Attachment 4 - HazMat Authorization Request.pdf
PDF 179 KB Posted
- Attached to
- PKAA - ATS Replacement & Disconnection (Service)
- Solicitation number
- FA461325Q0026
About this file
This document is a Hazardous Materials Authorization Request for Automatic Transfer Switch Replacement projects at F.E. Warren Air Force Base. The request covers three separate buildings (BLDG.34, BLDG.363, and BLDG.1284), each with a unique project/contract number. For all three locations, the contractor plans to use the same hazardous material: Rust-oleum Stops Rust Enamel Top Coat, a gloss black spray paint in 12 oz aerosol cans, with a projected on-site storage quantity of 35 cans.
The form requires submission of the Manufacturer's Safety Data Sheet (SDS) for the hazardous material, and provides space for detailed information about the material, including product part number (7779830), container type, and projected quantity. The project locations vary, including a mechanical room, an outer wall, and an electric room in different buildings. Each form is a template that would need to be filled out with specific contractor details, point of contact information, and contract dates.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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 i n l o h e o j e c t d
Q u a n t i o r
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.
BLDG.34 Automatic Transfer Switch Replacement
GHLN251779 - BLDG.34
Mechanical Room in BLDG.34
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 r n t a i n p i l o e o j e c t a n t i o r
S i
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.
BLDG.363 Automatic Transfer Switch Replacement
GHLN252377
The outer wall of BLDG.363
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 r n t a i n p i l o e o j e c t a n t i o r
S i
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.
BLDG.1284 Automatic Transfer Switch Replacement
GHLN252378
Electric Room in BLDG.1284
| GHLN251779-BLDG34 HazMat Authorization Request |
| GHLN252377-BLDG363 HazMat Authorization Request |
| GHLN252378-BLDG1284 HazMat Authorization Request |
File details come from the government source that posted it. Updated .