Attachment 6 -CAI Report Cvr Sht.xls

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Power Systems Installation
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DTFAAC-15-R-02838
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Attachment 6 -CAI Report Cvr Sht (xls)

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SIR-RFO DTFAAC-15-R-02838.pdf PDF
Attachment 6 -CAI Report Cvr Sht.xls XLS spreadsheet
Attachment 2 - CDRLs-DIDs 3-4-15.pdf PDF
Attachment 18 - Client Auth. Letter (Section J Attach.).Section J Attach. —
Attachment 4 - Perf. Bond SF 25.pdf PDF
Vendor Q A.pdf PDF
Attachment 8 - Excavation Contaminated Mat.doc DOC document
Attachment 14_FAA-D-2494b.pdf PDF
Attachment 1 - SOW (w_appendices).w_appendices —
DTFAAC-15-R-02838 A004 Conference Attendee List.pdf PDF
Attachment 19 - Business Declaration Form.pdf PDF
Attachment 9 -_FAA_ORDER_1050_10C.pdf PDF
DTFAAC-15-R-02838 A001-Apr 01.pdf PDF
Attachment 17(C) - Past Perf Quest. (Sec J Attach).C C file
Attachment 13_FAA-C-1217F.pdf PDF
Attachment 7 - Safety Health Checklist.doc DOC document
Attachment 3 - SF 25(a) Payment Bond.a A file
Attachment 10 -FAA_ORDER_6950_27.pdf PDF
DTFAAC-15-R-02838 A002-Apr 06.pdf PDF
Attachment 15_FAA_ORDER_1050_15.pdf PDF
DTFAAC-15-R-02838 A005 April 17 2015pdf.pdf PDF
DTFAAC-15-R-02838 A003 April 13 2015.pdf PDF
Attachment 11_FAA_STD_019E.pdf PDF
Attachment 12_FAA_STD_032.pdf PDF
Attachment 5 - Const Spec Template.doc DOC document
Attachment 20 - GFE.pdf PDF
DTFAAC-15-R-02838 A006 April 24 2015.pdf PDF
Attachment 16 - Past Perf History (Sec J Attach).Sec J Attach —
Attachment 7 - Safety Health Checklist.doc DOC document
Attachment 18 - Client Auth. Letter (Section J Attach.).Section J Attach. —
Attachment 13_FAA-C-1217F.pdf PDF
Attachment 10 -FAA_ORDER_6950_27.pdf PDF
DTFAAC-15-R-02838 A001-Apr 01.pdf PDF
Attachment 19 - Business Declaration Form.pdf PDF
Attachment 11_FAA_STD_019E.pdf PDF
Attachment 9 -_FAA_ORDER_1050_10C.pdf PDF
Attachment 12_FAA_STD_032.pdf PDF
SIR-RFO DTFAAC-15-R-02838.pdf PDF
Attachment 17(C) - Past Perf Quest. (Sec J Attach).C C file
Attachment 15_FAA_ORDER_1050_15.pdf PDF
Attachment 20 - GFE.pdf PDF
Attachment 14_FAA-D-2494b.pdf PDF
DTFAAC-15-R-02838 A005 April 17 2015pdf.pdf PDF
Attachment 8 - Excavation Contaminated Mat.doc DOC document
Attachment 5 - Const Spec Template.doc DOC document
Attachment 4 - Perf. Bond SF 25.pdf PDF
Attachment 3 - SF 25(a) Payment Bond.a A file
DTFAAC-15-R-02838 A004 Conference Attendee List.pdf PDF
DTFAAC-15-R-02838 A003 April 13 2015.pdf PDF
Attachment 2 - CDRLs-DIDs 3-4-15.pdf PDF
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Sheet1

CONTRACTOR ACCEPTANCE INSPECTIONLocation (City/State)
REPORT COVER SHEET
Cost Center CodeLocation Ident.Facility Alpha CodeFacility Ident. CodeSCFTMRunway No.
Delivery Order No.Contract No.Designated Lead ProjectDates of Final CAI
YesNo
Engineering Plan/Project:Dates of Commissioning/Restoration
Brief Description of Project:
Type of CAIPrevious Partial CAI's (Nos./Date)
PLANTSFINAL
ELECTRONICSPARTIAL NO.
Number of Exceptions:No. of CAI Reports Exception List and ClearancesNumber of Design Deficiencies or
Major:Record Sheets Attached:Improvements Identified or
Minor:Recommended:
Documents/Records Applicable to CAI:
FAA 6030-16 TRDR Cover/Transmittal SheetFAA Form 3900-1, Occupational Safety and Health
FAA 6030-17 TRDR's; FAA 6030-15Inspection Report
Fac. Gen. Ref. Data Record
Radiation Health Hazard Survey
Flight Inspection Reports/Results
FAA Form 6980-4, Standby Power Survey
Obstn. Survey and/or Hrzn Profile(new Fac.)
Plant Equipment Performance Test Data
Contractor Acceptance Inspection Participants (Name/Office)
Contractor Acceptance Inspection Participants (Name/Office)
We have reviewed the finding of this CAI Report and have determined that the facility/equipment or work
described in this report is (__acceptable __not acceptable) for (__transfer of custodialship __maintenance
__maintenance and operation on a commissioned bases) with (__no exceptions __exceptions) Listed on the
CAI Exception List and Clearance Record.
AFS Representative (Chairperson)AFD F&E RepresentativeRepresentative
AT Facility RepresentativeAFD Maint Br RepresentativeRepresentative
Acceptance by Airway Facilities Sector/Sector Field Office:
The facility/system/equipment or work described in this JAI Report was accepted for:
custodialshipmaintenancemaintenance and operation on:_________
AFS/SFO Manager
I have reviewed this CAI Report, and (__concur __nonconcur) with the Contractor Acceptance Inspection findings.
(If Applicable: __A letter is attached explaining nonconcurrence.)
AF ManagerDate

&C&"Arial,Bold"&12PART - III SECTION J ATTACHMENT J.6 &R&9Attachment 6

DTFAAC-15-R-02838

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Sheet2

CONTRACTOR ACCEPTANCE INSPECTION REPORT CHECKLISTSheet 1 of 5
Ident. & Fac. Alpha CodeDelivery Order No.Date of CAIType of CAI:
PlantsFinal
ElectronicsPartial no.
REQUIREMENTSException
MEETSCategory
Item No.REQUIREMENTN/AYESNOMajorMinor
Section A. Facility Construction and Installation Requirements
1Construction Standards and Specifications.
2Construction Appearance.
3Roads and Grounds:
a. Surface Condition.
b. Erosion Control.
c. Drainage.
d. Fences/Gates/Cattleguards.
e. Signs.
4Structures (Towers/Poles):
a. Tower/Pole Construction.
b. Ladders, Steps.
c. Guys/Anchors.
d. Lightning Protection
5Buildings:
a. Roof.
b. Exterior Walls.
c. Foundation.
d. Floors.
e. Interior Walls.
f. Ceiling/Lights.
g. Openings.
h. Plumbing, Water and Sewage Systems.
6Site/Facility Cleanup.

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Sheet3

CONTRACTOR ACCEPTANCE INSPECTION REPORT CHECKLISTSheet 2 of 5
Ident. & Fac. Alpha CodeJob Order No.Date of CAIType of CAI:
Plants____Final
Electronics____Partial no.
REQUIREMENTSException
MEETSCategory
Item No.REQUIREMENTN/AYESNOMajorMinor
Section A. Facility Construction and Installation Requirements
7Lessor's Inspection and Letter of Release.
8Commercial Power Service.
9Power Transformers.
10Facility Electrical Wiring and Lighting.
11Facility/Structure Grounding.
12Lightning and Surge Protection.
13Distribution, Demarcation, and Terminal Panels, Boxes, and Cabinets.
14Construction Inspection of Power, Control, Signal, and Coaxial Cables.
15Underground Cables.
16Cable Load and Voltage Drop.
17Standby Engine Generator.
18UPS/PCS/Battery Backup Systems.
19Environmental Systems (HVAC).
20Equipment Installation (Standards and Specifications).
21Equipment Appearance.
22Equipment Grounding, Bonding, and Shielding.
23Equipment Ventilation.
24Antennas and Antenna Systems.
25Coaxial Cable Tests and Documentation.
26Ground Check/Reference Markers.
27Equip. Mods., CCD's, Manufacturer's Field and Factory Changes.
28FAA/Telco Ground Rules.
29Telco Equipment Operation.
30Leased Telecommunications Service.
31Occupational Safety. Battery and electrical safety equipment.

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Sheet4

CONTRACTOR ACCEPTANCE INSPECTION REPORT CHECKLISTSheet 3 of 5
Ident. & Fac. Alpha CodeJob Order No.Date of CAIType of CAI:
Plants_____Final
Electronics_____Partial no.
REQUIREMENTSException
MEETSCategory
Item No.REQUIREMENTSN/AYESNOMajorMinor
Section A. Facility Construction and Installation Requirements
32Radiation Health Hazard Survey.
33Fire Protection.
34Security.
35Frequency Authorizations.
36ERMS P1 and P5 panel installation. Interface connection to equipment and comminications medium.
37UPS remote status panel installed and connected to UPS.
Section B. Facility/System/Equipment Performance Requirements.
1Systems/Equipment Adjustments and Tuneup.
2Systems/Equipment Operation.
3Standards and Tolerances.
4Deviation From National Standards.
5Special Component Selection.
6Capability.
7Compatibility.
8Reliability.
9Maintainability.
10Electromagnetic Interference.
11RMM software loaded on ERMS P1 and P5 CPUs. Communication to the OCC via the MPS. Test alarms and status reports.
12UPS remote status panel operational.

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Sheet5

CONTRACTOR ACCEPTANCE INSPECTION REPORT CHECKLISTSheet 4 of 5
Ident. & Fac. Alpha CodeJob Order No.Date of CAIType of CAI:
Plants_____Final
Electronics_____Partial no.
REQUIREMENTSException
MEETSCategory
Item No.REQUIREMENTSN/AYESNOMajorMinor
Section C. Commissioning Flight Inspection Requirements.
1Facility/System Certification.
2Issuance of Restrictive NOTAMS.
Section D. Facility Technical Performance Documentation and
Maintenance Reference data Requirements.
1Facility Reference Data File (FRDF)
2Facility Technical Reference Data:
a. FAA Form 6030-15, Facility General Reference Data Record.
b. FAA Form 6030-16, Tech. Ref. Data Record Cover/Transmittal Sheets.
c. FAA Form 6030-17, Technical Reference Data Records.
d. Initial FAA Form (6000 Series), Performance Records.
3Plant Equipment Performance Test Data.
4Engine Generator Installation:
a. Performance Test Data.
b. FAA Form 6980-4, Standby Power System.
5Facility Drawings.
6Facility Instruction Books.
7Facility Maintenance Technical Data.
8Facility Modification Records.
9Facility/System/Equipment, NCP's and CCD's

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Sheet6

CONTRACTOR ACCEPTANCE INSPECTION REPORT CHECKLISTSheet 5 of 5
Ident. & Fac. Alpha CodeJob Order No.Date of CAIType of CAI:
Plants______Final
Electronics______Partial no.
REQUIREMENTSException
MEETSCategory
Item No.REQUIREMENTSN/AYESNOMajorMinor
Section F. Final Acceptance and Commissioning Requirements.
Initial Operating Capability (IOC).
1(Includes operations, diagnostics, and support software).
2Final Preparation For Facility / System / Equipment Operations.
3Operational Readiness Date (ORD).
4Airway Facilities Staffing.
5Preventative Maintenance (PM).
6Facility / System / Equipment Certification and Commissioning Statements.
7Establishment and Scheduling of Instrument Approach Procedures (IAP's).
8Issuance of Commissioning NOTAM.
9Facilities Master File (FMF) Change.

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Sheet7

CONTRACTOR ACCEPTANCE INSPECTION REPORT EXCEPTIONS LIST AND CLEARANCE RECORDSheetof
AFS/SFO CC and LocationFac. ID & Alpha CodeJob Order No.Dates of CAIType of CAI:
PlantsFinal
ElectronicsPartial no.
Exception Category:Number of Sheets:Total Number of Exceptions:
MajorMinorMajorMinorMajorMinor
Sec/ Item No.Exceptions and Actions RequiredAction OfficeEstimated Completion DateClearance Action TakenDate Cleared
REMARKS:

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