Attachment 5 Contractor Hazardous Waste Form.docx
DOCX document 19 KB Posted
- Attached to
- DBEH 22-1580 Replace HVAC Controls Federal contract opportunity
- Solicitation number
- FA252123B0003
About this file
This solicitation is for a firm fixed price construction contract to replace HVAC controls at five facilities for Space Launch Delta 45. Work will involve providing labor, equipment, and materials to replace HVAC automation servers and integrate new graphical user interface screens, data logs, and alarms at buildings located at Cape Canaveral Space Force Station and Jonathan Dickinson Missile Tracking Annex in Florida. The acquisition is set aside for Service-Disabled Veteran-Owned Small Businesses and has an estimated value between $500,000 and $1,000,000. Funds are contingent on availability and the Government reserves the right to cancel the solicitation before or after closing. The soliciting agency is the Department of the Air Force Space Command.
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Text version
PROJECT #:
| DBEH 22-1580 |
| PROJECT TITLE: |
| Replace HVAC Controls Facilities 55899, 66250, 28001, 1606, & 1428 |
CONTRACTOR:
POINT OF CONTACT:
PHONE:
FAX:
| HAZARDOUS MATERIAL: |
| DESCRIPTION OF PROCESS(ES) INVOLVING MATERIAL |
(INCLUDE METHOD OF APPLICATION)
| DESCRIPTION OF WASTE: |
| QUANTITY: |
FORECAST OF CONTRACTOR’S HAZARDOUS WASTE GENERATION
CONTRACTOR’S SIGNATURE ______________________________________ DATE ________________ Purpose: The Forecast of Contractor’s Hazardous Waste Generation is required to assist the installation to identify processes using hazardous materials and regulate the generation and disposal of hazardous waste.
Instructions: The Forecast of Contractor’s Hazardous Waste Generation form must be completed by any contractor who:
| 1) Must remove and dispose of paints, building components, or equipment containing hazardous materials (lead, mercury, etc.) |
| 2) Submits an MSDS for approval of use of a material known to be hazardous. |
On multi contractor projects, each contractor (sub-contractor) must specify each process requiring the use of hazardous materials and the potential waste to be generated.
1. Project #: Provide installation project number.
2. Project Title: Provide installation project title.
3. Contractor: Enter complete name of contractor performing process.
4. Point of Contact: Provide name of individual knowledgeable on requirements of materials listed.
5. Phone/Fax: Provide phone and fax numbers for point of contact.
6. Hazardous Material: Provide common name of each hazardous material
7. Description of Process(es) Requiring Material: Describe each process in which the material will be used (Thinning paint, cleaning tools, etc.). Describe methods of application where appropriate (applied to rag, sprayed gun, etc.).
8. Description of Waste: Provide description of anticipated waste stream or enter “none” if no waste is anticipated to be generated.
9. Quantity: Estimate quantity of waste to be generated
10. Sign and date each form at bottom
File details come from the government source that posted it. Updated .