary: Glossary of Terms & Definitions

INTERNATIONAL ELECTROTECHNICAL COMMISSION (IEC)

IEC 60529-2004 Degrees of Protection Provided by Enclosures (IP Code) IEC 60068-2-30 Environmental Testing - Part 2–30: Tests - Test Db:

Damp heat, cyclic (12 h + 12 h cycle) IEC 60068-2-14 Environmental Testing. Tests. Test N. Change of temperature

NATIONAL ELECTRICAL MANUFACTURERS ASSOCIATION (NEMA)

NEMA C136.10 American National Standard for Roadway and Area Lighting Equipment�Locking-Type Photocontrol Devices and Mating Receptacles�Physical and Electrical Interchangeability and Testing

NEMA IC S6 Industrial Control and Systems: Enclosures WD 7-2000 NEMA Guide Publication: Occupancy Motion Sensors

NATIONAL FIRE PROTECTION ASSOCIATION (NFPA)

NFPA 70 National Electrical Code (NEC)

UNDERWRITERS LABORATORIES (UL)

UL 773 Standard for Plug-In, Locking Type Photocontrols for Use with Area Lighting

(3 of 10)

UL 773A Standard for Nonindustrial Photoelectric Switches for Lighting Control

UL 1310 Standard for Class 2 Power Units

1-2 DEFINITIONS

Unless otherwise specified or indicated, electrical and electronics terms used in these specifications and on the drawings shall be as defined in IEEE STDSPCD1155.

a. Useful Life – the operating hours before reaching 70% of the initial rated lumen output point with no catastrophic failures under normal conditions.

b. Correlated Color Temperature (CCT) – a visible light characteristic of comparing a light source to a theoretical, heated black body radiator (measured in kelvin).

c. Effective Projected Area (EPA) – the wind loading of the fixture.

d. International Protection (IP) Rating – delineates the level at which foreign objects and water can intrude inside a device.

e. Restriction of Hazardous Substances (RoHS) – products that are RoHS-compliant do not contain any of the following materials: lead (Pb), mercury (Hg), cadmium (Cd), hexavalent chromium (Cr6+), polybrominated byphenyls (PBB), and polybrominated byphenyl ether (PBBE).

1-3 SUBMITTALS. Government approval is required for items (a) through (d).

a. Shop drawings.

b. Certified lighting design incorporating requirements outlined in ETL 12-15, paragraphs 8 and 10, where applicable. Consider possible snow and ice buildup.

The luminaire fixture weight and effective projected area shall not exceed the pole’s requirements for all dynamic loading; e.g. wind, snow, ice.

c. IESNA LM-79 report on manufacturer’s standard production model luminaire to include:

� Testing agency, report number, date, manufacturer’s name, catalog number, LED driver, drive current, ambient temperature.

� Luminaire efficacy (lumens/watt), minimum light output, zonal lumen density.

� Color qualities (CCT, CRI, chromaticity).

� ANSI C78.377 Duv.

� Electrical measurements (input voltage, input current, input power [watts]).

� Spectral distribution over visible wavelengths (mW/nm).

� Absolute intensity candlepower (cd) summary table.

� Isocandela plot.

(4 of 10)

� Luminance summary table.

� Illuminance – point to point.

� Illuminance – cone of light plot.

� Illuminance – isofootcandle plot.

� Illuminance – roadway isofootcandle plot (if streetlight).

� Picture of sample.

� Photometric file, including BUG rating.

d. IESNA LM-80 report on LED package, array, or module, to include:

� Testing agency, report number, date, type of equipment, and LED light source being tested.

� All data required by IESNA LM-80.

Note: Test laboratories for the IESNA LM-79 and IESNA LM-80 reports shall be one of the following:

� National Voluntary Laboratory Accreditation Program (NVLAP) -accredited for solid-state lighting testing as part of the Energy-Efficient Lighting Products laboratory accreditation program.

� One of the qualified labs listed on the Department of Energy (DOE) SSL web site (http://www1.eere.energy.gov/buildings/ssl/test_labs.html).

� A manufacturer’s in-house lab that meets the following criteria:

(1) Manufacturer has been regularly engaged in the design and production of HID roadway and area luminaires and the manufacturer’s lab has been successfully certifying these fixtures for a minimum of 15 years,

(2) Annual equipment calibration, including photometer calibration, in accordance with the NIST.

e. Computer-generated photometric analysis of the designed-to values for the “end of useful life” of the lighting installation, using an LLD value of 0.7. Submittal shall include the following:

� Horizontal illuminance measurements at finished grade. Spacing between computer calculation points shall be 10 feet.

� Vertical illuminance measurements at 5-foot intervals above finished grade.

� Minimum footcandle level.

� Maximum footcandle level.

� Average maintained footcandle level.

� Maximum and minimum ratio (horizontal).

f. Product Certificates:

� Submitted by the installing contractor, certification from the manufacturer indicating the expected useful life of the provided luminaires. The useful life

(5 of 10) shall be directly correlated to the IESNA LM-80 test data, interpreted per IESNA TM-21. Minimum LED life shall be 50,000 hours.

� Manufacturer certification that fixture meets recyclability requirements.

� Manufacturer certification that the luminaires satisfy “Part 1-4 GENERAL

REQUIREMENTS” and “Part 2 PRODUCTS” portions of this specification.

1-4 GENERAL REQUIREMENTS

Include dimensions, EPA, accessories, and installation and construction details.

1-5 SAFETY CERTIFICATION

Provide safety certification and file number as required for the luminaire family that shall be listed, labeled, or identified per the NEC. Applicable testing bodies are determined by the Occupational Safety and Health Administration (OSHA) as nationally recognized testing laboratories (NRTL) and include CSA (Canadian Standards Association), ETL (Edison Testing Laboratory), and UL.

1-6 MATERIAL AND EQUIPMENT MANUFACTURING DATE

Products manufactured more than one (1) year prior to date of delivery to site shall not be used, unless specified otherwise.

1-7 WARRANTY

LED luminaires and replacement lamps available today claim long life (e.g., 50,000 hours or more), which exceeds the life ratings of nearly all other light sources (except for some electrodeless sources). These claims are based on the estimated lumen depreciation of the LED used in the product and often do not account for other components or failure modes. Projected life of LED luminaires is a key component to payback scenarios in project evaluations; therefore, it is critical that products perform as promised and anticipated. Since life claims provided by suppliers are typically 50,000 hours or more and the initial cost of exterior LED luminaires may be significant, warranties shall include product performance as claimed in terms of useful life.

Life claims by LED luminaire manufacturers shall take into account the whole system, not just the LEDs. A key lesson learned from early market introduction of compact fluorescent lamps was that long-life claims need to be credible and backed up with adequate manufacturer warranties.

Equipment items shall be supported by service organizations that are reasonably convenient to the equipment installation in order to render satisfactory service to the equipment on a regular and emergency basis during the warranty period of the contract.

Note: On-site replacement includes transportation, removal, and installation of new products.

(6 of 10)

a. The LED manufacturer shall provide a written five-year on-site replacement “finish” warranty for luminaires. Finish warranty shall include warranty against failure or substantial deterioration such as blistering, cracking, peeling, chalking, or fading.

b. The LED manufacturer shall provide a written five-year on-site replacement warranty for defective or non-starting power supply units and LED source assemblies, which include, but are not limited to, LED packages, LED arrays, LED modules, LED dies, encapsulates, and phosphors.

c. The LED manufacturer shall provide a written five-year on-site replacement warranty for any LED source assembly, package, array, or module, which does not include the power supply, against 10% or more of the individual LEDs in that assembly, package, array, or module failing to illuminate.

d. The LED manufacturer warranty period shall begin on the date of final acceptance, as executed by a DD Form 1354. The contractor will provide the contracting officer with the signed warranty certificates prior to final payment.

PART 2 PRODUCTS

2-1 LUMINAIRES

Provide luminaires complete with LED light source and power supply unit. Details, shapes, and dimensions are indicative of the general type desired but are not intended to restrict selection to luminaires of a particular manufacturer. Luminaires of similar design, light distribution and brightness characteristics, and of equal finish and quality will be acceptable.

2-1.1 GENERAL PRODUCT REQUIREMENTS

a. Luminaires shall be UL-listed for wet locations and wiring cavities shall be field-accessible for service or repair needs.

b. Luminaires must be rated for operation in ambient temperatures from -30 °C to [+40 °C] [+50 °C].

c. Luminaires shall be full cutoff or fully-shielded as defined by IESNA RP-8.

Alternatively, the full cutoff can be validated by meeting the following IESNA TM-15 BUG ratings (backlight, uplight, and glare):

� Maximum uplight (U) rating of U1.

� Maximum glare (G) rating equal to G2.

(7 of 10)

d. Optical systems for roadway and area luminaires, including the driver, shall be sealed and rated for IP 66 as defined in IEC 60529.

e. Luminaires shall be fully assembled and electrically tested prior to shipment from factory.

f. For all mast-arm-mounted luminaires, a wildlife shield shall be included on the fixture to prevent wildlife access.

g. The color of the luminaires shall be bronze, unless specified otherwise.

h. Coatings shall be capable of surviving ASTM B117 salt fog environment for 1000 hours minimum without blistering or peeling.

i. Coatings shall demonstrate gloss retention greater than or equal to 90% for 1000 hours’ exposure QUV test per ASTM G154 UVB313, 4-hour UV-B 60 °C/4-hour condensation 50 °C.

j. Luminaires shall be fully functional after testing for thermal shock according to IEC 60068-2-14 and be fully functional after testing.

k. Luminaires shall be tested according to IEC 60068-2-30, damp heat, steady state, for high humidity and high temperatures and be fully functional after testing.

l. Luminaire arm bolts shall be 304 stainless steel or zinc-plated steel.

m. If a lens not integral to the luminaire is used, the optical enclosure (lens/window) shall be constructed from clear and UV-resistant acrylic or UV-treated tempered glass.

n. If the lens is integral to the luminaire, the lens shall be UV treated tempered glass.

o. At least 80% of the luminaire material by weight shall be recyclable at the manufacturer’s stated end of life.

p. Luminaires shall produce a minimum efficacy according to the following table.

Application Luminaire Efficacy (lumens per watt)

Outdoor pole/arm-mounted area and roadway luminaires 65 Outdoor pole/arm-mounted decorative luminaires 65 Outdoor wall-mounted area luminaires 60 Bollards 35 Parking garage luminaires 70

(8 of 10)

q. Luminaires shall incorporate modular electrical connections and be constructed to allow replacement of all or part of the optics, heat sinks, power supply units, and electrical components using only a simple tool, such as a screwdriver.

r. Luminaires shall bear a nameplate inscribed with the manufacturer's name, address, model number, date of manufacture, and serial number, securely affixed in a conspicuous place. The nameplate of the distributing agent will not be acceptable.

s. Roadway and area mast-arm-mounted luminaires shall have an integral tilt adjustment of ±5°, in accordance with ANSI C136.3.

t. Luminaires must pass 3G vibration testing in accordance with ANSI C136.31.

u. Luminaires shall have surge protection to meet “C Low” waveforms as defined in ANSI/IEEE C62.41.2, Scenario 1 Location Category C.

v. Luminaires shall incorporate provisions to attach a twist-lock style photocell.

2-1.2 WIRING

Twist-style wire nuts and tap-style stripless connectors are not acceptable for factory electrical connections.

2-1.3 POWER SUPPLY UNITS

Note 1: Remove bracketed options that are not applicable to your project.

Note 2: Normal ambient temperature of 40 �C (104 �F) will be adequate for typical night-time operating environments. Selection of 50 �C (122 �F) will increase the system cost and should be used when required for a specific project location. Coordinate with [40] [50] bracketed options in other parts of specification as well. Use a dimmable driver for all applications that may utilize controls (e.g., curfew, motion sensing) as part of the project.

a. Minimum efficiency of 85%.

b. The maximum drive current to each individual LED shall not exceed 600 mA.

c. Rated to operate between -30 °C to [+40 °C] [+50 °C].

d. Designed to operate on voltage system [120V to 277V] [480V] nominal.

Fluctuations in line voltage up to 15% shall have no visible effect on the luminous output.

e. Operating frequency: 50/60 Hz.

(9 of 10)

f. �������

h. Comply with FCC 47 CFR Section 15, Class B, non-consumer RFI/EMI standards.

i. Reduction of hazardous substances- (RoHS-) compliant.

j. Luminaires under a covered structure shall be UL-listed Class P with a sound rating of “A.”

k. Driver shall be dimmable and compatible with standard dimming control circuits.

l. Driver shall be protected against damage due to either an open-circuit or short-circuit fault condition on the driver output. The driver shall resume normal operation when the fault is removed.

m. Over-temperature protection shall be provided to cut off output power if temperature limit is exceeded. The driver shall resume normal operation when within normal operating temperature.

2-1.4 LED LIGHT SOURCE

Note 1: Select CCT values and CRI bracketed options based on application. If a design strategy is to blend with traditional lighting systems in the local area, pick a CCT in the 4,000-5,000 K range. This temperature is a warmer light source than 6500 K and provides a balance between color temperature, color rendering, and efficacy of the light source. LED chips are manufactured to achieve maximum efficacy related to a specific color temperature and this varies with chip manufacturer and binning.

Note 2: High pressure sodium is 2700 K, warm metal halide is 3200 K, clear metal halide is 4000 K, and moonlight is 4100 K.

Note 3: 6500 K is a cooler temperature and should only be used when color rendering or environmental concerns such as sky glow are not a factor. Objects appear bluish and items in the red color spectrum may appear distorted.

a. Correlated color temperature (CCT) shall be in accordance with ANSI C78.377.

� [Nominal CCT: 3000 K: 3045 ± 175 K] � [Nominal CCT 3500 K: 3465 ± 245 K] � [Nominal CCT: 4000 K: 3985 ± 275 K] � [Nominal CCT 4500 K: 4503 ± 243 K] � [Nominal CCT 5000 K: 5028 ± 283 K] � [Nominal CCT 5700 K: 5665 ± 355 K]

(10 of 10)

� [Nominal CCT: 6500 K: 6530 ± 510 K]

b. Color Rendering Index (CRI) shall be > 65 for all CCTs.

c. Thermal management shall be passive by design and shall consist of heat sinks with no fans, pumps, or liquids.

2-2 ELECTRICAL SYSTEM

2-2.1 SURGE PROTECTION: Comply with ETL 12-15, paragraph 10.5.

2-2.2 DAYLIGHTING CONTROLS

a. All street, exterior parking lot, drive, and front aisle areas shall be controlled such that exterior luminaires shall not operate during hours of daylight.

b. Controls may include a combination photocell plus time switch or an energy management system.

c. Controls shall allow automatic on and off settings based on daylighting, plus timed off settings after expected activity ends.

d. The energy management system shall employ predetermined control strategies to include automatic dimming for adaptive standards, and remote control shall be in accordance with ETL 11-1, Civil Engineer Industrial Control System Information Assurance Compliance.

e. Consult Unified Facilities Guide Specification (UFGS) 26 56 00, Exterior Lighting, for photocell, time switch, and occupancy control requirements.

Atch 2 (1 of 1)

DISTRIBUTION LIST

DEPARTMENT OF DEFENSE

Defense Commissary Agency (1) Design and Construction Division 2250 Foulois St., Suite 2 Lackland AFB, TX 78236

AAFES (1)

ATTN: RE-C

PO Box 660202 Dallas, TX 75266-0202

SPECIAL INTEREST ORGANIZATIONS

Information Handling Services (1) 15 Inverness Way East Englewood CO 80150

Construction Criteria Database (1) National Institute of Bldg. Sciences 1201 L Street NW, Suite 400 Washington, DC 20005

WATER & SEWER UTILITY CONSTRUCTION FEES

TO: Richard Burnette, P.E., 6 CES/CEQ

FROM: Michael Wilson, FGUA/GSG Capital Projects Manager

DATE: May 5, 2011

SUBJECT: NVZR XX-XXXX, Water & Sewer Construction Fees

The FGUA has reviewed the XX% design drawings prepared for the above-referenced project and provides this memo regarding for estimated construction inspection fees.

Inspection Requirements - All Inspections require72 Hour Notification

Three stages of coordination between the construction contractor and FGUA are required:

Pre-construction Meeting, Construction Inspections, and Final Inspection for Utility

Clearance. It is the Contractors responsibility to request all meetings and inspections.

Prior to starting any site work, the Contractor shall contact FGUA at 727-359-1158 to schedule a Pre-Construction meeting (this meeting can be the same Pre-Construction meeting conducted for the Government, provided the FGUA is given at least one (1) week advance notice of the meeting). During this meeting, specific inspection requirements for the project will be determined and, procedures for contacting and scheduling inspections.

Final inspections are required upon completion of all utility work. Plans and shop drawing reviews remain the responsibility of the Government Agency contracting the work. Refer also to the Design Guide for information regarding applications required for service termination, service connection, temporary construction water meter, etc. All fees are paid in advance to the Florida Governmental Utility Authority (FGUA) prior to any Utility

Work commencement.

Construction & Inspection Fees

Fees are based upon review of the plans currently in preliminary design. Fees are subject to modification upon receipt of 100% plans. As a courtesy to the Government, the FGUA will review early versions of the WORK, however we cannot guarantee that the Inspection

Fees quoted will be complete without the benefit of 100% plans.

The following items are covered under the cost shown below:

One (1) Water main disconnect or connection

One (1) Sewer main disconnect or connection (contractor must repair any cored manhole)

All inspections of the utility work, including witnessing for certification purposes

*One Temporary Construction Water Meter with BFPD, installed and removed by FGUA

If CONTRACTOR requests more than one connection or disconnection, ADDITIONAL

CHARGES WILL APPLY.

We appreciate the opportunity to be of service to MacDill AFB and its construction contractors and look forward to assisting in your successful completion of your project.

Construction & Inspection Fees for Project NVZR XX-XXX: $0.00

*Temporary Construction Water Meter: $0.00 (includes $500 refundable deposit)

LEA ANN THOMAS, CHAIR

Polk County

DOUG MEURER

Lee County

ROBERT KNIGHT

Citrus County

SHANE PARKER

Hendry County

MICHELE BAKER

Pasco County

MICHAEL CRUMPTON, P.E.

DeSoto County

Full Name of Applicant:

Contractor/Business Name: Local Business Address:

Business Phone #:

Business Fax #: Email:

Name of Project Representative that will be Coordinating Work:

Mobile Phone #: Email:

MacDill AFB Project Name:

MacDill AFB Project Number: Date of Commencement:

MacDill Project Manager Name: Office Number #:

Email:

Intended Purpose of the Meter:

Estimated Time of Use: ________________ Date Meter is Required: ________________

Location of Hydrant HYDRANT NUMBER:

Signature Date

USW Job Number:

Meter Number Assigned: Date of Most Recent of Backflow Certification:

Date Installed: Technician:

Meter Reading Out:

Removal Request RCVD:

Date Removed: Technician:

Meter Reading In:

Confirmation Number: Deposit Returned:

FGUA Form 11, Temporary Water Meter Application

Approved applications are subject to the following conditions:

For Office USE ONLY

FGUA Utility Operations Center:

9109 Bayshore Boulevard, Building 84

Phone 813-828-3984 - Fax 813-828-3212

Mailing Address:

P.O. Box 6704

Tampa, FL 33608

I __________________________________ (Applicant/ Customer) have reviewed and accept the provisions within this agreement.

This agreement serves the need for Temporary Water Service for construction activities from a designated source. Applicants must submit the completed application, a copy of the Water & Sewer Contruction Fees letter provided by the FGUA, and pay all fees at the FGUA Utility Operations Center listed at the top of this form. All Payments shall be made to the Florida

Governmental Utility Authority (FGUA) by CHECK (cash not accepted).

Only FGUA authorized personnel are permitted to install, move or remove portable meters from Fire Hydrants. It is against the Law for anyone other than authorized personnel to tamper with or obtain unmetered water from a MacDill AFB Fire Hydrant.

No Private Meters may be installed on Base Hydrants, trucks or equipment. Violations will be reported to 6CES and Security Forces.

FGUA is not responsible for accident or injury caused by unauthorized placement of a portable meter and/or appurtenance.

The Applicant is liable for any damages to FGUA property and equipment during the contract.

This Section is Reserved for Office Use Only

Safety and Security of the meters assigned to the customer are the responsibility of the Customer.

All requests for installation, relocation and removal of potable water meters must be made in writing at least 3 days in advance and hand delivered or mailed to the FGUA Utility Operations Center listed at the top of this form.The FGUA Utility Operations Center is open during normal business hours are

8:00 to 4:00 Monday through Friday. (preceding text matches Form 427). Applications received will be scheduled within 3 business days of the date received. When Removal is required the customer must file a written request, in person, and pay outstanding fees (if any). A Confirmation Number will be issued to the Customer at this time, please retain this confirmation number. Upon account reconciliation a Refund of Deposit will be mailed to the address provided above.

Rev. (mjh) 102711 Florida Governmental Utility Authority - Form 11

Full Name of Applicant: Applicant Phone #:

Contractor / Business Name: Local Business Address:

Business Phone #:

Business Fax #: Email:

Name of Representative that will be on-site coordinating work:

Mobile Phone #: Email:

Justification for Work (add details): MacDill AFB Project #:

MacDill AFB Project Name:

Requested Date of Service: Facilities/ Buildings Impacted:

Government Approved Date and Duration:

Signature of Authorization (Gov't PM) Date

Signature of Applicant Date

USW Job Number: Payment Received

Work Scheduled for Day/Time Restoration of Service Date/Time

FGUA Technician Assigned BACTI TESTING Pass / Fail

FGUA Personnel On-Site

Utility Damage Observed: Boil Water Notice Issued: Date/ Time

Est. Additional Costs: Boil Notice Rescinded: Date/ Time

I ___________________________________ (Applicant/ Customer) have reviewed and understand the provisions within this agreement.

⃝ Other _____________________

All requests must be received at least 2-weeks prior to the earliest day needed at the FGUA Utility Operations Center listed at the top of this form. The FGUA Utility Operations Center normal business hours are 8:00 to 4:00 Monday through Friday. An FGUA Representative will contact you upon application approval.

Utility Terminations - All Utility Terminations are performed by the FGUA. Prior to the FGUA personnel arrival, the Contractor is required to excavate and expose all water or sanitary sewer piping at the point of termination. Upon completion, contractor will complete the line abandonment or properly restrain any remaining piping, as required by either Government Inspectors and in accordance with the Hillsborough

County Design Standards. All excavations must meet current OSHA regulations for pit excavation.

The following Terms and Conditions apply to all work performed on or around water and sewer utilities

Complete this Block for Water/Sewer Outages that Impact Customers

Phone and Email: ____________________________________________________

MacDill Air Force Base - FGUA Form 427

Gov't Project Manager Name:

FGUA Utility Operations Center:

Phone 813-828-3984 - Fax 813-304-2694

Mailing Address:

P.O. Box 6704

Tampa, FL 33608

This Section is Reserved for FGUA Office Use Only

⃝ Termination of Utility Service

⃝ Utility Outage Request

⃝ Inspection of Work

Applicants are liable for any damages caused by the Applicant during work on or around FGUA-owned utilities located and accepted under the terms of Air Force Form 103 and FGUA Form 301.

Applicant is responsible for chlorination and bacteriological testing of all new water mains and service connections in accordance with AWWA

C651. It is anticipated that all bacteriological tests, pressure tests, and record drawings will accompany the Certificate of Construction

Completion Forms for signature by the FGUA. If, during the initial testing of the water supply and as part of the restoration of service, it is found that proper disinfection and testing has not been performed, the contractor will be required to perform proper disinfection and flushing of the system until passing tests are received. Contractor is liable for the cost of additional testing and services.

This Request for Work must be submitted by all parties anticipating the need to perform work on or adjacent to existing Water or Sewer utilities, where assistance from the FGUA is required. This application ensures that proper construction techniques, utility terminations and physical line disconnections from FGUA-owned Water and Sanitary Sewer systems are followed.

Without exception, FGUA personnel must be present at all times during work of this type. For each work request, applicants must submit a completed form 427 along with the proper fees made by check (cash not accepted) and payable to the FGUA.

Only FGUA personnel are authorized to operate system valves and sanitary sewer lift station equipment.

Temporary Utility Outage - Upon proper notification and at a mutually agreed day and time, FGUA operations personnel will arrive onsite to perform a temporary shutdown of the service. Once the outage is complete, FGUA personnel will return to the site to restore the service. The maximum amount of time allowed for a service outage is determined by MacDill AFB authorities. Unless indicated during application, FGUA personnel are not required to be present during the time after Suspension and before Restoration of Service

Rev. (MJH) 05-10-13 Florida Governmental Utility Authority - Form 427 fill_1:

Full Name of Applicant:

Applicant Phone:

Contractor Business Name:

Business Phone:

Local Business Address 1:

Local Business Address 2:

Business Fax:

Email:

Name of Representative that will be onsite coordinating work:

Mobile Phone:

Email_2:

Justification for Work add details 1:

Justification for Work add details 2:

MacDill AFB Project:

MacDill AFB Project Name:

Requested Date of Service:

Facilities Buildings Impacted:

Govt Project Manager Name:

Government Approved Date and Duration:

Phone and Email:

Date:

I:

Date_2:

USW Job Number:

Payment Received:

FGUA Technician Assigned:

FGUA Personnel OnSite:

Utility Damage Observed:

Est Additional Costs:

Radio Button1: Yes

Text2:

Text3:

Text4:

Text5:

Temporary Water Meter Application

Date: ____________

Full Name of Applicant: Applicant Phone #:

Company Name: Company Address:

Company Phone #:

Company Fax #: Email Address :

MacDill Point of Contact: Division/Rank:

POC Phone #: POC Email Address:

Project Name:

Project Number: Date of Commencement:

MacDill Field Inspector: Phone Number:

Company Project Representative: Phone Number:

Intended Purpose of the Meter:

Estimated Time of Use: ________________ Date Meter is Required: ________________

Location of Hydrant HYDRANT NUMBER:

Meter Number Assigned: Date of Most Recent of Backflow Certification:

Date Installed: Technician:

Removal Request RCVD: Y / N Date:

Confirmation Number:

Tampa Florida 33621 Phone (813) 828 -3984 Fax (813) 828 -3212

Safety and Security of the Meters assigned to the customer are the responsibility of the Customer.

All requests for installation, relocation and removal of potable water meters must be made in writing at least 3 days in advance and delivered to Building

84 during normal business hours of 8:00am - 4:00pm, Monday through Friday. Applications received will be scheduled within 3 business days of the date received. When Removal is required the customer must file a written request, in person, and pay outstanding fees (if any). A Confirmation Number will be issued to the Customer at this time, please retain this confirmation number. Upon account reconciliation a Refund of Deposit will be mailed to the address provided above.

For Office USE ONLY

I __________________________________ (Applicant/ Customer) have reviewed and accept the provisions within this agreement.

The purpose of this agreement is to serve the temporary need for Water Service, such as construction, from a designated source. Applicants must submit completed application, water & sewer contruction fees letter provided by the FGUA and pay all fees outlined in FGUA letter at Building 84. All Payments shall be made by CHECK (cash not accepted) and made payable to

Florida Governmental Utility Authority (FGUA) Approved applications are subject to the following conditions:

Only FGUA authorized personnel are permitted to install, move or remove portable meters from Fire Hydrants. It is against the Law for anyone other than authorized personnel to tamper with or obtain unmetered water from a MacDill AFB Fire Hydrant.

No Private Meters may be installed on Base Hydrants, trucks or equipment. Violations will be reported to 6CES and Security Forces.

FGUA is not responsible for accident or injury caused by unauthorized placement of a portable meter and/or appurtenance.

The Applicant is liable for any damages to FGUA property and equipment during the contract.

Rev. (dbs) 042711 Florida Governmental Utility Authority - form 11

Contractor Utility Locate Acceptance

Date: ____________

Full Name of Applicant: Job Site Phone #:

Contractor Name: Contractor License #:

Job Trailer Located On-Site ( Y / N ) Job Site Location (Bldg./Intersection):

Contractor Supervisor:

Supervisor Phone #:

MacDill Construction Manager: Affiliation (6 CES, USACE):

Construction Manager Phone #: Email:

Project Number:

AF Form 103 (dated):

Description of Work:

Planned Work Start Date:

Locate Ticket #:

Date and Time of Utility Locate:

General Terms and Conditions of Acceptance:

(Initials)

Marked ( X ) Service Technician Acceptance

Pressurized Water Main

Water Service Lines

Reclaimed Water Main

Gravity Sewer

Sewage Forcemain

Office Tracking Log Completed: Date:

Relocate #1: Date:

Relocate #2: Date:

Relocate #3: Date:

Utility Damage: Date:

Cost Recovery: Date:

Contractors must report Any/All damage to Water or Sewer Utilities immediately to the FGUA.

Tampa Florida 33621 Phone (813) 828 -3984 Fax (813) 828 -3212

Location and Acceptance pertains to Water & Sewer Utilities Only and does not consider any other utilities.

The Contractor is responsible for obtaining all other utility locates from other base utility owners/operators.

Utility locates are valid for a period of 90 days from the date of acceptance, after which the Requestor is required to contact the FGUA for a new Utility Locate. A current copy of the Air Force Form 103 and project drawings shall be available at the Job Site.

This Section is Reserved for FGUA Office Use Only

Contractor will be responsible for all costs associated with the repair to utilities damaged as a result of Contractors Work.

Contractor is responsible for maintaining and protecting all utility locate marks during the 90 day period.

Conflicts / Comments

I ______________________________________________, have reviewed and accept the provisions stated within this agreement and understand them in their entirety wherein by signing this agreement I affirm that, to my knowledge, all Water and Sewer utilities have been properly identified.

Rev. (dbs) 042511 Florida Governmental Utility Authority - Form 301

Utility Service Termination Application

Name of Applicant: Date:

Company Name: Company Address:

Company Phone #:

Company Fax #: Company Email:

MacDill Point of Contact: POC Organization:

POC Phone #: POC Email:

Project Number:

MacDill Construction Manager: Phone Number:

Company Project Representative: Phone Number:

Check One: Sanitary Sewer_____ Water Distribution_____

Termination Conducted By: Contractor_________ FGUA________________

Brief description of utility termination requested. Be sure to include facility number/site location and pipe size:

Estimated Project Start Date: ________________ Estimated Date Disconnection Required ________________

Terms and Conditions:

Signature: Date:

Office Tracking Log Completed: Date:

Work ID #

Construction Inspector: Signature:

Date Completed: Time On-Site:

Utility Damage: Date:

Cost Recovery: Date:

9110 Bayshore Boulevard, Building 84

MacDill AFB, Florida 33621 Phone (813) 828-3984 Fax (813) 828 -0000

All requests must be made in writing and delivered to the FGUA in Building 84 during normal business hours of 8:00 to 4:00 Monday through

Friday. Approved applications will be scheduled within 5 business days of the date received.

All fittings and tools used to cut and cap water piping must be properly disinfected in accordance with AWWA C651, Current Edition.

The purpose of this application is to ensure proper utility terminations and physical line disconnection from FGUA-owned water and sanitary sewer utilities. Applicants must submit a completed application along with the proper fees. Applications that are approved are subject to the following conditions:

Only FGUA personnel are authorized to operate water system valves and sanitary sewer lift station equipment.

I_________________________ (Requesting Person/Company) have reviewed the Utility Service Termination Application and agree to all of the Terms and Conditions.

The Applicant is liable for any damages to FGUA-owned utility lines, including all costs and repairs to marked utility lines damaged by contractor during their work.

All work acomplished by contractor must be inspected by FGUA prior to backfilling. Contractor is required to make all corrections identified by the FGUA constuction inspector.

Contractor is required to excavate and expose all water or sanitary sewer piping at the point of termination; FGUA will perform and complete the proper cut and capping proceedure. Contractor may request, by identifying so on this application, to perform the cut and cap proceedure in accordance with specifications provided by FGUA. If this is approved, Contractor must contact FGUA to schedule an inspection of the work before work commencement.

6th Communications Squadron Supplement to

Engineering Technical Letter (ETL) 02-12: Communications and Information System

Criteria for Air Force Facilities, dated 27 June 2002

Communication Systems

24 July 2008

OPR: 6 CS/SCXX

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Table of Contents

Section Page ETL 02-12 para ref #

1. Purpose 1 1.

2. Scope 1 1.1.1.

3. Referenced Pubs 1 4 & 5

4. RUS/REA Bulletins 1 4 & 5

5. General Requirements-Intent 1 1.1.

6. Cable Management Plan 2 no ref.

7. Designer/Installer Qualifications 2 9.4.2.

8. Inside Wire and Cabling

8.1. Inside Fiber Optic Cable 3 8.3.1.

8.2. Inside Copper Cable 3 8.3.3.8.1.

8.3. House Backbone Cable 4 8.3.3.8.2. and 8.3.3.8.3.

8.4. Telecommunications Outlets 5 8.3.3.9.

8.5. Miscellaneous (Phones, PA Systems, LMR etc.) 6 no ref.

8.6. SIPRNET 7 1.1.1.

9. Communications Equipment Room and Distribution Frame

9.1. Communications Equipment Room 8 8.3.3.2.

9.2. Telecommunications Closet 9 8.3.3.3.

10. Exterior Work

10.1. Comm. Cables between Buildings 10 8.3.3.8.4.

10.2. Outside Copper Cable 10 no ref.

10.3. Outside Fiber Optic Cable 10 no ref.

10.4. Outside Plant Cable Entrance 11 8.3.3.2.1.

10.5. Conduits and Duct Banks 11 no ref.

10.6. Conduit Rodding and Cleaning 12 no ref.

10.7. Innerduct Installation 12 no ref.

10.8. Manholes 13 no ref.

10.9. Direct Buried Cable 14 no ref.

11. Installation and Testing 14 8.7.

12. CONSTRUCTION AND AS-BUILT DRAWINGS

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12.1. Design Drawings 15 9.4.4.

12.2. Underground Cable Drawings 15 9.4.4.

12.3. Direct Buried Cable Drawings 16 9.4.4.

12.4. Underground Conduit Drawings 16 9.4.4.

12.5. As-Built Drawings 17 9.4.4.

13. O & M Manuals 18 9.4.4.

14. DD-Form 1391, MilCon Project Data 18 9.2.

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SECTION 1. PURPOSE:

1.01. This supplement clarifies communications requirements for MacDill AFB facilities not covered in ETL 02-12. This supplement shall be used in conjunction with ETL 02-12. The 6th Communications Squadron Communications System Officer (CSO) or designee is the only one who can authorize deviation from this supplement.

SECTION 2. SCOPE.

2.01. This specification shall be used to plan, design, review and evaluate telecommunications cabling and distribution systems for service connections, pre-wiring of new and renovated facilities to support communications – computer systems (C-CS). This specification addresses C-CS as they relate to interior wiring, exterior duct bank and communications cable to the appropriate service connection point(s).

SECTION 3. REFERENCED PUBLICATIONS.

- ANSI/ICEA S-80-576 Standard (Std) for Telecomm Wire and Cable for Wiring of Premises

- TIA/EIA-569-A Commercial Building Std for Telecommunications Pathways and Spaces

- TIA/ EIA 590 Std for Physical Location & Protection of Below-Ground F.O. Plant

- ANSI/TIA/EIA TSB-75 Additional Horizontal Cabling Practices for Open Offices

- Unified Facilities Criteria 4-021-01 Design and O & M: Mass Notification Systems

SECTION 4. BULLETINS.

- REA 1753F-601 (PE-90) Fiber Cable, Outside

- REA 1753F-205 (PE-39) Copper Cable, Outside

- REA 1753F-208 (PE-89) Copper Cable, Outside

- RUS 1751F-640 Design of Buried Plant – Physical Considerations

- RUS 1751F-642 Construction Route Planning of Buried Plant

- RUS 1751F-644 Underground Plant Construction

SECTION 5. GENERAL REQUIREMENTS-INTENT

5.1. Whenever new construction or renovation takes place, the design, installation, and all related costs necessary to complete interior wiring and extend the conduit, ductwork and manhole system to the new or renovated location shall be included in the project cost.

5.1.1. Renovation shall include removal of old/unused telecommunications cabling from interior of facilities. 6th Communication Squadron (CS) will identify old/unused cabling.

5.1.2. Prior to demolition of any facility, 6th CS personnel shall remove the outside plant communications cables (copper and fiber) serving the facility, if applicable. These cables shall be removed back to the splice point and capped. The 6th Civil Engineering Squadron (project manager) shall notify the 6th Communications Squadron (Plans Office) at least 45 days prior to facilitate scheduling of work.

5.1.3. Prior to demolition or renovation of any facility, all network devices, LMR equipment and antennas serving the facility, which shall be impacted by the construction, shall be removed/relocated.

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The 6th Civil Engineering Squadron (project manager) shall notify the 6th Communications Squadron (Plans Office) at least 30 days prior to facilitate scheduling of work. Submit the removal/relocation request using automated Form 3215. The 6th Communications Squadron shall remove the antennas.

5.1.4. Communications design criteria is grouped into three areas: inside wire & cable; communications equipment room & distribution frame; and exterior work. The design requirements may vary depending on the size and type of facility being built or renovated.

5.1.5. The facility design shall provide for concealment of wiring/cabling systems, adequate space for installation, maintenance of C-CS equipment and wiring, and proper separation for specialized systems, if required.

5.1.6. The building communications infrastructure shall provide 50% spare capacity for future expansion of the user’s voice, network, security and video requirements.

5.1.7. The most practical cable/wire distribution system shall be selected, consistent with facility size/function and current/projected C-CS requirements.

5.1.8. To minimize the long-term cost of the infrastructure, local standards are established as follows and shall only be changed when approved in writing by the base CSO or their designee. These standards are intended to reduce cost associated with post construction C-CS requirements, to promote common skills among maintenance personnel and to minimize the necessity for excessive on-hand spare parts and equipment.

SECTION 6. CABLE MANAGEMENT PLAN.

6.1. Cable management is the planning, designing and accounting of cables routed throughout the building. Placement of any cable system in the building shall follow a well organized and well designed cable management plan. By keeping a record of cable pair counts and assignments and the routing of riser, tie, and distribution cables, future rearrangements or alterations to the wiring system shall be easier.

The overall cable management shall be implemented in accordance with TIA/EIA-606 (Administration Standard for the Telecommunications Infrastructure of Commercial Buildings).

6.2. The 6th Communications Squadron project manager shall review and approve the proposed cable management plan prior to construction

SECTION 7. DESIGNER-INSTALLER QUALIFICATIONS.

7.1. All furnished and installed equipment and all work accomplished under this section shall be performed by a certified telecommunications contractor, with the exception of furnishing and installing conduit, electrical boxes and pull wires. The contractor shall have the following qualifications in telecommunication systems installations:

7.2. The contractor shall have a minimum of 3 years experience in the application, installation, splicing and testing of the specified telecommunications systems and equipment.

7.3. All craftsmen installing fiber optic and level Cat-6 cables and their associated hardware shall have certification that they are qualified to install and test the provided equipment and materials. General electrical trade staff (electricians) shall not be used for the installation of the premises distribution system cables and associated hardware. Electricians shall be used for installation of the raceway systems.

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7.4. All installers assigned to the installation of this system or any of its components shall have a minimum of 3 years experience in the installation of telecommunications system components.

SECTION 8. INSIDE WIRE AND CABLING

8.1 INSIDE FIBER OPTIC CABLE

8.1.1. Fiber cable type shall depend on the user/base requirements. 6th Communications Squadron (Plans Office) shall make final decision (ex: 8.3/125 microns for single mode and 62.5/125 microns for multi-mode).

8.1.2. All fiber cables shall be run in inner duct, with an individual inner duct for every fiber cable.

Secure the inner duct along the route with cable ties or U-shaped mounting brackets. Protective bushing(s) shall be used where the fiber enters and exits the interduct. All plastic cable ties shall be trimmed with a flush-cut tool to ensure that no sharp edges result.

8.1.3. Fiber cable installed inside conduit/ducts shall have no less than ¼ inch air gap existing around the outside perimeter of the cable.

8.1.4. Fiber optic cable shall be installed from the facility demarcation back to the nearest service connection point(s) (Information Transfer Node - ITN). The cable shall be connected/terminated to existing infrastructure. This may require the installation of a new/addition to the manhole/ductbank system. The contractor shall complete the connection/termination.

8.1.5. The fiber optic patch panel shall provide a location for maintenance and cross-connecting of fiber optic cables. Patch panel shall have connectors that interface the inside plant cable with the outside plant cable. Panels shall have engraved laminated plastic nameplates above each connector. The nameplates shall indicate panel designation.

8.2. INSIDE COPPER CABLE

8.2.1. Copper cable shall be CAT-6 cable. The CAT-6 cable used for voice shall be gray and the CAT-6 cable used for data shall be blue

8.2.2. Maintain manufacturer’s recommended minimum bend radius of the cables at all times. Do not stretch, stress, tightly coil, bend or crimp the workstation cables when leaving them out of…