Attachment 4 - Hazmat Authorization.pdf
PDF 148 KB Posted
- Attached to
- PKAB Maintain Missile Alert Fields (MAFs) Septic Tanks and Grease Traps (Services) AMENDMENT 03
- Solicitation number
- FA461326R0007
About this file
This is a Hazardous Materials Authorization Request form for federal construction work at F.E. Warren Air Force Base. The form is used by contractors to request approval for hazardous materials needed on military construction projects and must be submitted with manufacturer Safety Data Sheets (SDS) for each requested material.
The specific project documented is "Maintain/Pump Septic Tanks and Grease Traps at MAFs" under contract number GHLN 27-9987 at F.E. Warren AFB MAFs. The form identifies the F.E. Warren AFB Point of Contact as Fotios Papadopoulos (773-3379) and the Construction Management Representative as Carla J. Mlinar (773-3574). The form includes a data table for submitting hazardous material information, with columns for material name, manufacturer, product part number, container type and size, paint color/sheen, and projected quantity stored on-site. One material is listed in the example: Rust-Oleum Stops Rust Enamel Top Coat (Part #7779830), supplied in 12 oz aerosol cans, gloss black finish, with 35 units projected for on-site storage. Contractors may submit complete SDS documentation in lieu of completing the detailed HAZMAT information table.
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Text version
Environmental Protection Section 01 57 19.05 32 Page 32
SECTION 01 57 19.05 32
ATTACHMENT 1
HAZARDOUS MATERIALS AUTHORIZATION REQUEST
Contractor Name:
POC: Phone:
Project Name:
Project/Contract Number:
Contract Start Date/period: End Date: _
Location of Project:
F.E. Warren AFB POC: Phone:
Construction Mgmt Rep: Phone:
HAZMAT Information
Material Name Manufacturer
P r o d u c t
P a r
C o n t a i n e r
T y p
S i z a i n
C o l o h e o j e c t d
Q u a n t i y o r d
O
S i
Rust-oleum Stops
Rust Enamel Top
Coat
Rust-Oleum 7779830 12 oz
Aerosol
Can
Gloss
Black
Submission of this form must be accompanied by a copy of the
Manufacturer’s SDS for every HAZMAT requested. SDSs including all information requested below may be submitted in lieu of completing the
HAZMAT information table below.
| Contractor Name: |
| POC: |
| Phone: |
| Project Name: Maintain/Pump Septic Tanks and Grease Traps at MAFs |
| ProjectContract Number: GHLN 27-9987 |
| Location of Project: FE Warren AFB MAFs |
| FE Warren AFB POC: Fotios Papadopoulos |
| Phone_2: 773-3379 |
| Construction Mgmt Rep: Carla J. Mlinar |
| Phone_3: 773-3574 |
| Rustoleum Stops Rust Enamel Top CoatRow1: |
| RustOleumRow1: |
| 7779830Row1: |
| 12 oz Aerosol CanRow1: |
| Gloss BlackRow1: |
| 35Row1: |
| Rustoleum Stops Rust Enamel Top CoatRow2: |
| RustOleumRow2: |
| 7779830Row2: |
| 12 oz Aerosol CanRow2: |
| Gloss BlackRow2: |
| 35Row2: |
| Rustoleum Stops Rust Enamel Top CoatRow3: |
| RustOleumRow3: |
| 7779830Row3: |
| 12 oz Aerosol CanRow3: |
| Gloss BlackRow3: |
| 35Row3: |
| Rustoleum Stops Rust Enamel Top CoatRow4: |
| RustOleumRow4: |
| 7779830Row4: |
| 12 oz Aerosol CanRow4: |
| Gloss BlackRow4: |
| 35Row4: |
| Rustoleum Stops Rust Enamel Top CoatRow5: |
| RustOleumRow5: |
| 7779830Row5: |
| 12 oz Aerosol CanRow5: |
| Gloss BlackRow5: |
| 35Row5: |
| Rustoleum Stops Rust Enamel Top CoatRow6: |
| RustOleumRow6: |
| 7779830Row6: |
| 12 oz Aerosol CanRow6: |
| Gloss BlackRow6: |
| 35Row6: |
| Contract Start Dateperiod: |
| Contract End Dateperiod: |
File details come from the government source that posted it. Updated .