Attachments J-0200000-01 through 10.pdf

REAGIONAL LEAD, ASBESTOS Testing for the Hampton Roads Area of Responsibility

(AOR)

N40085-22-R-2635 Source Selection Plan

Rev Dec 2021 1

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY

SECTION J

DOCUMENTS, EXHIBITS, AND OTHER ATTACHMENTS

TABLE OF CONTENTS

ATTACHMENT

NUMBER

ATTACHMENT TITLE

J-0200000-01 DEFINITIONS AND ACRONYMS

J-0200000-02 WAGE DETERMINATIONS

J-0200000-03 DIRECTIVES, INSTRUCTIONS, AND REFERENCES

J-0200000-04 INVOICE FORM

J-0200000-05 FORMS

J-0200000-05-01 NNSY HAZARDOUS MATERIAL AND EMERGENCY PLANNING

J-0200000-05-02 REVIEW OF ASBESTOS REMOVAL PLANS

J-0200000-05-03 SOIL COVERAGE GUIDANCE

J-0200000-05-04 SOLID WASTE MANAGEMENT

J-0200000-05-05 SAMPLING AND MONITORING REQUEST FORM

J-0200000-05-06 ANNUAL EPCRA HAZARDOUS MATERIAL REPORT

J-0200000-05-07 PCB DISPOSAL

J-0200000-05-08 CONTRACT LEAD PAINT REMOVAL WORK PLAN

J-0200000-05-09 RECOVERED MATERIALS DETERMINATION FORM

J-0200000-05-10 BALLAST DISPOSAL

J-0200000-05-11 FLUORENT LIGHT DISPOSAL

J-0200000-05-12 HAZARDOUS WASTE MANAGEMENT

J-0200000-05-13 SERVICE INTERRUPTION REQUEST

J-0200000-05-14 CONTRACTOR INCIDENT REPORT SYSTEM (CIRS)

J-0200000-06 INSTALLATION SPILL CONTROL PLAN

J-0200000-07 CONTRACTOR HAZARDOUS MATERIAL INVENTORY LOG

J-0200000-08 EXHIBIT LINE ITEM NUMBERS

J-0200000-09 CORPORATE EXPERIENCE DATA SHEET

J-0200000-10 PAST PERFORMANCE QUESTIONNAIRE

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Rev Dec 2021 2

ATTACHMENT J-0200000-01

DEFINITIONS AND ACRONYMS

Definition Description Assessment A general term referring to either a survey or inspection of a facility to determine condition.

Asset A general term used to refer to an item, such as a component, system, building or facility, which is managed by an automated data management program.

Business Management System (BMS)

A web-based tool that provides a systematic method for the management of business processes, common practices, and process quality improvements that produce and support the most efficient and effective delivery of NAVFAC’s products and services.

Competent Person A person who has the professional experience and training necessary to identify existing and predictable hazards at a work or service environment, and who has the authority to take prompt and corrective action to eliminate or remove dangers from the environment.

Component Inventory Management Unit

(CIMU)

An organization of like-kind real property into manageable maintenance units. CIMU is a building component, group of components or component assemblies, serving a specific purpose in a facility that can be expected to follow a common and predictable lifecycle behavior. This class of non-equipment will include items such as exterior walls, exterior windows, interior finish, and roofs. This class of equipment will include items such as fan coil units, air handling units, lighting, and water closets. CIMUs can include one or more items of installed equipment typically subject to routine scheduled maintenance.

Confined Work Space A space that is large enough and so configured that a person may bodily enter a space (such as in tanks, vessels, silos, storage bins, hoppers, vaults, pits, and like spaces where there is limited means of entry) and is hindered or restricted from escaping during an emergency.

Contracting Officer

(KO)

That individual with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority as delegated by the Contracting Officer.

Contractor That entity or its representative responsible for the delivery of the services or materials specified in this contract, as designated by contract award. The term Contractor as used herein refers to both the prime Contractor and any subcontractors. The prime Contractor shall insure that subcontractors comply with the provision of this contract.

Contractor Representative

That individual appointed by the Contractor, either orally or in writing, who has been assigned responsibility for executing the requirements of this contract.

Direct Material Costs The actual vendor invoice charges for materials used for performance of work under this contract. Direct material costs shall include transportation charges when such charges are included on the invoice by the vendor, as well as any discounts allowed for prompt payment and discounts or rebates for core value or salvage value that accrue to the Contractor. When questions arise concerning the cost of materials, material costs will be based on the lowest of quotes provided by the Contractor from at least three different commercial vendors for the direct material cost. The Government retains the right to obtain additional quotes in questionable situations. The lowest price will be used.

Electronic Operation And Maintenance And Support Information (eOMSI)

A set of consultant-prepared data and document files that contain detailed, as-built technical information that describes the efficient, economical and safe operation, maintenance and repair of a facility, plant, equipment or system throughout its life cycle.

Generally it is prepared during construction and submitted upon completion of a new facility or major facility upgrade. eOMSI’s typically include asset information, staffing and budgeting information, supply support including critical spare parts, operating procedures, troubleshooting and diagnostic guides, extended warranty data, maintenance task frequencies and documentation, technical data, repair procedures and manufacturer’s product data. eOMSI data and document files are provided in electronic formats.

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Rev Dec 2021 3

Definition Description Equipment Tangible asset that is functionally complete for its intended purpose, durable, and non-expendable.

Facility A building or structure designed and created to serve a particular function.

Fixed Burden Rate

(FBR)

The additional costs (expressed in percent of direct material cost) for ordering, handling, and stockpiling materials and repair parts. For example, if the offeror's Fixed Burden Rate for materials in the Base Period is 10% then:

$100,000.00 + ($100,000.00 x 10%) = $110,000.00

The Government will compensate the Contractor for the required parts and materials and not the total amount shown in Schedule of Indefinite Delivery Indefinite Quantity Work.

Frequency Of Service Annual (A). Services performed once during each 12-month period of the contract at intervals of 335 to 395 days.

Biennial (B). Services performed once during each 24-month period of the contract at internals of 670 to 790 days.

Daily (D5). Services performed once each calendar day, Monday through Friday, including holidays unless otherwise noted.

Daily (D7). Services performed once each calendar day, seven days per week, including weekends and holidays.

Monthly (M). Services performed 12 times during each 12-month period of the contract at intervals of 28 to 31 calendar days.

Quarterly (Q). Services performed four times during each 12-month period of the contract at intervals of 80 to 100 calendar days.

Semiannual (SA). Services performed twice during each 12-month period of the contract at intervals of 160 to 200 calendar days.

Semimonthly (SM). Services performed 24 times during each 12-month period of the contract at intervals of 14 to 16 calendar days.

Three times weekly (3W). Services performed three times a week, such as Monday, Wednesday, and Friday.

Twice weekly (2W). Services performed twice a week, such as Monday and Thursday or Tuesday and Friday.

Weekly (W). Services performed 52 times during each 12-month period of the contract at intervals of six to eight calendar days.

Government Furnished Property (GFP)

Property in the possession of, or directly acquired by, the Government and subsequently furnished to the contractor for performance of a contract. Government furnished property includes, but is not limited to, spares and property furnished for repairs, maintenance, overhaul, or modification. Government furnished property also includes contractor acquired property if the contractor acquired property is a deliverable under a cost contract when accepted by the Government for continued use under the contract.

Infrastructure Condition Assessment Program

(ICAP)

A Navy automated data management program that utilizes historical asset lifecycle data and a structured assessment process to evaluate the condition facilities and their components.

Inspection A rigorous, detailed assessment of the condition of a facility performed to generate a fundable scope and cost estimate for prioritization and funding of maintenance and repair.

Job or Work Order An authorization for work that requires planning and estimating and has an individual line of accounting for financial and performance evaluation.

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Rev Dec 2021 4

Definition Description Maintenance And Repair

The preservation or restoration of a piece of equipment, system, or facility to such condition that it may be effectively used for its designated purposes. Maintenance/repair may be adjustment, overhaul, reprocessing, or replacement of constituent parts or materials that are missing or have deteriorated by action of the elements or usage, or replacement of the entire unit or system if beyond economical repair.

NAVFAC MAXIMO A specially configured software version of MAXIMO®, a commercially available computerized maintenance management system (CMMS), adopted by NAVFAC for enterprise facility asset data management. The terms “MAXIMO”, “NAVFAC MAXIMO” or “Government’s MAXIMO” shall be used interchangeably in the document.

Performance Assessment

A method used by the Government to provide some measure of control over the quality of purchased goods and services received.

Performance Assessment Representative (PAR)

That individual designated by the KO to be responsible for the monitoring of Contractor performance.

Pre-Expended Bin Materials And Supplies

The minor materials and supplies that are incidental to the job, for which the total direct cost of any one material line item shown on the material estimate is $10.00 or less.

Examples of pre-expended bin materials and supplies include, but are not limited to, solder, lead, flux, electrical connectors, electrical tape, fuses, nails, screws, bolts, nuts, washers, spacers, masking tape, sand paper, solvent, cleaners, lubricants, grease, oil, rags, mops, glue, epoxy, spackling compound, joint tape, plumbers tape and compound, clips, welding rods, and touch up paint.

Property Administrator An authorized representative of the Contracting Officer who is responsible for administering contract property requirements, terms and conditions of the contract

Property Management Program

A Government program established for the purpose of reviewing and approving the Contractor’s Property Management Plan and System through performance of a system analysis whenever government property is in the possession of the Contractor.

Quality Assurance

(QA)

The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled.

Quality Control (QC) The observation techniques and activities used to fulfill requirements for quality.

R. S. Means A data collection and organization system developed by R. S. Means Company which can be used to prepare accurate, dependable construction estimates and budgets in a variety of ways. The Contractor shall use the latest edition. Material prices are based on a national average and computed labor costs are based on a 30-city national average. An estimate prepared using this data is called a "Means estimate"; data may simply be referred to as "Means".

Real Property Inventory Equipment (RPIE)

A Government owned or leased individual pieces of equipment, apparatus, or fixture that are essential to the function of the real property (i.e. plumbing, electrical, heating, cooling and elevators). It is physically attached to, integrated into, and built in or on the property.

Individual RPIE’s can be combined to make a CIMU to facilitate facilities management.

An individual RPIE can also be a CIMU if the equipment is complex enough to require its own management planning.

Response Time The time allowed the Contractor after initial notification of a work requirement to be physically on the premises at the work site with appropriate personnel, tools, equipment, and materials, ready to perform the work required.

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Rev Dec 2021 5

Definition Description Unit Priced Labor (UPL) Hour

The unit price bid by the Contractor to perform one hour of work-in-place. With the exception of direct material and construction equipment costs, the unit price includes all indirect and direct costs associated with performing work. The price includes the Contractor’s hourly composite trade wage, adjusted to allow for workforce productivity;

costs for pre-expended bin materials, union agreements, crew sizes, hand tools, payroll burdens and fringes, overtime, job (field) overhead (including clerical support, supervision, inspection, fees, taxes, licenses, permits, and insurance), general and administrative (home office) overhead, and profit. Additionally, time for job preparation, safety standby personnel, and similar indirect labor elements are included.

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Rev Dec 2021 6

Acronym Title ACO Administrative Contracting Officer BW Biweekly CDR Contract Discrepancy Report CIA Controlled Industrial Area CIMU Component Inventory Management Unit CMMS Computerized Maintenance Management System COR Contracting Officer Representative COR Condition of Readiness DBH Diameter at Breast Height DCR Direct Condition Rating DoD Department of Defense DoN Department of Navy DRMO Defense Reutilization Management Office EPA Environmental Protection Agency EPCRA Emergency Planning and Community Right-to-Know Act FAR Federal Acquisition Regulation FFP Firm Fixed Price FIFRA Federal Insecticide, Fungicide, and Rodenticide Act FSC Facility Support Contract GIS Geospatial Information System GFE Government-furnished Equipment GFF Government-furnished Facilities GFM Government-furnished Materials HCA Head Contracting Agency ICAP Infrastructure Condition Assessment Program ICP Integrated Contingency Plan IDIQ Indefinite Delivery Indefinite Quantity iNFADS Internet Navy Facilities Asst Data Store IPM Integrated Pest Management IPMIS Integrated Pest Management Information System IPMP Integrated Pest Management Plan KO Contracting Officer LAN Local Area Network M Monthly MAP Maintenance Action Plan MDI Mission Dependency Index MEP Mechanical, Electrical and Plumbing MRI Mission Readiness Index MSDS Material Safety Data Sheets NAVFAC Naval Facilities Engineering Command NMCI Navy Marine Corps Intranet NOSC Navy-On-Scene Coordinator PAP Performance Assessment Plan PAR Performance Assessment Representative PAW Performance Assessment Worksheet PEO Program Executive Officer

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Rev Dec 2021 7

Acronym Title PM Project Manager PM Planned Maintenance or Preventative Maintenance PRCSP Permit Required Confined Space Program PWS Performance Work Statement PWO Public Works Officer Q Quarterly QC Quality Control RPIE Real Property Inventory Equipment RSL Remaining Service Life SC Security Clearances SM Semimonthly SPAR Senior Performance Assessment Representative TE Technical Exhibit VIQ Variation in Quantity WBS Work Breakdown Structure

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Rev Dec 2021 8

ATTACHMENT J-0200000-02

WAGE DETERMINATIONS

Wage Determinations to be inserted by Contract Specialist

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Rev Dec 2021 9

ATTACHMENT J-0200000-03

DIRECTIVES, INSTRUCTIONS, AND REFERENCES

Reference Title

EM 385-1-1 U.S. Army Corps of Engineers Safety and Health Requirements

P.L. 91-596 Occupational Safety and Health Act

Code of Federal Regulations

(CFR) 40

Environmental Protection Regulations

NAVSHIPYDNORINST

4101.2A 22 June 1981

Energy Conservation Standard

NAVSHIPYDNORINST

P11320.6 29 April 1982

Fire Prevention

NAVSHIPYDNORINST

P.5090.1

Environmental Protection Manual

NFPA 54 (2006) National Fuel Gas Code

NFPA 70 (2005) National Electrical Code

NAVY OSHE Program Manual(s)

NAVSHIPYDNORINST

P.5090.2, Volume II

Chapter 27 Hazardous Material Controls and Management

NAVY OSHE Program Manual(s)

NAVSHIPYDNORINST

P.5090.2, Volume II

Chapter 38 Non-Bulk Recovery Material Control

NAVY OSHE Program Manual(s)

NAVSHIPYDNORINST

P.5090.2, Volume II

Chapter 40 Emergency & Hazardous Materials Discharge Contingency Plan

NAVY OSHE Program Manual(s)

NAVSHIPYDNORINST

P.5090.2, Volume II

Chapter 58 Water Pollution Control Plan

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Rev Dec 2021 10

ATTACHMENT J-0200000-04

INVOICE FORM

To be inserted by Contract Specialist

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Rev Dec 2021 11

ATTACHMENT J-0200000-05

FORMS

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Rev Dec 2021 12

ATTACHMENT J-0200000-05-01

NNSY HAZARDOUS MATERIAL AND EMERGENCY PLANNING

CONTRACTORS HAZARDOUS MATERIAL (HM) AND EMERGENCY PLANNING

AND COMMUNITY RIGHT TO KNOW ACT (EPCRA) REPORTING FORM

CONTRACTORS NAME:

POINT OF CONTACT / PHONE NUMBER:

SUBCONTRACTORS NAME/ PHONE NUMBER:

DATE OF WORK: BEGIN END

JOB LOCATION

CONTRACTING OFFICE

(IE., ROICC, PWC, SUPSHIP

EMERGENCY (24 HR.) POINT OF CONTACT

NAME: PHONE#:

Mail form & Material safety Data Sheets (MSDS) to:

NAVFAC MIDLANT

9742 Maryland Ave. Phone # 757-444-3028 Norfolk, Virginia 23511-3095 Fax # 757-445-9837

Hazardous Materials Name

Manufacturer’s Name

Amt. Stored on Base (Gal/Lb)

Storage Location on Base

Usage for Calendar Yr.

(gal/Lb)

How will Waste be Disposed of?

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Rev Dec 2021 13

ATTACHMENT J-0200000-05-02

CODE 106 ASBESTOS CHECK OFF LIST

REVIEW OF ASBESTOS REMOVAL PLANS

Contract # ________________________ Project ________________________

__ 1. Was plan signed, sealed and prepared by a Certified Industrial Hygienist (CIH)? (NOTE: New contract specs may allow plan to be prepared by someone other than a CIH – check the contract spec if prepared by someone other than a CIH to see what is required.) If answer is NO, review of plan stops at this point.

__ 2. Is CIH certificate or credentials of person preparing plan included?

Independent Laboratory

__ 3. Is laboratory identified?

__ 4. Is laboratory licensed in Virginia?

__ 5. Is a copy of current license included?

__ 6. Is a copy of the latest Proficiency Analytical Testing (PAT) round for asbestos provided?

Current published PAT round is ____________.

__ 7. Is certification that laboratory personnel that will be working on site meet current medical and training requirements included?

__ 8. Are provisions for laboratory to report results within the time limits specified in the contract included?

__ 9. Are limits specified in 29 CFR 1926.1101 specified for the work to be performed? Negative Pressure

Enclosures – 0.1 f/cc and Glovebag – 0.01 f/cc. Note contract may require clearance at 0.01 f/cc.

__ 10. Are monitoring frequency and locations correct?

Contractor

__ 11. Is the Asbestos Contractor identified?

__ 12. Is a copy of the contractor's current Virginia license provided?

__ 13. Is the contractor's Competent Person identified?

__ 14. Is the Competent Person licensed in Virginia?

__ 15. Is a copy of the Competent Person's license provided?

__ 16. Will all licenses be valid throughout the course of the contract? If no, make a tickle to obtain a copy of the renewed license.

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Rev Dec 2021 14

__ 17. Are contractor employees that will perform the asbestos removals identified?

__ 18. Are all identified employees licensed in Virginia as Asbestos Workers or Supervisors?

Equipment

__ 19. Is manufacturer's data for vacuums and ventilation equipment included?

__ 20. Are dioctylphalate (DOP) test certificates provided for each piece of equipment?

__ 21. Were the test conducted within the last 90 days?

__ 22. Will the asbestos removal be done within the DOP test period for the equipment? If yes, make a tickle to obtain updated test certificates.

__ 23. If rental equipment will be used on the job, is a copy of the notification that the equipment will be used for asbestos included?

Work Procedures

__ 24. Is a sketch of the asbestos work area provided?

__ 25. If glovebags are used are glovebag work procedures that meet the requirements of 29 CFR 1926.1101 included?

__ 26. Does the plan require a 24 hour guard at the regulated area or is the regulated area built of structural materials?

__ 27. Does plan require smoke testing of containments and glovebags?

__ 28. Does the plan provide for monitoring of the negative pressure in Negative Pressure Enclosures?

Miscellaneous

__ 29. Is the Asbestos Landfill identified?

__ 30. Is EPA/state approval for landfill provided?

__ 31. Is a properly completed copy of the EPA/Virginia notification included?

__ 32. Does the plan require all bags of asbestos waste to have the contract number and contractor's name on them?

__ 33. Does the plan adequately protect shipyard personnel and property?

Check list completed by: ____________________________________

Date: ______________________

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Rev Dec 2021 15

A COPY OF THIS CHECK LIST WILL BE FILED WITH THE REMOVAL PLAN IN THE CODE 106 OFFICE.

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Rev Dec 2021 16

ATTACHMENT J-0200000-05-03

SOIL COVERAGE GUIDANCE

The construction of the soil storage area shall be as follows:

Plastic sheeting shall be laid on the ground surface prior to any soil collection.

Hay bales, or similar structure, will be placed around the perimeter of the storage area.

The ground cover plastic will be placed up and over the hay bales at the perimeter and anchored with a heavy object (brick, rock, lumber).

The entire pile must be covered with plastic at all times the soil pile is not being actively worked to prevent collection of potentially hazardous rainwater.

Holes in any plastic should be repaired, or the entire sheet replaced.

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Rev Dec 2021 17

ATTACHMENT J-0200000-05-04

SOLID WASTE MANAGEMENT

I DEFINITIONS

1) Solid Waste: For purposes of the waste management program, solid waste shall be categorized as material for disposal in a landfill or incinerator (for energy recovery such as SEPSA), or as waste materials for salvage or resale, salvage for reuse, or recycling.

2) Recyclable Materials: Products and materials that can be recovered and remanufactured into a new product.

Recyclable materials include, but are not limited to, the following:

a) Metals (ferrous and non-ferrous), including banding, metal studs, ductwork, piping

b) Asphalt

c) Concrete, including concrete compression test cylinders, and rubble

d) Land clearing and grubbing debris, dirt and soil

e) Gypsum board

f) Paper and cardboard

g) Wood products, including crates and pallets

h) Brick and masonry

i) Carpet and padding

j) Plastics

k) Aluminum, including beverage cans

l) Copper wiring

m) Mechanical and electrical products and equipment

3) Recycling Facility: A business that specializes in collecting, handling, processing, distributing, or remanufacturing waste materials such as those generated by this project, into products or materials that can be used by others.

4) Salvage and Reuse: Existing usable product or material that can be saved and reused in some manner on the project site. Materials that can be salvaged and reused must comply with the applicable technical specifications and include, but are not limited to, the following:

a) Dimensional lumber and other wood products

b) Metal scrap

c) Structural steel items

d) Mechanical or electrical equipment

e) Gypsum board

f) Brick and masonry

5) Salvage for Resale: Existing usable product or material that can be saved and removed intact (as is) from the project site to another site for resale to others without re-manufacturing.

6) Trash: Product or material unable to be salvaged for resale, salvaged and reused, returned, or recycled.

II SOLID WASTE MANAGEMENT

1) General Intent: The Contracting Officer is concerned with the polluting effect, on the local environment, associated with waste generated by this project being sent to a landfill or SEPSA incinerator. Therefore, it

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Rev Dec 2021 18 is the intent of the Contracting Officer, to the greatest extent practical and economically feasible, to provide for affirmative procurement requirements IAW reference 2.12, that all solid waste materials generated be salvaged for resale, salvaged and reused, or appropriately recycled, rather than transported to a landfill, and control and dispose of solid waste IAW reference 2.13.

2) An effective waste management program will benefit the Contractor through reduced landfill tipping fees and reduction in material usage.

3) Waste Management Operations: Take a pro-active, responsible role in management of waste and require all subcontractors, vendors, and suppliers to participate in the effort. Establish a management program that includes, but is not limited to:

a) Salvage for resale

b) Salvage and reuse

c) Recycling

d) Disposal

e) Minimizing Packaging Waste

4) Salvage and Reuse: Salvage and reuse is a better waste management method than recycling because little or no reprocessing is necessary, thus less pollution is created when items are reused in their original form.

Therefore, a diligent effort shall be made to salvage and reuse products and materials. Waste materials that cannot be salvaged and reused, and have value as being recyclable, shall be recycled. Only trash shall be transported to a landfill or SEPSA incinerator. The Contractor shall be responsible for implementation of any special programs involving rebates or similar incentives related to recycling waste for this project.

Revenues or other savings obtained for recycling or returns shall accrue to the Contractor.

5) Solid Waste Management Plan: Perform a waste analysis to determine the types and quantity of waste anticipated and identify salvage for resale, salvage and reuse , recycling and disposal options available.

Within 30 days after contract award and prior to performing work, submit a Waste Management Plan for review and approval. The Solid Waste Management Plan shall include the following:

a) Project waste analysis.

b) Landfill or incinerator name, address and phone number, tipping fee amounts, projected cost of disposing of all trash and waste materials in the landfill or incinerator as if there would be no salvage or recycling on this project.

c) A list of waste materials that will be salvaged for resale and salvaged and reused, and the recycling facilities that will be utilized.

d) Anticipated net cost savings determined by subtracting the cost of separating and recycling from the following:

1. Revenue from the sale of salvaged for resale products and materials.

2. Revenue from the sale of recycled products and materials.

3. Landfill or incinerator tipping fees saved due to diversion of materials to recycling.

e) Description of the means by which waste materials, selected for recycling, will be protected from contamination and a description of the means to be employed in recycling waste materials so they will be consistent with the requirements for acceptance by the recycling facilities.

f) Description of the means of transportation of recyclable materials and the destination of the materials.

6) Transportation of Recyclable Materials: Contractor must comply with all federal, state, and local environmental regulations and laws, including, but not limited to, the following:

a) DOT requirements for 49 CFR 173 and 178.

III EXECUTION

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Rev Dec 2021 19

1. Program Implementation And Monitoring: Implement and maintain, for the duration of the project, the solid waste management program. Establish a method of documenting and monitoring the program, and submit a report by the 10th of the next month for the prior month with each application for payment that includes the following:

a) Amount and type of material that is recycled, by weight, including the means of transportation and the destination.

b) Amount and type of material disposed of in a landfill or SEPSA incinerator, by weight.

c) Earned revenue and the savings projected from tipping fee savings.

d) Cost benefit to the Project and general effectiveness of the program.

1) Salvage And Reuse: Encourage the practice of efficient waste management when using, sizing, cutting, and installing the products and materials required for this project, and reuse as many discarded original materials as possible (that would traditionally become waste) that are within the limits of other specification requirements concerning material quality.

2) Separation Of Recyclable Waste Materials: Provide the necessary containers and bins, to facilitate the solid waste management program, that are clearly and appropriately marked with Contractor Name and acceptable waste. Prevent contamination of recyclable materials from non-compatible products and materials. Separate waste at the project site by one of the following methods:

a) Source Separated Method: Waste products and materials, that are recyclable, are separated from trash and sorted into appropriately marked separate containers and then transported to the respective recycling facility for further processing. Trash is transported to a landfill or SEPSA incinerator.

b) Co-Mingled Method: All waste is placed into a single container and then transported to a recycling facility where the recyclable materials are sorted and processed and the remaining trash is transported to a landfill or SEPSA incinerator.

Other methods that are proposed by the Contractor and approved by the Contracting Office.

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Rev Dec 2021 20

ATTACHMENT J-0200000-05-05

SAMPLING AND MONITORING REQUEST FORM

Name: Code 106.323 USE ONLY

Code: Date Received:

Phone: Date Completed:

FAX:

Date: 106 -

THE FOLLOWING TYPES OF DATA IS PROVIDED TO REQUEST AND SCHEDULE

SAMPLING / MONITORING

Description of Project:

Type Of

Material:

Specific

Analysis Required:

Point of Contact:

Name Code Phone/FAX

Program Code: I.D. No.

PIN No.

LOCATION: (Be Very Specific) :

PRIORITY ASSIGNED: 106.323: LAB:

Priority (1) = 1 - 5 working days, with overtime Priority (2) = 6 - 15 working days

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Rev Dec 2021 21

Priority (3) = 16 - 20 working days

COMMENTS:

JOB ORDER NUMBER (All programs must have a JOB ORDER NUMBER)

J.O. # J.O. #

PROGRAM

MANAGER:

Name Code Phone/Ext.

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Rev Dec 2021 22

ATTACHMENT J-0200000-05-06

ANNUAL EPCRA HAZARDOUS MATERIAL REPORT

Information for EPCRA reporting is provided to the Environmental Office at Norfolk Naval Shipyard via the EPCRA Database. The information is input by the tenant or contractor into a table in Microsoft. Below is the structure for the database table. It shows the names to be used for the different data fields, the size of the field, and the type of data stored in each field. The following page gives more explicit instructions as to the data that will be entered into each field.

1.2 STRUCTURE FOR EPCRA DATABASE

Field

Field Name Type Width Dec Remarks

1 ACTIVITY Text 45 0 Name of Activity 2 POC Text 25 0 Point of Contact (Last Name, First Initial) 3 PHONE Text 10 0 Phone No. for POC (Incl. Area Code, No "( ", " )", or "-" 's) 4 PROD_NM Text 70 0 Product or Trade Name per Label or MSDS 5 MFR_NM Text 50 0 Manufacturer's Name 6 NSN Text 13 0 National Stock Number (excluding dashes) 7 MAX_AMT Numeric 13 2 Max Amount on Site (pounds) 8 AVG_AMT Numeric 13 2 Average Amount on Site (pounds) 9 STOR_LOC Text 20 0 Storage Location 10 CAS Text 11 0 CAS No.

11 CAS_NM Text 70 0 Chemical Name 12 PCT_WT Numeric 6 2 Percent (by Weight) of the chemical 13 EHS Logical 1 0 Is this CAS an EHS? (Y/N) 14 S313 Logical 1 0 Is this a Section 313 chemical or chem. category? (Y/N) 15 AMT_MFR Numeric 13 0 Amount of the chemical manufactured if no. 14 is "Y" 16 AMT_PRO Numeric 13 0 Amount of the chemical processed if no. 14 is "Y" 17 AMT_USE Numeric 13 2 Amount of the chemical otherwise used if no. 14 is "Y"

NOTE: Capital letters should be used at all times.

INSTRUCTIONS FOR COMPLETION OF EPCRA DATABASE

1. ACTIVITY NAME: Name of the contractor/tenant activity

2. POC NAME: Name of the contractor/tenant activity point of contact

3. PHONE: Phone number of the point of contact

4. PRODUCT OR TRADE NAME: Product or trade name of the material as it appears on the MSDS

5. MANUFACTURE'S NAME: Name of manufacturer as it appears on the MSDS

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Rev Dec 2021 23

6. NSN: National Stock Number of the item, if applicable.

7. MAXIMUM AMOUNT ON SITE: The maximum amount of the material on site at any given time, including both bench stock and floor stock, in pounds

8. AVERAGE AMOUNT ON SITE: The average amount of the material on site during the calendar year, including both bench and floor stock, in pounds

9. STORAGE LOCATION: The locations where the material is stored within the facility (Note any locations that need to be kept confidential)

10. CAS: Chemical Abstract Service Number of the hazardous chemical, as noted on the MSDS

11. CAS NAME: The name of chemical with the CAS number on line 10, as shown on the MSDS

12. PERCENT: Percent by weight of the CAS number of the chemical as shown on the MSDS

13. EHS(Y/N): Whether or not the CAS number appears in 40 CFR 355 as an Extremely Hazardous Substance

14. SEC. 313 (Y/N): Whether or not the CAS number is an EPCRA Section 313 reportable toxic chemical

15. AMOUNT MANUFACTURED: The amount of the CAS number produced or imported for: (a) on-site use/processing, (b) sale/distribution, or (c) as a byproduct, or as an impurity.

16. AMOUNT PROCESSED: The amount of the CAS number processed: (a) as a reactant, (b) as a formulation component, (c) as an article component, or (d) for repackaging

17. AMOUNT OTHERWISE USED: The amount of the CAS number otherwise used: (a) as a chemical processing aid, (b) as a manufacturing aid, (c) for ancillary or other use

(AOR)

Rev Dec 2021 24

ATTACHMENT J-0200000-05-07

PCB DISPOSAL

Contact the Environmental Coordinator prior to performing any work that is expected to generate Recovery Material /Polychlorinated Biphenyl (RM/PCB). This action will establish the area the work will be performed in, determine the proper posting requirements, determine the appropriate containers for storage/disposal of the waste, and labeling requirements in accordance with (IAW) EP Manual III-A-6.

All workers involved with removal of the PCB containing materials shall be personnel trained and qualified in PCB Awareness. Package, handle, and label PCB waste in accordance with the following instructions. Shop personnel must utilize proper personal protective equipment (PPE) for PCB work and any clothing that becomes contaminated with PCB shall be disposed of as PCB waste and disposed via the Environmental Coordinator.

Setting up a work area for PCB greater than 50ppm:

1. Posting- Isolate the work area with boundary tape or rope. Affix the “PCB Caution Label” to the boundary tape or rope on all sides.

2. Labeling- Ensure the Environmental Coordinator has labeled the collection container with “PCB Caution” labels (NAVSEA form 5090/3) and “Recovery Material Label” labels (NNSY 4410/183) prior to placing any waste into the container.

3. Containers- All RM/PCB will be stored in appropriate Performance Oriented Packaging (POP) with the proper POP (UN) markings on the container with watertight lids.

Ensure the area is properly posted, labeled, containers are kept closed and secured at all times except when adding waste.

When storing any PCB waste, the generator shall ensure that the date the first amount of waste is placed in a container is written on the container label as the "Date Removed from Service". To Ensure the EPA’s 30-day time limit on PCB waste stored in "less than 30 day storage areas" are not exceeded; containers must be called in for pickup within 21 days of the container’s "Date Removed from Service". The date the container is complete should also be reported to the Environmental Coordinator for record keeping and timely disposal.

Prior to removing liquid PCB waste C-106.32 must be notified 3 days prior to removal from service.

Liquid PCB waste greater than 50 ppm must be placed in storage the same day they are generated.

(AOR)

Rev Dec 2021 25

ATTACHMENT J-0200000-05-08

CONTRACT LEAD PAINT REMOVAL WORK PLAN

Contract # ______________ Project ________________ CA _______________

This checklist is not all inclusive and is provided to aid the CA in reviewing contract lead paint removal plans. Any item not ‘checked’ will require a reason be provided. Submit copy of approved lead plan with signed checklist to C106 prior to commencement of lead operations.

CHECKS & SUBMITTALS: (respond w/ a “” or “NA”)

Certified Industrial Hygienist/Certified Safety Professional:

1. ___ Plan signed, sealed, prepared and/or approved, dated by Certified Industrial Hygienist (CIH) and/or Certified Safety Professional (CSP).

2. ___ Name, address, phone number of CIH or CSP.

3. ___ CIH or CSP certificate submitted.

Contractor:

1. ___ Name, address, phone number of contractor/subcontractor to perform work.

2. ___ Documentation, e.g., training certificates, showing contract employee has current annual lead training required by 29 CFR 1926.62 or 29 CFR 1915.1025/1910.1025, as applicable, is submitted.

NOTE: State Licensing, state training or other HUD or Abatement courses are not acceptable substitutes for documentation of annual OSHA training.

3. ___If applicable, contractor employees to perform airborne monitoring under the cognizance of the CIH and/or CSP identified. If not applicable, skip to 4.

3a. ___ Documentation of training, by CIH, related to airborne monitoring for those employees are included in the submittals.

4. ___ Safety, respirator programs and waste disposal plan submitted.

4a. ___ Safety program includes emergency response for the naval facility/location where work is to take place.

Laboratory:

1. ___ Name, address, telephone number of AIHA accredited laboratory.

2. ___ The testing laboratory firm is independent of the contractor including no employee or employer relationship which could constitute a conflict of interest.

(AOR)

Rev Dec 2021 26

3. ___ Accreditation certificate is submitted and current.

4. ___ ELPAT testing rounds are submitted.

4a ___ Testing rounds are less than a year old.

4b. ___ Testing rounds show proficiency in testing for metals and/or lead.

5. ___ Airborne monitoring results will be available for the CIH/CSP to review within 16 hours of sampling.

General:

1. ___ Description of work process (es) reference 29 CFR 1926.62 or 29 CFR 1915.1025/1910.1025 and/or OPNAVINST 5100.23, as applicable.

2. ___ Details of how contractor intends to prevent lead exposure, at or above 30 micrograms (mg) of lead per cubic meter (m3) of air, to shipyard/ship’s force/tenant command employees and equipment.

3. ___ Sketch (es) of worksite including location, size, details of lead control area (s) are submitted.

4. ___ Details of monitoring frequency and strategy, including worksite release.

5. ___ Contractor to forward sampling results/reports to the CA in 3 working days.

5a. ___ Report will be signed by persons who performed the monitoring, analysis and the

CIH/CSP.

5b. ___ CA will forward copies of results/reports to C106 upon receipt.

6. ___ CA will be contacted immediately if monitoring results at the work boundary equals or exceeds 30 mg/m3.

6a. ___ CIH/CSP will identify cause of high airborne levels.

6b. ___ CA must approve of corrective actions prior to contractor resuming work.

7. ___ ‘Negative exposure assessments’ and requests to cease monitoring will be forwarded to C106 via the CA for approval.

8. ___SDSs for the hazardous materials to be used during work are submitted.

8a. ___ CA will forward copies of MSDSs to C106 upon receipt.

Contract Administrator: ______________________ ____________________ (Signature/Code) (Date)

Phone Number: ____________ Email Address: ___________________

Plan Approval Date: _____________ Estimated Start Date: ______________

(AOR)

Rev Dec 2021 27

ATTACHMENT J-0200000-05-09

RECOVERED MATERIALS DETERMINATION FORM

This form is to be completed by the procurement originator when EPA-designated items included in the Green Procurement Program for Recovered Materials are being procured from outside vendors. For questions on whether the product counts as “EPA-designated” or what the required recycled content is, refer to product descriptions on EPA’s website at www.epa.gov/cpg/products . The completed form becomes part of the contracting office contract file.

Procurement Request / Project No._______________________________________________

The EPA-designated items being procured are:

___ Building insulation

___ Polyester carpet

___ Binders (paper, solid plastic or plastic covered)

___ Playground surfaces

___ Park and recreational furniture

Cement & concrete containing:

___ Coal fly ash

___ Ground granulated blast furnace slag

___ Cenospheres

___ Silica fume

___ Plastic presentation folders

___ Plastic file folders

___ Plastic clip portfolios

___ Plastic clipboards

___ Running tracks

___ Playground equipment

___ Traffic barricades

___ Traffic cones

___ Parking stops

___ Flowable fill

___ Latex paint

___ Floor tiles

___ Laminated paperboard

___ Office furniture

___ Office recycling containers

___ Office waste receptacles

___ Plastic desktop accessories

___ Plastic fencing (snow or erosion control, safety barriers)

___ Channelizers

___ Patio blocks ___ Plastic envelopes ___ Delineators

___ Shower & restroom dividers/partitions

___ Plastic trash bags

___ Flexible delineators

___ Rebuilt vehicular parts

___ Structural fiberboard ___ Printer ribbons

___ Engine coolants

___ Railroad grade crossing surfaces

___ Toner cartridges

___ Newsprint ___ Re-refined lubricating oils

___ Retread tires

___ Garden and soaker hoses

___ Lawn and garden edging

___ Commercial/industrial sanitary tissue products

___ Sorbents

___ Awards and plaques

___ Landscaping timbers and posts (plastic lumber)

___ Printing and writing papers

___ Paperboard and packaging ___ Mats

___ Signage

___ Hydraulic mulch ___ Tray liners ___ Strapping

___ Compost from yard

___ Pallets

(AOR)

Rev Dec 2021 28 trimmings or food waste ___ Industrial drums

___ Modular threshold ramps

___ Non-pressure pipe

___ Bike racks

___ Roofing materials

___ Blasting grit

___ EPA recycled content requirements have been met for this procurement action.

**** OR *****

___ The following EPA designated guideline item is included in the specifications for project number , however, compliance with EPA standards is not attainable.

Item:

I have determined that the EPA guidelines were considered and determined inapplicable, based on the following:

_____ Item is not available within a reasonable period of time.

Need date: _____________________ Date available: ____________________________

Item fails to meet a performance standard in the specifications.

Describe the standard and why it is needed:

Describe how the guideline item fails to meet the standard: _________________________

_____ Item is not available from 2 or more sources.

Market research was performed by calling ____(insert number) vendors, but only ________________________________ (enter name) was able to supply the item.

_____ Item was only available at an unreasonable price (i.e., recycled item is more expensive).

Price of recycled item: ___________________

Price of non-recycled item: ________________

This determination is made in accordance with FAR 23.405(c).

Technical OPR - Signature and Office Symbol Date

Concurrence - Contracting Officer Date

(AOR)

Rev Dec 2021 29

ATTACHMENT J-0200000-05-10

BALLAST DISPOSAL

I. PCB BALLAST

Ballast that are NOT IDENTIFIED as "PCB FREE" or "NO PCB" handle and dispose of as (PIN 650) PCB > 500 ppm.

1. Place ballast (s) in an appropriate storage container (i.e. drum).

2. Shop/Ship Environmental Coordinator call C-106.322 Dispatcher (396-7287 for turn in

I.A.W. OSHE Program Manual Chapter II-38 Non Bulk Recovery Material Control as (PIN 650) PCB > 500 ppm within 24 hours of removal.

WARNING: Ballast identified as "No PCB" may contain PCB's up to 50 ppm, ballast identified as "NO PCB" handle and dispose of as (PIN 650B) PCB 1< 50 ppm.

2. Shop/Ship Environmental Coordinator call C-106.322 Dispatcher (396-7287 for turn in

I.A.W. OSHE Program Manual Chapter II-38 Non Bulk Recovery Material Control as (PIN 650B) PCB 1< 50 ppm.

II. NON - PCB BALLAST

Ballast marked "PCB FREE" or marked with these military specifications, MIL-F-16377/44-001 and MIL- F-16377/45-001 are dry type ballast(s), handle and dispose of as "PCB FREE" PCB < 1 ppm

1. Double bag in green poly.

2. Mark the outer bag PCB FREE, PCB < 1 ppm, shop/project point of contact, and phone number.

3. Place the bag of ballast (s) in a black dumpster for disposal as solid waste.

III. LEAKING BALLAST

For leaking ballast (s), where leakage has not run off the ballast, this is considered "minor seepage" and is not a "PCB SPILL". Assume leaking ballast (s) contains PCB > 500 ppm until proven otherwise.

2. Shop/Ship Environmental Coordinator call C-106.322 Dispatcher 396-7287 for turn in I.A.W.

OSHE Program Manual Chapter II-38 Non Bulk Recovery Material Control as (PIN 650) PCB >500 ppm within 24 hours of removal/analysis determination. Only qualified personnel are to take PCB samples.

For leaking ballast (s), where leakage has run off the ballast onto the fixture, or dripped onto the floor or deck this is a "PCB SPILL" and the Fire Department must be called (911) for cell phones 396-3333. Do not handle the ballast. The PCB Program Manager will provide guidance on how to handle the spill, spill materials, etc...

IV. FIXTURES

The remaining light cover and frame work are scrap metal, dispose in green dumpsters.

(AOR)

Rev Dec 2021 30

V. OTHER - Ballasts are identified with markings on a label or stamped into the metal casing.

For questions contact Program Manager, Matt Peppers @ 396-4403.

Personnel must be PCB worker qualified to perform the work of this section. Contact C-900T

James Kasey @ 6-4895/4980 for PCB training information.

(AOR)

Rev Dec 2021 31

ATTACHMENT J-0200000-05-11

FLUORESCENT LIGHT DISPOSAL

Fluorescent lights will be handled as a Hazardous Waste; the Shipyard will no longer dispose of small quantities of fluorescent lights in open containers.

There are two types of fluorescent lights, regular duty and rough service. The rough service fluorescent light is protected by a thin plastic shell that encases the tube.

Fluorescent lights WITHOUT the plastic shell will be turned over to Code-106.32 by calling 396-7287 to coordinate delivery to Building 281. The Outage Verification Log for this waste stream is required for transferring custody to C-106 personnel.

Prior to transporting the fluorescent lights, double bag / wrap in poly or place in the manufacture's original container. The Process Identification Number (PIN) is not required for this waste stream, C-106 assigns the PIN after crushing.

Fluorescent lights WITH the plastic shell will be turned over to Code-106.32 by calling 396- 7287 to coordinate delivery to Building 281. The Outage Verification Log for this waste stream is required for transferring custody to C-106 personnel.

Prior to transporting the fluorescent lights, call 396-7287 to obtain disposal container, or place in the manufacture's original DOT approved performance oriented package. Use Process Identification Number (PIN) 1416 to identify this waste stream.

Fluorescent lights BROKEN use PIN 943 “Mercury contaminated Debris, Hg > 260ppm.”

Sodium vapor lights INTACT OR BROKEN use (PIN) 1434 “Sodium Vapor Lamps W/ Mercury & Lead.”

Mercury vapor lights INTACT OR BROKEN use (PIN) 943.

(AOR)

Rev Dec 2021 32

ATTACHMENT J-0200000-05-12

HAZARDOUS WASTE MANAGEMENT

The purpose of this instruction is to provide guidance to sample for hazardous constituents. Identification of waste shall be accomplished by analyzing for the following properties as a minimum: Toxicity Characteristic Leaching Procedure (TCLP) metals and where applicable ignitability, and corrosiveness for liquid waste.

The Contractor shall identify all work activities which will generate hazardous waste. The Contractor shall conduct testing for hazardous constituents and submit results to the contracting officer prior to beginning work operations.

The contracting officer shall contact the cognizant Environmental Coordinator and provide a copy of the laboratory results to Code 106 prior to performing any work that is expected to generate Recovery Material /Hazardous Waste (RM/HW). This action is mandatory to identify the work area where RM/HW will be generated; establish and properly post any accumulation areas, as applicable; determine the appropriate containers for storage/disposal of the waste and labeling requirements in accordance with (IAW) OSHE Chapter II-38.

All Hazardous Waste/Recovery Materials will be stored in contractor provided UN Performance Oriented Packaging (POP) containers with watertight lids IAW OSHE Chapter II-38. The storage areas are authorized by Code 106.321 and the containers should be labeled IAW OSHE Chapter II-38. The Environmental Coordinator shall ensure the area is properly posted, outage date entered on label, and the contractor shall ensure containers are kept closed and secured at all times except when adding waste. Upon completion of packaging the Environmental Coordinator should be contacted for disposal requirements. The Environmental Coordinator must notify Code106 on the same day the drum is filled. Material in excess of 55 gallons in Satellite Accumulation Areas cannot be stored for longer than 72 hours.

The government will dispose of all Polychlorinated Biphenyls /hazardous waste. The Contractor will dispose of all other wastes.

(AOR)

Rev Dec 2021 33

ATTACHMENT J-0200000-05-13

SERVICE INTERRUPTION REQUEST

Subj: REQUEST FOR UTILITIES OUTAGE

Ref: (a) PWCINST 11310.5

1. As set forth in reference (a), an outage is requested.

Contract No. ________________ Title:

Contractor:

PAR:

(Contractor shall fill out all information below and return to the Government Representative)

Description of work to be accomplished:

Boundaries of work:

Expected start date: Days Required:

Expected completion date:

Requested by: Date:

Authorized by: Date:

Work completed:

(AOR)

Rev Dec 2021 34

ATTACHMENT J-0200000-05-14

Contractor Incident Report System (CIRS)

SEE WORD FILE J-0200000-05-14

(AOR)

Rev Dec 2021 35

ATTACHMENT J-0200000-06

INSTALLATION SPILL CONTROL PLAN

In case of a spill, the contractor shall call the following numbers for instructions

Norfolk Naval Shipyard (NNSY ECC) 757-396-3333 Environmental 757-396-8270

Spill Procedures

1. Stop the Spill Source (If safe to do so)

*If unsure of material, or un-trained, leave the area and call the ECC.

2. Contact the Installation Emergency Communications Center

3. If Safe, Prevent Spill from…