Attachment3_Form 66.pdf

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Attached to
Repair Fuel Pumphouse 2 Containment Federal contract opportunity
Solicitation number
FA500021R0035
Issued by
Department of the Air Force Pacific Air Forces

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AF FORM 66, OCT 99 Previous Edition Will Be Used

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B ER Note: 3 copies required per submittal.

Government will retain all submittals.

Provide an electronic copy for each submittal.

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NOTES

GENERAL

1 Project Specific Form 66 X NTP + 10 2 Construction Schedule X NTP + 10 3 Contractor's QA/QC Plan X NTP + 10 4 673 ABW Form 3 X Prior to Start 5 Material Safety Data Sheet (MSDS) X See Notes MSDSs must be submitted and approved by the Government prior to procurement of all potential hazardous materials.

6 Notice of Start of Work X NPT +10 Request Letter 7 Notice of Utility Outages X 14 Days Prior Request Letter 8 Fence Plan X NTP + 10 9 Quality Control Plan X NTP + 10

10 Record of Proper Disposal X Completion of Disposal

11 Operation of On-Base Gravel Extraction Pit X Prior to Extraction 12 Hazzard Communication Plan See Notes Minimum 20 working days prior to start of work

CIVIL

13 Fusion joint records X Completion +5 14 Shear gate X

15 FML X X

16 Blind flange X 17 Post indicator valve X 18 Heat trace channel X 19 Pipe X 20 Pipe Insulation X X 21 Pipe Jacket X 22 Sieve Analysis X 23 Density Tests X 3 Days After Test 24 Compaction Test Plan and Data X NTP + 10 25 Demolition Plan X Prior to Start 26 Concrete Admixtures X NTP + 10 27 Concrete Mix Design Data X NTP + 10 28 Concrete Strength X 3 Days After Test 29 Concrete Curing Materials and Methods X NTP + 10

HAZMAT

30 Environmental Pre-Construction Checklist X NTP + 10 31 JBER HAZMAT Usage Tracking Form X See Notes NLT 10 working days prior to material being brought onto installation 32 JBER HAZMAT Usage Tracking Form X See Notes NLT 7 working days after final acceptance 33 Fuel Spill Clean Up Plan X NTP + 10 34 Enviornmental Protection Plan X See Notes Within 15 working days after award and 10 days prior to preconstruction meeting

SOLICITATION /CONTRACT NUMBERPROJECT NAME

Repair Fuel Pumphouse 2 Contaiment

SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER TO BE COMPLETED BY CONTRACT ADMINISTRATOR

PROJECT NUMBER

FXSB 19-4700

FA500021F0035

FXSB 19-4700 Repair Fuel Pumphouse 2 Containment

Attachment#3_Form 66

AF FORM 66, OCT 99 Previous Edition Will Be Used

LI

N

E N

U M

B ER Note: 3 copies required per submittal.

Government will retain all submittals.

Provide an electronic copy for each submittal.

C

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PL

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NOTES

SOLICITATION /CONTRACT NUMBERPROJECT NAME

Repair Fuel Pumphouse 2 Contaiment

SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER TO BE COMPLETED BY CONTRACT ADMINISTRATOR

PROJECT NUMBER

FXSB 19-4700

35 Erosion and Sediment Control Plan X NTP + 10 36 Spill Prevention and Clean-Up Plan X NTP + 10

CLOSEOUT

O&M maint. data and maint manuals & Manufacturer's Warranty for All Equipment Installed X X X Install + 5

Factory and Field Test Certificates, Logs and Test Results X Before Acceptance

39 Completion of DD 1354 X Final + 7 40 As Builts X Final + 7

FA500021F0035

FXSB 19-4700 Repair Fuel Pumphouse 2 Containment

Attachment#3_Form 66

Submittal 1

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