Attachment 5 Facility ACM Report.pdf
PDF 11 MB Posted
- Attached to
- Kayenta Staff Quarters Abatement and Demolition
- Solicitation number
- 75H70123R00063
About this file
This document is an attachment to a federal solicitation for abatement and demolition services at the Kayenta Staff Quarters. The Indian Health Service is seeking bids to remove asbestos-containing materials from several buildings as identified in the 11MB facility assessment report. Contractors must be able to complete the abatement work by January 2023 and finish demolition of all structures by April 2023. Bids are due by October 15, 2022 and the award is expected to be made by November 2022. The set-aside is for small businesses owned by Alaska Native Corporations located in the state of Arizona.
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Other files
| File | Type | Posted |
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| B05 Amendment 3.pdf | ||
| B05 Amendment 2.pdf | ||
| B05 Amendment 1.pdf | ||
| MB01 23R00063.pdf | ||
| Attachment 4 Facility Lead Report.pdf | ||
| Attachment 10 Key Personnel Resume Form.docx | DOCX document | |
| Attachment 9 Specialized Experience Form.docx | DOCX document | |
| Attachment 7 Guidance Document for Managing Hazardous Materials in IHS Facilities.pdf | ||
| Attachment 11 Past Performance Questionnaire.docx | DOCX document | |
| Attachment 2 Project Location Map.pdf | ||
| Attachment 6 Plan for Discoveries.pdf | ||
| Attachment 3 Bldg Schedule.docx | DOCX document | |
| Attachment 8 Self Performed Calculation Sheet.docx | DOCX document | |
| Attachment 1 Wage Determination 2015-5477.pdf |
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ASBESTOS-CONTAINING MATERIAL (ACM) SAMPLING REPORT
KAYENTA SERVICE UNIT – KAYENTA HEALTH CENTER
KAYENTA, APACHE COUNTY, ARIZONA
March 15, 2012
4801 N. Butler Ave.
Farmington, NM 87401 www.iinábá.com Phone: (505) 327-1072
Fax: (505) 327-1517 iiná bá, Inc. Project No. IHS0000-00016 IHS Contract No. HHSI161201200001C
ATTACHMENT 5
75H70123R00063 Kayenta Staff Quarters Abatement and Demolition
APPENDIX 1 APPENDIX 1 APPENDIX 1 ——— FUNCTIONAL SPACE MAPS AND BULK SAMPLE LOGSFUNCTIONAL SPACE MAPS AND BULK SAMPLE LOGSFUNCTIONAL SPACE MAPS AND BULK SAMPLE LOGS
AAASBESTOSSBESTOSSBESTOS---CCCONTAININGONTAININGONTAINING MMMATERIALATERIALATERIAL (ACM) S(ACM) S(ACM) SAMPLINGAMPLINGAMPLING RRREPORTEPORTEPORT
KKKAYENTAAYENTAAYENTA SSSERVICEERVICEERVICE UUUNITNITNIT
KKKAYENTAAYENTAAYENTA, A, A, APACHEPACHEPACHE CCCOUNTYOUNTYOUNTY, A, A, ARIZONARIZONARIZONA
CCCONTRACTONTRACTONTRACT NNNOOO. HHSI161201200001C. HHSI161201200001C. HHSI161201200001C
WaterWastewaterSolid WasteRoadsStormwaterSubdivisionsSurveyingGIS
HydrologyAir QualityESASoil InvestigationsSPCCWater RightsLUST
PPREPAREDREPARED FFOROR::
IINDIANNDIAN HHEALTHEALTH SSERVICESERVICES
DDIVISIONIVISION OFOF FFACILITIESACILITIES MMANAGEMENTANAGEMENT & E& ENGINEERINGNGINEERING/OEHE/OEHE
P. O. BP. O. BOXOX 90209020
WWINDOWINDOW RROCKOCK, A, ARIZONARIZONA 8651586515
PPPREPAREDREPAREDREPARED BBBYYY:::
IINÁIINÁIINÁ BÁBÁBÁ, , , IIINCNCNC. . .
4801 N. B4801 N. B4801 N. BUTLERUTLERUTLER AAAVENUEVENUEVENUE, S, S, SUITEUITEUITE 110111011101
FFFARMINGTONARMINGTONARMINGTON, NM 87401, NM 87401, NM 87401
www.iinábá.comwww.iinábá.comwww.iinábá.com
PPPHONEHONEHONE: (505) 327: (505) 327: (505) 327---107210721072
FFFAXAXAX: (505) 327: (505) 327: (505) 327---151715171517
MMMARCHARCHARCH 15, 201215, 201215, 2012
APPENDIX 2 APPENDIX 2 APPENDIX 2 ——— POSITIVE BULK SAMPLE RESULTS, PHOTOGRAPHS AND COST POSITIVE BULK SAMPLE RESULTS, PHOTOGRAPHS AND COST POSITIVE BULK SAMPLE RESULTS, PHOTOGRAPHS AND COST
ESTIMATESESTIMATESESTIMATES
AAASBESTOSSBESTOSSBESTOS---CCCONTAININGONTAININGONTAINING MMMATERIALATERIALATERIAL (ACM) S(ACM) S(ACM) SAMPLINGAMPLINGAMPLING RRREPORTEPORTEPORT
KKKAYENTAAYENTAAYENTA SSSERVICEERVICEERVICE UUUNITNITNIT
KKKAYENTAAYENTAAYENTA, A, A, APACHEPACHEPACHE CCCOUNTYOUNTYOUNTY, A, A, ARIZONARIZONARIZONA
PPREPAREDREPARED FFOROR::
IINDIANNDIAN HHEALTHEALTH SSERVICESERVICES
DDIVISIONIVISION OFOF FFACILITIESACILITIES MMANAGEMENTANAGEMENT & E& ENGINEERINGNGINEERING/OEHE/OEHE
P. O. BP. O. BOXOX 90209020
WWINDOWINDOW RROCKOCK, A, ARIZONARIZONA 8651586515
PPPREPAREDREPAREDREPARED BBBYYY:::
IINÁIINÁIINÁ BÁBÁBÁ, , , IIINCNCNC. . .
4801 N. B4801 N. B4801 N. BUTLERUTLERUTLER AAAVENUEVENUEVENUE, S, S, SUITEUITEUITE 110111011101
FFFARMINGTONARMINGTONARMINGTON, NM 87401, NM 87401, NM 87401
www.iinábá.comwww.iinábá.comwww.iinábá.com
PPPHONEHONEHONE: (505) 327: (505) 327: (505) 327---107210721072
TABLE 1: SUMMARY OF POSITIVE ASBESTOS-CONTAINING MATERIAL BULK SAMPLES BY BUILDING
KAYENTA SERIVCE UNIT
Kayenta, Apache County, Arizona IHS Contract No. HHSI161201200001C iiná bá, Inc. Project No. – IHS0000-00016
Building No.1 Building Function1 Bulk Sample Material % ACM Present2 Functional Space Condition3 Color Photograph Available Quantity Present4
2002 General Residence White/Brown Floor Tile #1 Mastic 2% Room No. 2 Poor Black Yes 56 ft2
2003 Single-Family Home (3 BR) Floor Tile #2 Mastic 2% Room No. 3 Poor Black Yes 56 ft2
2003 Single-Family Home (3 BR) White/Gray Floor Tile #2 Mastic <1% Room No. 3 Poor Black Yes
2003 Single-Family Home (3 BR) White/Gray Floor Tile #3 Mastic <1% Room No. 8 Poor Black/Yellow Yes 144.5 ft2
2004 Single-Family Home (3 BR) Floor Tile #2 Mastic 2% Room No. 3 Poor Black Yes 120.75 ft2
2004 Single-Family Home (3 BR) Floor Tile #2 Mastic <1% Room No. 5 Poor Black Yes 48 ft2
2004 Single-Family Home (3 BR) Floor Tile #2 Mastic <1% Room No. 6 Poor Black Yes 24 ft2
2005 Single-Family Home (3 BR) White/Brown Floor Tile #2 Mastic 2% Room No. 5 Poor Black Yes 121 ft2
2006 Single-Family Home (3 BR) Floor Tile #2 2% Room No. 2 & 3 Poor Beige Yes 137.75 ft2
2006 Single-Family Home (3 BR) Floor Tile #3 Mastic <1% Room No. 6 Poor Black Yes 55 ft2
2007 Single-Family Home (2 BR) Beige Floor Tile #3 Mastic <1% Room No. 3 Poor Black/Yellow Yes
85.5 ft2
2007 Single-Family Home (2 BR) Beige Floor Tile #3 Mastic 2% Room No. 3 Poor Black/Yellow Yes
2008 Single-Family Home (2 BR) Floor Tile #1 Mastic <1% Room No.1 Poor Black Yes 283.5 ft2
2008 Single-Family Home (2 BR) Floor Tile #1 Mastic 2% Room No. 10 Poor Black Yes 35 ft2
2009 Single-Family Home (2 BR) Gray/Tan Floor Tile #1 Mastic <1% Room No. 1 Fair Black Yes 283.5 ft2
2010 General Administration White/Gray Floor Tile #2 Mastic 2% Room No. 3 Poor Black Yes 90.25 ft2
2012 Single-Family Home (3 BR) Floor Tile #3 5% Room No. 6 Poor White/Blue-Gray Yes 55 ft2
2012 Single-Family Home (3 BR) White/Blue-Gray Floor Tile #3 Mastic 2% Room No. 6 Poor Black Yes 55 ft2
2013 Single-Family Home (3 BR) Floor Tile #2 Mastic 2% Room No. 5 Poor Black Yes 121 ft2
2013 Single-Family Home (3 BR) Floor Tile #2 Mastic 3% Room No. 2 Poor Black Yes 90.25 ft2
3000 Maintenance Shop White/Beige Floor Tile #1 Mastic 5% Room No. 2 Poor Black Yes 45 ft2
3003-1 General Residence Floor Tile #1 Mastic 2% Room No. 2 Poor Black Yes 144 ft2
3003-1 General Residence Floor Tile #1Mastic 3% Room No. 3 Poor Black Yes
45 ft2 3003-1 General Residence Floor Tile #1 Mastic 2% Room No. 3 Poor Black Yes
3003-2 General Residence Floor Tile #1 Mastic <1% Room No. 3 Fair Black/Yellow Yes
3003-2 General Residence Floor Tile #2 Mastic 2% Room No. 5 Poor Black Yes
108 ft2 3003-2 General Residence Floor Tile #2 Mastic 4% Room No. 5 Poor Black Yes
3003-2 General Residence Floor Tile #2 Mastic 5% Room No. 5 Poor Black Yes
TABLE 1: SUMMARY OF POSITIVE ASBESTOS-CONTAINING MATERIAL BULK SAMPLES BY BUILDING (continued)
KAYENTA SERIVCE UNIT
Kayenta, Apache County, Arizona
IHS Contract No. HHSI161201200001C iiná bá, Inc. Project No. – IHS0000-00016
Building No.1 Building Function1 Bulk Sample Material % ACM Present2 Functional Space Condition3 Color Photograph Available Quantity Present
3004 House Trailer (3 BR) Floor Tile #1 Mastic 4% Room No. 100 Fair Black Yes 156 ft2
3004 House Trailer (3 BR) Floor Tile #1 Mastic 2% Room No. 101 Fair Black Yes 288 ft2
3005 House Trailer (3 BR) Yellow/Brown Floor Tile #3 Mastic 4% Room No. 107 Poor Black Yes 59.5 ft2
3006 House Trailer (3 BR) Marble Pattern Floor Tile 1.1% Unknown Unknown Unknown No Unknown
4001 House Trailer (3 BR) Roofing Tar <1% Ext. Roof Poor Black Yes 672 ft2
4001 House Trailer (3 BR) Roofing Tar 2% Ext. Roof Poor Black Yes
4011 House Trailer (3 BR) Hardened Sealant 2% - 5% Unknown Unknown Gray No Unknown
4013 Human Resources Black Roof Caulk <1% Roof Poor Silver/Black Yes 612 ft2
4015 House Trailer (3 BR) Floor Tile #2 Mastic 5% Room No. 3 Poor Black Yes
63.75 ft2 4015 House Trailer (3 BR) Floor Tile #2 Mastic 4% Room No. 3 Poor Black Yes
4015 House Trailer (3 BR) Floor Tile #2 Mastic 4% Room No. 3 Poor Black Yes
4015 House Trailer (3 BR) Flashing Tar 3% Roof Poor Silber Yes
672 LF 4015 House Trailer (3 BR) Flashing Tar 3% Roof Poor Silver Yes
4015 House Trailer (3 BR) Flashing Tar <1% Roof Poor Silver Yes
4018 House Trailer (3 BR) White/Tan Floor Tile #1 Mastic <1% Room No. 1 Poor Black/Yellow Yes 110 ft2
5110 House Trailer (3 BR) White/Tan Floor Tile #2 Mastic 3% Room No. 3 Poor Black Yes
63.75 ft2 5110 House Trailer (3 BR) White/Tan Floor Tile #2 Mastic 2% Room No. 3 Poor Black Yes
5110 House Trailer (3 BR) White/Brown Floor Tile #3 Mastic 2% Room No. 3 Poor Black Yes
5110 House Trailer (3 BR) Flashing Tar <1% Roof Poor Black Yes
672 LF 5110 House Trailer (3 BR) Flashing Tar <1% Roof Poor Black Yes
5110 House Trailer (3 BR) Flashing Tar <1% Roof Poor Black Yes
5113 House Trailer (3 BR) Brown/Tan Floor Tile #1 Mastic 4% Room No. 1 Poor Black Yes 110 ft2
5113 House Trailer (3 BR) Brown/Tan Floor Tile #1 Mastic 3% Room No. 1 Poor Black Yes
Footnotes:
1 – Denotes building number and function as represented on the Real Property Reported provided by Indian Health Service, Navajo Office.
2 – Denotes percentage of ACM as Chrysotile asbestos. Concentrations at or above 1% are regulated.
3 – “Condition” represents the “parent” bulk sample analyzed (e.g. tile, tar, shingle, etc.) and not the associated material testing positive, such as a mastic.
4 – Quantities of materials that are less than 1% ACM are not included in the abatement cost estimates.
ft2 – square feet.
LF – linear feet.
APPENDIX 3 APPENDIX 3 APPENDIX 3 ——— CERTIFIED LABORATORY ANALYTICAL RESULTSCERTIFIED LABORATORY ANALYTICAL RESULTSCERTIFIED LABORATORY ANALYTICAL RESULTS
AAASBESTOSSBESTOSSBESTOS---CCCONTAININGONTAININGONTAINING MMMATERIALATERIALATERIAL (ACM) S(ACM) S(ACM) SAMPLINGAMPLINGAMPLING RRREPORTEPORTEPORT
KKKAYENTAAYENTAAYENTA SSSERVICEERVICEERVICE UUUNITNITNIT
KKKAYENTAAYENTAAYENTA AAAPACHEPACHEPACHE CCCOUNTYOUNTYOUNTY, A, A, ARIZONARIZONARIZONA
PPREPAREDREPARED FFOROR::
IINDIANNDIAN HHEALTHEALTH SSERVICESERVICES
DDIVISIONIVISION OFOF FFACILITIESACILITIES MMANAGEMENTANAGEMENT & E& ENGINEERINGNGINEERING/OEHE/OEHE
P. O. BP. O. BOXOX 90209020
WWINDOWINDOW RROCKOCK, A, ARIZONARIZONA 8651586515
PPPREPAREDREPAREDREPARED BBBYYY:::
IINÁIINÁIINÁ BÁBÁBÁ, , , IIINCNCNC. . .
4801 N. B4801 N. B4801 N. BUTLERUTLERUTLER AAAVENUEVENUEVENUE, S, S, SUITEUITEUITE 110111011101
FFFARMINGTONARMINGTONARMINGTON, NM 87401, NM 87401, NM 87401
www.iinábá.comwww.iinábá.comwww.iinábá.com
PPPHONEHONEHONE: (505) 327: (505) 327: (505) 327---107210721072
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