Attachment 3 - Performance Work Statement.pdf

1.0 General Information:

This is a non-personal service contract to provide Underground Storage Tank (UST) Testing for 319 Civil Engineering Squadron (CES) at Grand Forks AFB (GFAFB), ND. The government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the contractor who, in turn is responsible to the government.

1.1 Description of Services/Introduction:

The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform UST testing as defined in this PWS except for those items specified as government furnished property and services. The contractor shall perform to the industry standards and contract requirements.

1.2 Background:

GFAFB is located 15 miles west of Grand Forks, North Dakota. GFAFB operates aircraft and many support vehicles, that all need fuel and petroleum products, stored on site. This requires underground storage tanks that need line tightness testing, probe functionality testing, hydrostatic spill bucket testing, overfill protection, sump integrity, under dispenser containment, and submersible turbine sump testing per Department of the Air Force (DAF) instructions, Environmental Protection Agency (EPA) and North Dakota Department of Environmental Quality (ND DEQ) guidelines. Requirements can be found at: https://deq.nd.gov/WM/Publications.aspx

1.3 Objectives:

Conduct all required federal, state, local and DAF regulatory compliance tests for each GFAFB UST in the frequency specified according to the tank system configuration per CFR 40 Part 280, the North Dakota Administrative Code (NDAC), Chapter 33-24-08 Technical Standards and Corrective Action Requirements for Owners and Operators of USTs and the North Dakota Century Code §23.1-04-06 Underground storage tank regulations to meet tank testing compliance rules. All test data, information and associated results produced by the contractor for GFAFB USTs shall be submitted in electronic form to the 319 Civil Engineer Squadron (319 CES/CEIE) on individual forms published by the ND DEQ for each sensor, spill bucket, line, overfill, alarm, associated piping, pumps, and/or probe type of test within 10 days of test completion (Attachment 1). Test forms are to be filled out in their entirety. Properly identify tank and/or associated tank equipment on forms using tank identification (ID) name/number, sensor, sensor location and other equipment using the ID information provided in the Estimated Workload table (Section 4).

Performance Work Statement (PWS)

Petroleum, Oil, and Lubricant (POL) Underground Storage Tank Testing https://deq.nd.gov/WM/Publications.aspx

1.4 Scope:

The contractor shall provide all management, tools, supplies, equipment, and labor necessary to conduct and successfully complete all required regulatory tests in the mandatory frequency for GFAFB USTS, sensors, spill buckets, sumps, line tightness and associated piping to meet test compliance with all federal, state, and local laws. The Contractor shall verify tank types and classifications and abide by the appropriate test types and frequencies as annotated by the ND DEQ and AF. The contractor shall implement approved engineering practices and be trained and certified IAW the Petroleum Equipment Institute RP-1200: Testing of UST Spill, Overfill, Leak Detection and Secondary Containment manual as identified on the required ND DEQ reporting forms. The required ND DEQ forms can be found at https://deq.nd.gov/WM/Publications.aspx. A separate form must be used for each piece of equipment tested. For example, if five pump sensors were tested, the contractor may not just indicate that five sensors were tested and passed tests. The contractor must provide the test results for each sensor on the identified compliance form (A0001) by ND DEQ and 319 CES point of contact (POC). The forms must be completed in full to include listing the date of each test. Verified test failures shall be annotated in full description as a separate report in memorandum format (A0002) for communication to the CO/319 CES POC to support appropriate AF planning and identification of any needed repairs or replacement of UST operations by the AF.

The contractor shall be responsible to identify test failures and unresponsive test probe sensors, wires and flexible piping for test operation and completion only. All malfunctions of test failure must be identified to the government include what probes, wires or piping, etc. failed. Any failed tests due to contractor’s testing equipment malfunction or contractor’s representative error shall be retested at the expense of the contractor. Any retests performed will include the resubmission of another ND DEQ form (All ND DEQ forms are available at https://deq.nd.gov/WM/Publications.aspx) to include updated test results and data to the government.

1.5 Period of Performance:

The Period of Performance (PoP) shall be for one (1) Base Year of twelve (12) months and four (4) option years. This will include annual probe functionality tests and reports for each tank and its associated piping, and the required annual line tightness tests to be completed within each PoP for every tank and its associated piping as listed in the estimated workload. The base year will include 3-year tank tests that are required for two (2) pressurized systems and piping along with associated report forms. The base and third option years will include 3-year tests that are required for all pressurized systems and associated piping. Th e annual and 3-year tests should be conducted between the months of April and October to plan for limited UST access due to typical winter snow cover and negative air temperatures present at Grand Forks AFB. ND DEQ compliance testing is based on a 12-month calendar.

1.5.1 Recognized Holidays:

Contractor is not required to work on any of the following federal holidays:

New Year's Day - 1 January Martin Luther King Day – 3rd Monday in January President’s Birthday – 3rd Monday in February Memorial Day – last Monday in May Juneteenth – 19 June Independence Day – 4 July Labor Day – 1st Monday in September

Columbus Day/Indigenous Peoples' Day – 2nd Monday in October Veteran’s Day – 11 November Thanksgiving Day – 4th Thursday in November Christmas Day – 25 December

1.6 Quality Control Program:

The contractor shall develop and maintain an effective Quality Control Program (QCP) to ensure services are performed in accordance with (IAW) this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is how they assure themselves that their work complies with the requirement of the contract. This shall be delivered to the Contracting Officer (CO) and/or 319 CES POC within thirty (30) calendar days after contract award. One (1) copy of a comprehensive written QCP shall be submitted to the CO and/or 319 CES POC within five (5) calendar days when any changes are made thereafter for review and acceptance by the CO and/or 319 CES POC. After acceptance of the QCP changes, the contractor will receive, in writing, acceptance or denial of any proposed changes from the contractor’s QCP.

1.6.1 Hours of Operation:

The contractor is responsible for conducting business, between the hours of 7:30am to 4:30pm, local time, Monday through Friday, except federal holidays mentioned above, or when the government facility is closed due to local or national emergencies, administrative closings, or similar government directed facility closings. When one of the above designated holidays falls on a Sunday, the following Monday will be observed as a legal holiday. When a legal holiday falls on a Saturday, the preceding Friday is observed as a holiday by US Government Agencies. The contractor must, at all times, maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the government facility is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.6.2 Place of Performance:

The work to be performed under this contract will be performed at Grand Forks Air Force Base, ND. Contractor will coordinate scheduled work 14 days prior to beginning any tank inspections and provide a written schedule to 319 CES. An Air Force Form 74 will be provided to the contractor to be filled out and returned to the 319 CES POC to allow base access if personnel are not currently allowed base access. Escorts will be provided if access is required in controlled areas.

1.6.3 Type of Contract:

The government will award a firm fixed price contract.

1.6.4 BASE ENTRY PROCEDURES AND AIRFIELD SECURITY REQUIREMENTS:

1.6.4.1 Minimum Security Requirements for Base Entry and All Areas

Sponsoring Squadrons for approved contracts will submit a SF-74 to the Pass and Registration Office no later than 10 days prior to the contract start date. The SF-74 must include the following:

employee full name, driver's license number, date of birth, country of citizenship, and contract start and end date.

1.6.4.1.1

Sponsoring Squadrons for approved contracts with more than 10 employees will submit a Large Volume Issuance Request (LVIR) to the Pass and Registration office no later than 10 days prior to the contract start date.

1.6.4.1.1.1

LVIR MUST include the following: employee full name, driver’s license state/number, social security number, date of birth, country of citizenship, contract start/end date, authorized day/times for base access, authorized locations, and sponsors contact information.

1.6.4.1.1.1.1

Contractors and employees that are foreign nationals must undergo additional background checks and processing before being issued a visitor's pass. This includes all non-U.S. citizens who hold a foreign passport and are not a U.S. permanent resident.

1.6.4.1.1.1.2

Foreign nationals must submit a temporary worker visa that has been approved by the United States through the sponsoring squadron to the Pass & Registration office no later than three days in advance for processing.

1.6.4.1.1.1.3

All Foreign Workers will have ESCORTED access and must always remain with the sponsor while on the installation. Request for UNESCORTED access can take up to 15 additional days to receive approval.

1.6.4.1.1.2

Sponsoring Squadrons for approved contracts with less than 10 employees will submit a properly filled out Standard Forms 74s for each employee to the Pass and Registration office no later than three days prior to the contract start date.

1.6.4.1.1.3

Upon completion of the screening process, Pass and Registration will notify the Sponsoring Squadron of the results.

1.6.4.1.1.3.1

The Sponsoring Squadron will then be notified that approved contractors may pick up their DBIDS card (visitor pass) from the Main Visitor Control Center and/or the Commercial Visitor Control Center no earlier than 24 hours prior to the contract start date.

1.6.4.1.1.3.2

Denied contractors and employees that are deemed ESSENTIAL to the completion of contract may present factors in extenuation, mitigation, or defense in a rebuttal packet to the sponsoring squadron. Only official police/court documentation will be accepted for proof of severity or disposition.

1.6.4.1.1.3.3

Sponsor’s squadron will submit the rebuttal requests through their Chain of Command to the Visitor Control Center. Rebuttal requests are reviewed and considered by the 319th Mission Support Group and/or 319th Reconnaissance Wing Commander for final determination.

1.6.4.1.2 Special Provisions for Working On or Near the Airfield

By basic definition, all areas within the airfield fence are considered on the airfield. This is a controlled area, and entry can be gained by escort from owner/user of the area or obtaining a flight line badge. Projects requiring airfield access will have special provisions in the individual RFPs, in addition to what is contained in this section.

1.6.4.2 Coordination of Work

The contractor shall coordinate airfield work through the base operations, Security Forces, Civil Engineering and the contracting officer (CO). The contractor shall contact Base Operations for daily construction restrictions involving the flight line, taxiway, and runway areas, and shall comply with DOD FAR SUP 252.236-7005, Airfield Safety Precautions, AFI 13-213, Airfield Management, Grand Forks AFBI 24-101 Flightline Driving. References will be provided after contract start.

1.6.4.3 Closures

All runway or taxiway closures will require the coordination of Base Operations through the CO not less than fourteen (14) calendar days prior to the requested closure, unless otherwise provided for in these specifications. The contractor will make the maximum utilization of time during the requested closure period and schedule his/her operations in phases if necessary, so as to minimize the effect of construction closures on normal base operations. Upon completing the work requiring the closure, the contractor shall immediately notify the CO so normal operations may resume.

1.6.4.4 Personnel Safety Precautions

Site workers shall ensure they arrive at the work site with appropriate Personnel Protective Equipment (PPE) to complete the task safely due to the proximity to an active airfield. Jet aircraft operating on the runways, taxiways, and aprons make the area of inspection a zone of high-level noise. Individuals are responsible for inspecting and keeping PPE in good condition.

1.6.4.5 Restrictions

The government does not allow personal use vehicles inside the flight line fence. The con-tractor’s employees and subcontractors shall park their personal vehicles in authorized parking lots outside the flight line fence. Personnel requiring entry to the flight line shall be escorted by owner/ user of the area or possess a line badge. Contractor vehicles required in the performance of the work shall have a company sign (minimum size 6 inches by 18 inches) on both front doors. No contractor vehicles, equipment, or personnel shall be on or crossing any active runway or taxiway, except during construction period closures as outlined herein, or when the escort requests and gains clearance from the control tower.

1.6.4.6 Cleanliness of Work Area

The contractor shall maintain the cleanliness of all work areas, as well as taxiway, runway, and apron pavements at all times in order to prevent foreign object damage (FOD). The contractor shall remove all materials and equipment to a safe distance from the runway as required by base operations.

1.6.4.7 Emergencies

There may be periods when the government, due to declared aircraft emergencies, will require the contractor to vacate the work site and move his/her personnel and equipment a distance of several hundred feet away from the work site. Such removals, when ordered, will come on short notice and require expeditious action.

1.6.4.8 Airfield Security Restrictions.

The government will not grant access to restricted areas for the contractor and/or subcontractors without a proper escort from owner/user of the area or establishment of a Free Zone. Five (5) workdays prior to commencing work, the contractor shall submit, in writing, a list of all personnel who will perform work in the restricted area.

1.6.4.9 Security forces will be included in the contracts Multi-functional Team.

1.6.5 Restricted/Controlled Areas Entry Procedures

Security requirements for Air Force facilities under control of Grand Forks Air Force Base are specific and rigidly enforced. Levels of security include Restricted and Controlled areas.

Differing degrees of security are enforced at each area. Minimum security requirements, common not only to each of these secure areas, are also required for entry onto Grand Forks AFB.

Questions of clarification on locations or procedures for controlled/restricted areas contact Security Forces at 701 747-4234. These minimum requirements are outlined below.

1.6.5.1 Restricted Areas

Restricted areas are identified in GFAFBI 31-101 Grand Forks AFB Installation Security Instructions and include the Command Post (CP) and Mass Parking Area (MPA). Each area is fenced or conspicuously identified by posted signs and red Lines.

1.6.5.2 Controlled Areas

Controlled areas include many base facilities; only a few of are located within the base aircraft flight-line controlled area. Each of these areas is identified in GFAFBI 31-101 and each is conspicuously identified by posted signs.

1.6.6 Work in Restricted/Controlled areas.

1.6.6.1 Restricted Areas

Restricted Areas: Contractor’s personnel must be escorted by Owner/User of the area when in the restricted area. Work in this area may require the creation of a free zone so the contractor’s personnel can work in the area without security escorts. The contractor shall work with the Owner/User of the restricted area to establish this area. The request to establish this free zone is to be initiated by the Owner/User of the area in question. Once the Free Zone is authorized, Security Forces will assist in the establishment of the area per GFAFBI 31-101 requirements. Contractor personnel may need to be escorted by the Owner/User from the perimeter of the restricted area to the free zone and back out.

1.6.6.2 Controlled Areas

Controlled Areas: Contractor’s personnel must be escorted by owner/user of the area when in the controlled area. Work in this area may require the creation of a free zone so the contractor’s personnel can work in the area without security escorts. The contractor shall work with the Owner/User of the controlled area to establish this area. Once the Free Zone is authorized, Security Forces will assist in the establishment of the area per GFAFBI 31-101 requirements.

Contractor personnel may need to be escorted by the owner/user from the perimeter of the controlled area to the free zone and back out.

1.6.6.3 Free Zones

Contractors will be required to provide weighted construction barrels and rope to mark the free zone.

1.6.6.4 Opening/Closing Work Area

Contractor must contact Security Forces at 747-5351 when the area is opened or closed.

1.6.7 Minimum Security Requirements (All Areas Including Base Entry)

1.6.7.1 Visitor Passes

The Commercial Visitor Control Center will issue a SFMIS AF Form 75 (Visitor Pass) to the contractor and his/her employees upon completion of screening process for the duration of the contact. The screening process takes time, and the contractor shall visit the Commercial Visitor Control Center prior to expecting base entry to receive required forms and instruction on the application process, to include estimated time of receiving the visitor pass.

1.6.7.2 Vehicles on the Installation

Although contractors will not be issued vehicles passes vehicles are subject to search while on the installation. Employee privately owned vehicles will not be allowed access to restricted/controlled areas without a free zone being established. Company vehicles will be allowed access to restricted/controlled areas.

1.6.7.3 Contractor Vehicles

All Contractor vehicles should have markings with the company name for quick identification of ownership and notification if they are involved in an incident.

1.6.7.4 Conduct Requirements

The contractor shall ensure that his/her employees comply with all base traffic regulations and properly conduct themselves while on the base.

1.6.8 Information Protection

1.6.8.1 Security Requirements

The security manager for the Sponsoring unit (i.e. LRS, CE etc..) will determine individual requirements for contractor personnel to have a background check.

Contractor personnel performing work under this contract must be able to obtain access to Grand Forks AFB, by having favorable clearance at time of the contract award.

1.6.8.2 National NACI

If a National NACI is determined to be required by the security manager, the security manager will coordinate the check with the wing Information Security Office.

1.6.9 Anti-Terrorism

1.6.9.1 All contractor employees requiring access to any Federally controlled facility and logical access to Federally controlled information systems except for “national security systems” as defined by 44 U.S.C. 3542(b)(2), should be certified in Level 1 Anti-Terrorism Training. The training is accessible from any computer with access to the World Wide Web and is available at https:/atlevel1.dtic.mil/at. The contractor is responsible for ensuring that the training has been satisfactorily completed and that valid certificates of completion have been submitted to the Customer with a copy furnished to the Contracting Officer. The Certificates are valid for one year;

therefore, training shall be completed every year for the duration of the contract.

1.6.9.2 Unit anti-terrorism managers will be responsible for organizing this level 1 training.

1.6.10 OPSEC

1.6.10.1 General. Contractors who have access to mission critical information require a general knowledge of threats, vulnerabilities and their responsibilities associated with protecting critical information. This is accomplished through initial and annual OPSEC training. Standardized AF OPSEC awareness training located on the AF Advanced Distributed Learning Service (ADLS) is the baseline training required for all personnel. Organization specific training will be provided in addition to this training to ensure all personnel in the Air Force are aware of local threats, vulnerabilities and critical information unique to their duty assignment.

1.6.10.2 Opsec the customer units Coordinator (319 CES) will provide OPSEC training or training materials to contract employees within 90 days of employees’ initial assignment to the contract.

1.6.11 Physical Security:

The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.6.12 Key Control:

The contractor shall establish and implement methods of making sure all keys/key cards issued to the contractor by the government are not lost or misplaced and are not used by unauthorized persons. If keys are required to be issued, they will be signed for by the contractor.

NOTE: All references to keys include key cards. No keys issued to the contractor by the government shall be duplicated. The contractor shall develop procedures covering key control that shall be included in the QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the CO and/or 319 CES POC.

In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon direction of the CO, re-key or replace the affected lock or locks; however, the government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the next payment due the contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the government and the total cost deducted from the next payment due the contractor.

The contractor shall prohibit the use of government issued keys/key cards by any persons other than by contractor employees. The contractor shall prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the CO.

1.6.14 Lock Combinations:

The contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s Quality Control Plan.

1.6.15 Special Qualifications:

Contractors’ inspection team must include a Class B Operator as defined by CFR Title 40 part 280 and they must follow the Petroleum Equipment Institute RP-1200 manual for “Testing of UST Spill, Overfill, Leak Detection and Secondary Containment” as identified on the required ND DEQ reporting forms. Current training certifications will be available upon request of the CO/319 CES

POC.

1.6.16 Post Award Conference/Periodic Progress Meetings:

The contractor agrees to attend any post award conference(s) convened by the contracting activity or contract administration office IAW the Federal Acquisition Regulation (FAR), Subpart 42.5.

The CO, 319 CES POC, and other government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the CO will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the government of problems, if any are being experienced. Appropriate action shall be taken to resolve outstanding issues. Meetings can be scheduled at any time by the contractor or the CO to ensure open lines of communication are maintained. These meetings shall be at no additional cost to the government.

1.6.17 Key Personnel:

The follow personnel are considered key personnel by the government: The contractor shall provide a contract manager who shall be responsible for the performance of all work performed by the contractor. The name and contact information for this person, and an alternate, who shall have the ability to act on behalf of the contractor when the manager is absent shall be designated in writing to the CO and/or 319 CES POC. The contract manager or alternate shall have full authority to act on behalf of the contractor while work is being performed on all contract matters relating to daily operation of this contract. The contract manager, or alternate, shall be available between 7:30am and 4:30pm, local time, Monday through Friday, except federal holidays listed above, or when the government facility is closed for administrative or other reasons.

1.6.18 Identification of Contractor Employees:

All contractor personnel attending meetings, answering government telephones, and working in other situations where their contractor’s status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are government officials. Contract personnel must have a contractor issued shirt, hat, or badge, identifying them as an employee of the contractor’s company. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

1.6.19 Data Rights

The government has unlimited rights to all documents and material produced under this contract.

All documents and materials, to include the source codes of any software, produced under this contract shall be government owned, and are the property of the government, with all rights and privileges of ownership and copyright belonging exclusively to the government. These documents and materials may not be used or sold by the contractor without written permission from the CO.

All materials must be turned over to the government, and shall be the sole property of the government, and may not be used for any other purpose. This right does not repeal, or do away with, any other government rights.

1.6.20 Organizational Conflict of Interest:

Contractor and subcontractor personnel performing work under this contract may receive, have access to, or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications, or work statements, etc.), or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR, Subpart 9.5. The contractor shall notify the CO and/or 319 CES POC immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the CO and/or 319 CES POC to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the CO, and in the event the CO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the CO may affect other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.6.21 Contractor Manpower Reporting:

The Contractor shall report all contractor labor hours (including sub-contractor labor hours) required for performance of services provided under this contract for “U.S. Air Force” via a secure data collection site. The Contractor is required to completely fill in all required data fields using the following web address http://sam.gov/content/home/. Reporting inputs will be for the labor executed during the period of performance during each government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the Systems of Award Management (SAM) help desk.

http://sam.gov/content/home/

2. DEFINITIONS & ACRONYMS

2.1 Definitions:

Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

Contracting Officer: A person with authority to enter into, administer, and/or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

Defective Service: A service output that does not meet the standard of performance associated with the Performance Work Statement.

Deliverable: Anything that can be physically delivered but may include non-manufactured items such as meeting minutes and/or reports.

Key Personnel: Contractor personnel that are required to be used in the performance of a contract by the Key Personnel listed in the Performance Work Statement.

Physical Security: Actions that prevent the loss or damage of government property.

Quality Assurance: The government procedures to verify that services being performed by the contractor are performed according to acceptable standards.

Quality Control: All necessary measures taken by the contractor to assure that the quality of an end product or service shall meet contract requirements.

Subcontractor: One that enters a contract with a prime contractor. The government does not have privity of contract with the subcontractor.

Workday: The number of hours per day the contractor provides services in accordance with the contract.

Workweek: Monday through Friday, unless specified otherwise.

2.1 Acronyms:

AAFES: Army & Air Force Exchange Service AFJAM: Air Force Joint Manual AGE: Air Ground Support Equipment CFR:

Code of Federal Regulations CO: Contracting Officer Communications DAF: Department of the Air Force ELLD:

Electronic Line Leak Detection EPA:

Environmental Protection Agency FAR:

Federal Acquisition Regulation GUP:

Gasoline Unleaded Premium GUR:

Gasoline Unleaded Regular HQ: Headquarters IAW: In Accordance With IM:

Interstitial Monitoring MLLD: Mechanical Line Leak Detection NDAC: North Dakota Administrative Code ND DEQ: North Dakota Department of Environmental Quality OCI:

Organizational Conflict of Interest PIPO: Phase In/Phase Out POC: Point of Contact POL: Petroleum, Oil, and Lubricant POP: Period of Performance PRT: Product Recovery Tank PRS: Performance Requirements Summary PWS: Performance Work Statement QCP: Quality Control Program TE: Technical Exhibit UST: Underground Storage Tank

3 Deliverables Schedule

Deliverable Frequency # of Copies Medium Format Submit To

A0001 - ND DEQ Within ten (10) One (1) copy Adobe Acrobat Electronic

319 CES POC

identified at post award conference.

Test Form Report business day of per tank tested. Form from the Para 1.4. test completion. ND DEQ website

A0002 - Test Within ten (10) One (1) copy Adobe Acrobat Electronic

Failure Report business day of per tank tested. Form from the 319 CES POC Para 1.4 test failure ND DEQ website identified at completion post award only. conference.

A0003 – Quality Control Program Written document Para 1.6

Within thirty (30) business day after contract award

One (1) copy

Adobe Acrobat document

Contracting officer and/or

319 CES POC

identified at post award conference

A0004 – Testing Schedule Para 1.6.2

Within fourteen

(14) business day prior to tank testing

One (1) testing schedule

Adobe Acrobat document

319 CES POC

identified at post award conference

4 Estimated Workload

Base yr (2025) Annual Every 3 years

Tank ID

Line Tightness Test for each pipe run contractor form

MLLD

Functionality

Test

SFN 62229

ELLD

SFN 62238

Piping Sump Sensor

Functionality Test

SFN 62153

Under Dispenser Sump (UDC)

Sensor Functionality

Test

SFN 62153

Tank Interstitial Probe

Functionality Test

SFN 62153

Spill Bucket Integrity Test -

Hydrostatic

SFN 62224

SFN 62222

Under Dispenser

Sump (UDC) Integrity Test -

Overfill Equipment Functionality Test -

Alarm Operation

SFN 62146

Functionality Test - Automatic Shutoff

Device

SFN 62218

Pr es su riz ed

240-1-2 1 1 2 (UDC 1/2 & UDC 3/4) 1

240-2-2 1 1 2 (UDC 5/6 & UDC 7/8) 1

454-1-2 1 2 (UDC 5/6 & UDC 7/8) 1

454-2-2 1 2 (UDC 1/2 & UDC 3/4) 1

454-3 1 1 (UDC 9/10) 1

661-1* 1 (North) 1 (UDC 1) 1 1 (UDC 1)

661-2 1 1 1 (UDC 2) 1 1 1

661-3 1 1 1 (UDC 3) 1

Sa fe S uc tio n 314-1 1

580-1 1

605-1 1

649-2 1

661-4 1 Total each test 4 4 3 1 12 13 1 0 1 0 1

* 661-1 has post 2009 pipingmodifications so requires IMtestingfor lines. 3-yr pipingsump integritytest last passing2023. 3-yr UDC sump to be re-tested after repair.

Option yr 1 (2026) Annual Every 3 years

Sensor

Functionality Test

SFN 62153

Under Dispenser Sump (UDC)

Sensor Functionality

Test

SFN 62153

Tank Interstitial

Dispenser

Sump (UDC) Integrity Test -

Functionality Test -

Pr es su

240-1-2 1 1 2 (UDC 1/2 & UDC 3/4) 1 1 1

240-2-2 1 1 2 (UDC 5/6 & UDC 7/8) 1 1 1

454-1-2 1 2 (UDC 5/6 & UDC 7/8) 1 1 1

454-2-2 1 2 (UDC 1/2 & UDC 3/4) 1 1 1

454-3 1 1 (UDC 9/10) 1 1 1

661-1* 1 (North) 1 (UDC 1) 1 1 1 (North) 1 (UDC 1) 1

661-2* 1 1 1 (UDC 2) 1 1 1

661-3 1 1 1 (UDC 3) 1 1 1

Sa fe S uc tio n 314-1 1

580-1 1

605-1 1

649-2 1

661-4 1

Total each test 4 4 3 1 12 13 8 0 1 5 3

* Repeat these 3 year tests from 2025 to get tests/tanks on same schedule at B661

Option yr 2 (2027) Annual Every 3 years

Sensor

Functionality Test

SFN 62153

Under Dispenser Sump (UDC)

Sensor Functionality

Test

SFN 62153

Tank Interstitial

Dispenser

Sump (UDC) Integrity Test -

Functionality Test -

Pr es su

454-1-2 1 2 (UDC 5/6 & UDC 7/8) 1

454-2-2 1 2 (UDC 1/2 & UDC 3/4) 1

454-3 1 1 (UDC 9/10) 1

661-1 1 (North) 1 (UDC 1) 1

661-2 1 1 1 (UDC 2) 1

661-3 1 1 1 (UDC 3) 1

Sa fe S uc tio n 314-1 1

580-1 1

605-1 1

649-2 1

661-4 1 Total each test 4 4 3 1 12 13 0 0 0 0 0

Option yr 3 (2028) Annual Every 3 years

Sensor

Functionality Test

SFN 62153

Under Dispenser Sump (UDC)

Sensor Functionality

Test

SFN 62153

Tank Interstitial

Dispenser

Sump (UDC) Integrity Test -

Functionality Test -

Pr es su

454-1-2 1 2 (UDC 5/6 & UDC 7/8) 1

454-2-2 1 2 (UDC 1/2 & UDC 3/4) 1

454-3 1 1 (UDC 9/10) 1

661-1 1 (North) 1 (UDC 1) 1

661-2 1 1 1 (UDC 2) 1

661-3 1 1 1 (UDC 3) 1

Sa fe S uc tio n 314-1 1

580-1 1

605-1 1

649-2 1

Total each test 4 4 3 0 12 13 0 0 0 0 0

Option yr 4 (2029) Annual Every 3 years

Sensor

Functionality Test

SFN 62153

Under Dispenser Sump (UDC)

Sensor Functionality

Test

SFN 62153

Tank Interstitial

Dispenser

Sump (UDC) Integrity Test -

Functionality Test -

Pr es su

240-1-2 1 1 2 (UDC 1/2 & UDC 3/4) 1 1 1

240-2-2 1 1 2 (UDC 5/6 & UDC 7/8) 1 1 1

454-1-2 1 2 (UDC 5/6 & UDC 7/8) 1 1 1

454-2-2 1 2 (UDC 1/2 & UDC 3/4) 1 1 1

454-3 1 1 (UDC 9/10) 1 1 1

661-1 1 (North) 1 (UDC 1) 1 1 1 (North) 1 (UDC 1) 1

661-2 1 1 1 (UDC 2) 1 1 1

661-3 1 1 1 (UDC 3) 1 1 1

Sa fe S uc tio n 314-1 1

580-1 1

605-1 1

649-2 1

Total each test 4 4 3 1 12 13 8 1 1 5 3

Attachment 1

ND DEQ Testing Forms

This data sheet can be used to record tests for mechanical line leak detectors (MLLD) with submersible turbine pump (STP) systems. See PEI/RP1200-17, Section 9.1 for inspection procedures.

FACILITY INFORMATION

Facility Name Telephone Number

Address City State ZIP Code

TESTER INFORMATION

Name of Tester: Name of Company:

Telephone Number Email Address:

MLLD (ALL PRESSURE MEASUREMENTS ARE MADE IN PSIG)

Date of Test:

Line ID

Product Stored

Leak Detector Manufacturer

Leak Detector Model

STP Full Operating Pressure

Check Valve Holding Pressure

Line Resiliency (ml) (line bleed back volume as measured from check valve holding pressure to 0 psig)

Step through time in seconds (time the MLLD hesitates at metering pressure before going to full operating pressure as measured from 0 psig with no leak induced on the line)

Does the STP pressure remain at or below the metering pressure for at least 60 seconds when the simulated leak is induced?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Does the leak detector reset (trip) when the line pressure is bled off to zero psig? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Does the STP properly cycle on/off under normal fuel system operating conditions? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Pass/Fail Criteria: A “No” to any item indicates a test failure.

Test Results □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail

Comments:

ND DEQ, Underground Storage Tank Program, 4201 Normandy Street, Bismarck ND 58503

MECHANICAL LINE LEAK DETECTOR PERFORMANCE TESTING

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT – UST PROGRAM Telephone: 701-328-5166 SFN 62229 (09/2022) Fax: 701-328-5200

Email: ndust@nd.gov Website: https://deq.nd.gov/wm

Clear Form mailto:ndust@nd.gov https://deq.nd.gov/wm

This data sheet can be used to record tests for electronic line leak detectors (ELLD) with submersible turbine pump (STP) systems. See PEI/RP1200-17, Section 9.2 for inspection procedures.

TESTER INFORMATION

Name of Tester Name of Company

Telephone Number Email Address

ELLD (All Pressure Measurements are Made in PSIG)

Line ID

Product Stored

Leak Detector Manufacturer

Leak Detector Model

How many test cycles are observed before alarm/shutdown occurs?

Does simulated leak cause an alarm? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Does the simulated leak cause an STP shutdown?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

□ N/A

□ N/A

□ N/A

□ N/A

□ N/A

□ N/A

Pass/Fail Criteria: A “No” answer to the above question indicates the ELLD fails the test.

Test Results □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail Comments:

ND DEQ, Underground Storage Tank Program, 4201 Normandy Street, Bismarck ND 58503

ELECTRONIC LINE LEAK DETECTORS PERFORMANCE TESTING

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT - UST PROGRAM Telephone: 701-328-5166 SFN 62238 (09/2022) Fax: 701-328-5200

This procedure is used to test the leak integrity of spill buckets. See PEI/RP1200-17, Section 6.2 for hydrostatic test method.

SUMP TESTER INFORMATION

SUMP TEST

Tank Number

Product Stored

Spill Bucket Capacity

Liquid and debris removed from bucket? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No Visual inspection (No cracks, loose parts or separation of containment sump)

□ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail

Tank riser cap included in a test? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Is drain valve included in test?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

□ N/A □ N/A □ N/A □ N/A □ N/A □ N/A

Starting Water Level

Test Start Time

Ending Water Level

Test End Time

Test Period (minimum Test Time: 1 Hour)*

Water Level Change

Pass/Fail Criteria: Must pass visual inspection and water level drop of less than 1/8 inch.

Test Results □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail

Comments:

ND DEQ, Underground Storage Tank Program, 4201 Normandy Street, Bismarck ND 58503

SPILL BUCKET INTEGRITY TESTING – HYDROSTATIC TESTING METHOD

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT - UST PROGRAM Telephone: 701-328-5166 SFN 62224 (09-2022) Fax: 701-328-5200

This procedure is to determine whether liquid sensors located in the interstitial space of UST systems are able to detect the presence of water and fuel. See PEI/RP1200 Section 8.3 for the test procedure.

Date of Test: Tank ID: Tank ID: Tank ID: Tank ID: Tank ID:

Sensor Location

Product Stored

Type of Sensor Discriminating Non- Discriminating

Discriminating Non- Discriminating

Discriminating Non- Discriminating

Discriminating Non- Discriminating

Discriminating Non- Discriminating

Test Liquid Water Product

Water Product

Water Product

Water Product

Water Product

Is the ATG console clear of any active or recurring warnings or alarms regarding the leak sensor? If the sensor is in alarm and functioning, indicate why.

Yes ❑ No

Is the sensor alarm circuit operational? Yes ❑ No Yes ❑ No Yes ❑ No Yes ❑ No Yes ❑ No

Has sensor been inspected and in good operating condition? ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No

When placed in the test liquid, does the sensor trigger an alarm? Yes ❑ No Yes ❑ No Yes ❑ No Yes ❑ No Yes ❑ No

When an alarm is triggered, is the sensor properly identified on the ATG console?

❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No

Any “No” answers indicate the sensor fails the test.

Test Results Pass ❑ Fail Pass ❑ Fail Pass ❑ Fail Pass ❑ Fail Pass ❑ Fail

Comments/Repairs/Retest:

LIQUID SENSOR FUNCTIONALITY TESTING

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT - UST PROGRAM Telephone: 701-328-5166 SFN 62153 (03-2022) Fax: 701-328-5200

Clear Form Website: https://deq.nd.gov/wm

This data sheet is for inspecting automatic shut off devices. See PEI/RP1200-17, Section 7 for inspection procedures.

Address City State Zip Code

AUTOMATIC SHUTOFF DEVICE INSPECTION

Tank Volume, gallons

Tank Diameter, inches

Drop tube removed from tank? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Drop tube and float mechanisms free of debris? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Float moves freely without binding and poppet moves into flow path?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Bypass valve in the drop tube open and free of blockage (if present)?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Flapper adjusted to shut off flow at 95% capacity? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Pass/Fail Criteria: A “No” to any item indicates a test failure.

Test Results □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail

Comments:

ND DEQ, Underground Storage Tank Program, 4201 Normandy Street, Bismarck ND 58503

OVERFILL EQUIPMENT INSPECTION – AUTOMATIC SHUTOFF DEVICE

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT - UST PROGRAM Telephone: 701-328-5166 SFN 62218 (09/2022) Fax: 701-328-5200

This procedure is to determine whether the overfill alarm is operating properly and will trigger an alarm when the tank is no more than 90% full. See PEI/RP1200-17, Section 7.3 for inspection procedures. This procedure is applicable to tank level monitor stems that touch the bottom of the tank when in place.

Date of Test Tank ID Tank ID Tank ID Tank ID Tank ID

1. Tank Volume, gallons

2. Tank Diameter, inches

3. Overfill alarm activates in the test mode at the console? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

4. When activated, overfill alarm can be heard or seen while delivering to the tank?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

5. After removing the probe from the tank, it has been inspected and any damaged or missing parts replaced?

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

6. Float moves freely on the stem without binding? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

7. Moving product level float up the stem trigger alarm? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

8. Inch level from bottom of stem when 90% alarm is triggered? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

9. Tank volume at inch level in line 8.

10. Calculate (Line 9 / Line 1) x 100

11. Is Line 10 less than 90% □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

12. Fuel float level on the console agrees with the gauge stick reading? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

13. Overfill alarm activates at any product level above 90% tank capacity? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Pass/Fail Criteria: If any answers to Lines 3, 4, 5, 6, 7 or 11 are “No,” or line 13 is “Yes”, the system has failed the test.

Test Results □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail

Comments/Repairs/Retest

OVERFILL ALARM OPERATION INSPECTION

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT - UST PROGRAM Telephone: 701-328-5166 SFN 62146 (02-2022) Fax: 701-328-5200

Clear Form Email: ndust@nd.gov

This procedure is used to test the leak integrity of containment sumps which include piping sumps and under dispenser containment sumps. This procedure is not used to test spill buckets. See PEI/RP1200-17, Section 6.5 for test method.

FACILITY INFORMATION

Address City State ZIP Code

Telephone Number Email Address

SUMP TEST

Date of Test:

Containment Sump ID

Containment sump material

Liquid and debris removed from sump? □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Visual inspection (No cracks, loose parts or separation of containment sump)

□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No

Containment sump depth

Height from bottom to top of highest penetration

Starting Water Level

Test Start Time

Ending Water Level

Test End Time

Test Period (minimum Test Time: 1 Hour)**

Water Level Change

Pass/Fail Criteria: Must pass visual inspection and water level drop of less than 1/8 inch.

Test Results □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail □ Pass □ Fail

** Accelerated precision hydrostatic tests may be used. See PEI/RP1200-17, Section 6.6.

ND DEQ, Underground Storage Tank Program, 4201 Normandy Street, Bismarck ND 58503

CONTAINMENT SUMP INTEGRITY TESTING – HYDROSTATIC TESTING

METHOD

NORTH DAKOTA DEPARTMENT OF ENVIRONMENTAL QUALITY

DIVISION OF WASTE MANAGEMENT – UNDERGROUND STORAGETANK PROGRAM

SFN 62222 (09-2022) Telephone: 701-328-5166

Fax: 701-328-5200 Clear Form Email: ndust@nd.gov