Attachment 5 Submittal Register 12KV OH-UG.pdf

ENG FORM 4025, MAY 2017 Page 1 of 2 PREVIOUS EDITIONS ARE OBSOLETE.

U.S. Army Corps of Engineers (USACE)

TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, OR

MANUFACTURER'S CERTIFICATES OF COMPLIANCE

For use of this form, see ER 415-1-10; the proponent agency is CECW-CE.

DATE TRANSMITTAL NO.

SECTION I - REQUEST FOR APPROVAL OF THE FOLLOWING ITEMS (This section will be initiated by the contractor)

TO: FROM: CONTRACT NO. CHECK ONE:

THIS IS A NEW TRANSMITTAL

THIS IS A RESUBMITTAL OF

TRANSMITTAL

SPECIFICATION SEC. NO. (Cover only one section with each transmittal) PROJECT TITLE AND LOCATION THIS TRANSMITTAL IS FOR: (Check one)

FIO GA DA CR DA/CR DA/GA

ITEM

NO.

(See

Note 3) a.

DESCRIPTION OF SUBMITTAL ITEM

(Type size, model number/etc.)

b.

SUBMITTAL

TYPE CODE

(See Note 8) c.

NO.

OF

COPIES

d.

CONTRACT DOCUMENT

REFERENCE

CONTRACTOR

REVIEW

CODE

g.

VARIATION

Enter "Y" if requesting a variation

(See Note 6) h.

USACE

ACTION

CODE

(Note 9) i.

SPEC.

PARA. NO.

e.

DRAWING

SHEET NO.

f.

REMARKS I certify that the above submitted items had been reviewed in detail and are correct and in strict conformance with the contract drawings and specifications except as otherwise stated.

NAME OF CONTRACTOR

SIGNATURE OF CONTRACTOR

SECTION II - APPROVAL ACTION

ENCLOSURES RETURNED (List by item No.) NAME AND TITLE OF APPROVING AUTHORITY SIGNATURE OF APPROVING AUTHORITY DATE

ENG FORM 4025, MAY 2017 Page 2 of 2

INSTRUCTIONS

1. Section I will be initiated by the Contractor in the required number of copies.

2. Each Transmittal shall be numbered consecutively. The Transmittal Number typically includes two parts separated by a dash (-). The first part is the specification section number. The second part is a sequential number for the submittals under that spec section. If the Transmittal is a resubmittal, then add a decimal point to the end of the original Transmittal Number and begin numbering the resubmittal packages sequentially after the decimal.

3. The "Item No." for each entry on this form will be the same "Item No." as indicated on ENG FORM 4288-R.

4. Submittals requiring expeditious handling will be submitted on a separate ENG Form 4025-R.

5. Items transmitted on each transmittal form will be from the same specification section. Do not combine submittal information from different specification sections in a single transmittal.

6. If the data submitted are intentionally in variance with the contract requirements, indicate a variation in column h, and enter a statement in the Remarks block describing he detailed reason for the variation.

7. ENG Form 4025-R is self-transmitting - a letter of transmittal is not required.

8. When submittal items are transmitted, indicate the "Submittal Type" (SD-01 through SD-11) in column c of Section I.

Submittal types are the following:

SD-01 - Preconstruction SD-02 - Shop Drawings SD-03 - Product Data SD-04 - Samples SD-05 - Design Data SD-06 - Test Reports SD-07 - Certificates SD-08 - Manufacturer's Instructions SD-09 - Manufacturer's Field Reports SD-10 - O&M Data SD-11 - Closeout

9. For each submittal item, the Contractor will assign Submittal Action Codes in column g of Section I. The U.S. Army Corps of Engineers approving authority will assign Submittal

Action Codes in column i of Section I. The Submittal Action Codes are:

A -- Approved as submitted.

B -- Approved, except as noted on drawings. Resubmission not required.

C -- Approved, except as noted on drawings. Refer to attached comments.

Resubmission required.

D -- Will be returned by separate correspondence.

E -- Disapproved. Refer to attached comments.

F -- Receipt acknowledged.

X -- Receipt acknowledged, does not comply with contract requirements, as noted.

G -- Other action required (Specify)

K -- Government concurs with intermediate design. (For D-B contracts) R -- Design submittal is acceptable for release for construction. (For D-B contracts)

10. Approval of items does not relieve the contractor from complying with all the requirements of the contract.

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 1 OF 21 PAGES

SUBMITTAL REGISTER

CONTRACT NO.

TITLE AND LOCATION

12KV OVERHEAD TO UNDERGROUND POWER LINE REPLACEMENT

A C T I V I T Y

N O

R A N S M I T T

L

S P E

DESCRIPTION

ITEM SUBMITTED

R A G # R A

H

G

V

C T L A O S R S I A F / I E C A R T E I V O W N R

CONTRACTOR:

SCHEDULE DATES

ACTION

APPROVING AUTHORITY

MAILED

TO

CONTR/

DATE RCD

FRM APPR

AUTH

REMARKS

SUBMIT

APPROVAL

NEEDED

BY

MATERIAL

T I

D

DATE

DATE FWD

TO APPR

AUTH/

DATE RCD

FROM

CONTR

TO OTHER

REVIEWER

DATE RCD

FROM OTH

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

01 14 00 SD-01 Preconstruction Submittals List Of Contact Personnel 1.3.1.1 01 32 01 SD-01 Preconstruction Submittals Project Scheduler Qualifications 1.3 G Bar Chart Schedule 3.5 Project Schedule 3.1 G Preliminary Project Schedule 3.5.1 G Initial Project Schedule 3.5.2 G 01 33 00 SD-01 Preconstruction Submittals Submittal Register 1.9 G 01 35 29 SD-01 Preconstruction Submittals Accident Prevention Plan (APP) 1.7 G DO Health Hazard Control Plan 1.7.2.10 G Emergency Action Plan 1.7.2.11 G Standard Lift Plan 1.7.2.1 G Critical Lift Plan 1.7.2.2 G DO Activity Hazard Analysis (AHA) 1.8

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 2 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

SD-07 Certificates Crane Operators/Riggers 1.6.1.4 Hot Work Permit 1.9.1 Certificate of Compliance 1.12.4 Excavation Permit 3.7 Proof of Current Qualification 1.6.1.4 01 45 00 SD-01 Preconstruction Submittals Contractor Quality Control (CQC) 3.2 G Plan 01 57 19 SD-01 Preconstruction Submittals Environmental Protection Plan 1.8 G DO Monthly Solid Waste Disposal 1.9.5.1

Report

017800 PROJECT CLOSE OUT

SD-02 SHOP DRAWINGS

As-Built Drawings 1.2.1 G

SD-03 PRODUCT DATA

As-Built Record of Equipment and Material. 1.2.2 G Warranty Management Plan 1.3.1 G Final Cleaning 1.6 G

SD-11 CLOSEOUT SUBMITTALS

Record Drawings 1.2.1 G Post construction Survey 1.6.1 G

02 41 00 SD-01 Preconstruction Submittals Demolition Plan 1.2.2 G Existing Conditions 1.10

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 3 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

02 41 00 SD-07 Certificates

Notification 1.6 G

03 30 53 SD-03 Product Data

Air-Entraining Admixture 2.2.3.1

Accelerating Admixture 2.2.3.2 G

Water-Reducing or Retarding 2.2.3.3

Admixture

Curing Materials 2.2.10

Expansion Joint Filler Strips, 2.2.6

Premolded

Joint Sealants - Field Molded 2.2.7

Sealants

Conveying and Placing Concrete 3.2

Mix Design Data 2.3 G

Ready-Mix Concrete 2.3

Curing Compound 2.4.1

Mechanical Reinforcing Bar 2.2.5

Connectors

SD-06 Test Reports

Aggregates 2.2.2

Concrete Mixture Proportions 2.1.3 G

Compressive Strength Testing 3.9.3 G

Slump 3.9.3 G

Air Content 3.9.3

Water 2.2.4

SD-07 Certificates

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 4 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

03 30 53 Cementitious Materials 2.2.1

Pozzolan 2.2.1.2 Aggregates 2.2.2 Delivery Tickets 2.3 SD-08 Manufacturer’s Instructions Curing Compound 2.4.1

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 5 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

26 12 19.10 SD-02 Shop Drawings

Pad-mounted Transformer 1.5.1 G

Drawings

SD-03 Product Data

Pad-mounted Transformers 2.2 G

Acceptance Checks and Tests 3.7.1 G

SD-07 Certificates

Transformer Efficiencies 2.2.2.1 G

SD-09 Manufacturer’s Field

Reports

Transformer Test Schedule 2.7.1 G

Design Tests 2.7.2 G

Routine and Other Tests 2.7.3 G

SD-10 Operation and Maintenance

Data

Transformer(s) 1.6.1 G

26 13 01 SD-02 Shop Drawings

Switchgear Drawings 1.5.1 G

SD-03 Product Data

Fuse Time-Current Characteristic 1.5.3 G

Curves

Air Insulated Pad-mounted 2.1 G

Switchgear

Insulated High-Voltage 2.2 G

Connectors

Surge Arresters 2.3 G

SD-06 Test Reports

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 6 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

Acceptance Checks and Tests 3.4.1 G

SD-07 Certificates

Paint Coating System 1.5.2 G

26 13 01 SD-09 Manufacturer’s Field Reports

Switchgear Design and 2.6.1 G

Production Tests

SD-10 Operation and Maintenance

Data

Air Insulated Pad-Mounted 1.6.1 G

Switchgear Operation and

Maintenance

26 20 00 SD-07 Certificates

Fuses 2.9 G

SD-09 Manufacturer’s Field

Reports

Transformer Factory Tests 2.23.1

SD-10 Operation and Maintenance

Data

Metering 2.20 G

26 56 00 SD-02 Shop Drawings

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 7 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

Luminaire Drawings 1.5.1.1 G

Pole Drawings 1.5.1.2 G

SD-03 Product Data

Luminaires 2.2 G

Light Sources 2.3 G

26 56 00 LED Drivers 2.4 G Luminaire Warranty 1.7.1 G

Lighting Controls Warranty 1.7.2 G

Pole Warranty 1.7.3 G

Photosensors 2.5.1.1 G

Lighting Contactor 2.5.1.3 G

Poles 2.6 G

Brackets 2.6.3

SD-05 Design Data

Luminaire Design Data 1.5.2 G

Photometric Plan 1.5.6 G

SD-06 Test Reports

IES LM-79 Test Report 1.5.3 G

IES LM-80 Test Report 1.5.4 G

IES TM-21 Test Report 1.5.5 G

SD-08 Manufacturer’s Instructions

Poles 2.6

SD-10 Operation and Maintenance

Data

Lighting System 1.8.1 G

Exterior Lighting Control System 1.8.2 G

Maintenance Staff Training Plan 3.3.1.1 G

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 8 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

End-User Training Plan 3.3.1.2 G

31 00 00 SD-01 Preconstruction Submittals

Shoring 3.3 G

31 00 00 Dewatering Work Plan 1.4.3 G

SD-03 Product Data

Utilization of Excavated Materials 3.6 G

Shoulder Construction 3.11

SD-06 Test Reports

Testing 3.14

Borrow Site Testing 2.1

SD-07 Certificates

Testing 3.14

32 11 23 SD-03 Product Data

Plant, Equipment, and Tools 1.4 G

SD-06 Test Reports

Initial Tests 2.4.1 G

In-Place Tests 3.12.1 G

32 12 13 SD-03 Product Data

Caltrans and CARB 2.1.1

SD-06 Test Reports

Sampling and Testing 3.7

32 12 16.16 SD-02 Shop Drawings

Placement Plan 2.1 G

SD-03 Product Data

Mix Design 2.4 G

Contractor Quality Control 3.1 G

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 9 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

SD-04 Samples

Aggregates 2.2

Asphalt Cement Binder 2.3

32 12 16.16 SD-06 Test Reports

Aggregates 2.2 G QC Monitoring 3.1.3.9 SD-07 Certificates Asphalt Cement Binder 2.3 G Laboratory Accreditation and 1.6.9 Validation 32 17 23 SD-03 Product Data Surface Preparation Equipment 2.1.1.1 G List Application Equipment List 2.1.2 G Exterior Surface Preparation 3.2 Safety Data Sheets 1.3.1 G Reflective media for roads 2.2.6.1 G Waterborne Paint 2.2.1 G Solventborne Paint 2.2.2 G Thermoplastic compound 2.2.3 G Thermoplastic compound 3.3.2 G Raised Pavement Markers 2.2.5 G Primers and Adhesives SD-06 Test Reports Reflective Media for Roads 2.2.6.1 G Waterborne Paint 2.2.1 G Solventborne Paint 2.2.2 G

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 10 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

Thermoplastic Compound 2.2.3 G Thermoplastic Compound 3.3.2 G 32 17 23 Raised Pavement Markers 2.2.5 G Primers and Adhesives

Test Reports 3.4.1

SD-07 Certificates

Qualifications 1.3.2 G

Reflective Media for Roads 2.2.6.1

Waterborne Paint 2.2.1

Solventborne Paint 2.2.2

Volatile Organic Compound 1.3.1 G

Thermoplastic Compound 2.2.3

Thermoplastic Compound 3.3.2

SD-08 Manufacturer’s Instructions

Waterborne Paint 2.2.1 G

Solventborne Paint 2.2.2 G

Thermoplastic Compound 2.2.3 G

Thermoplastic Compound 3.3.2 G

33 71 01 SD-03 Product Data

Conductors 2.6 G

Insulators 2.5 G

Steel Poles 2.2.2 G

Wood Poles 2.2.1

Nameplates 2.17 G

Pole Top Switch 3.1.8 G

Cutouts 2.12 G

Surge Arresters 2.11 G

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 11 OF 21 PAGES

Guy Strand 2.7

SUBMITTAL REGISTER

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

33 71 01 Anchors 2.9

SD-05 Design Data

Steel Poles 2.2.2 G

Power-Installed Screw 3.1.3.2 G

Foundations

SD-06 Test Reports

Wood Crossarm Inspection 1.5.4

Report

Field Test Plan 1.5.4.1 G

Field Quality Control 3.5 G

Ground Resistance Test Reports 1.5.3 G

Medium-Voltage Preassembled 3.5.3 G

Cable Test

Sag and Tension Test 3.5.4 G

Low-Voltage Cable Test 3.5.5 G

Acceptance Checks and Tests 3.5.7

SD-07 Certificates

Steel Poles 2.2.2 G

Wood Poles 2.2.1 G

Wood Crossarms 2.3.1 G

SD-09 Manufacturer’s Field

Reports

Operation and Maintenance 1.6 G

Manuals

Operation and Maintenance 1.6.1 G

Manuals

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 12 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

33 71 01 SD-10 Operation and Maintenance

Data Operation and Maintenance 1.6 G Manuals Operation and Maintenance 1.6.1 G Manuals 33 71 02 SD-02 Shop Drawings Aluminum conductors 2.2.1 G Precast underground structures 1.5.1 G SD-03 Product Data Medium voltage cable 2.5 G Medium voltage cable joints 2.7 G Medium voltage cable 2.6 G terminations Precast concrete structures 2.13.2.1 G Sealing Material 2.13.2.4 Pulling-In Irons 3.5.3 Manhole frames and covers 2.13.3 G Handhole frames and covers 2.13.4 G Composite/fiberglass handholes 2.13.6 G Cable supports 2.14 G SD-06 Test Reports Medium voltage cable 2.16.2 G qualification and production tests Field Acceptance Checks and 3.18.1 G Tests

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 13 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

33 71 02 Arc-proofing test 2.16.1 G

Cable Installation Plan and 3.3 G Procedure SD-07 Certificates Cable splicer/terminator 1.5.2 G Cable Installer Qualifications 1.5.3 G 33 82 00 SD-02 Shop Drawings Telecommunications Outside 1.6.1.1 G Plant Telecommunications Entrance 1.6.1.2 G Facility Drawings SD-03 Product Data Wire and cable 2.7 G Cable splices, and connectors 2.4 G Closures 2.3 G Building protector assemblies 2.2.1 G Protector modules 2.2.2 G Spare Parts 1.8.2 G SD-06 Test Reports Pre-installation tests 3.4.1 G Acceptance tests 3.4.2 G Outside Plant Test Plan 1.6.3 G SD-07 Certificates Telecommunications Contractor 1.6.2.1 G Key Personnel 1.6.2.2 G Manufacturer's Qualifications 1.6.2.3 G

SUBMITTAL FORM,Jan 96 PREVIOUS EDITION IS OBSOLETE PAGE 14 OF 21 PAGES

CONTRACT NO.

TITLE AND LOCATION

T I V I

A N S M I T T

R A G # R A

V

C T L A O S R S I A F / I E C A R T E I V

CONTR/

DATE RCD

T I

AUTH/

DATE RCD

T I

ACTION

(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) (o) (p) (q) (r)

33 82 00 SD-08 Manufacturer’s Instructions

Building protector assembly 2.2.1 G installation

Cable tensions 3.1.7.1 G

SD-09 Manufacturer’s Field

Reports

Factory Reel Test Data 2.15.1 G

SD-10 Operation and Maintenance

Data

Telecommunications outside 1.6.1.1 G plant (OSP)

SD-11 Closeout Submittals

Record Documentation 1.8.1 G