8_Ft_Carson_Sample_Project.pdf

STATEMENT OF WORK

DPW18-999

REPAIR HARDSTAND POSTWIDE

FORT CARSON, CO

DIRECTORATE OF PUBLIC WORKS

30 NOV 2017

30 November 2017 1 DPW18-999

STATEMENT OF WORK

DPW18-999

REPAIR HARDSTAND POSTWIDE

1.0 BACKGROUND

1.1. THE LEGACY MOTORPOOLS ON FORT CARSON STILL RESIDE ON THE

ORIGINAL CONCRETE HARDSTAND. MUCH OF THIS HARDSTAND IS NOW

EXPERIENCING SEVERE SPALLING, JOINT FAILURE, AND GENERAL

STRUCTURAL FAILURE AS IT EXCEEDS ITS USEFUL LIFE.

2.0 GENERAL

2.1. SCOPE

2.1.1. THE CONTRACTOR SHALL PROVIDE ALL LABOR, EQUIPMENT, AND

MATERIALS TO ACCOMPLISH THE FOLLOWING IAW THE

ACCOMPANYING PLANS AND SPECIFICATIONS.

2.1.1.1. CONDUCT HARDSTAND REPLACEMENT ON ALL HATCHED

AREAS. DIMENSIONS ARE APPROXIMATE AND SHALL BE TAKEN TO

NEAREST EXISTING JOINT. INTEGRAL CURBS SHALL BE REPLACED IN

KIND. EXISTING PAVEMENT MARKINGS SHALL BE REPLACED IN KIND.

DOWELED CONTRACTION JOINTS OR CONSTRUCTION JOINTS SHALL BE

USED ON ALL INTERIOR JOINTS. THICKENED EDGE JOINTS SHALL BE

USED ON ALL JOINTS ABUTTING GRAVEL. THICKENED EDGE

EXPANSION JOINTS SHALL BE USED ON ALL JOINTS ABUTTING

EXISTING HARDSTAND AND OTHER STRUCTURES (I.E. BUILDINGS,

LIGHT POLES, MANHOLES). NEW HARDSTAND SECTION SHALL BE 10"

THICK WITH A CDOT CLASS 5 BASE COURSE THICKNESS OF 12".

EXISTING HARDSTAND IS 10" THICK.

2.1.1.2. REMOVE SUBGRADE, REMOVE GRAVEL, AND REINSTALL

GRAVEL AS NECESSARY 5' FROM ALL INTEGRAL CURBS BEING

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REPLACED SO IT FALLS 1/2 INCH BELOW THE EDGE OF CURB TO

PREVENT OVERFLOW INTO THE HARDSTAND.

2.1.1.3. CONDUCT PARTIAL DEPTH PATCHING (ALLOWANCE) OF 50 SY.

ALL ALLOWANCE WORK SHALL BE DECIDED ON SITE WITH A

GOVERNMENT REPRESENTATIVE. PATCHING SHALL BE DONE USING A

GOVERNMENT APPROVED POLYMERIC CONCRETE PATCH MATERIAL

DESIGNED FOR THAT PURPOSE. PRODUCT SHALL BE ON CDOT

APPROVED PRODUCTS LIST.

2.2. CONSTRAINTS

2.2.1. PHASING: WORK SHALL BE PHASED TO ALLOW FOR CONTINUOUS

ACCESS TO COMPOUND. CONTRACTOR SHALL DEVELOP PHASING

PLANS AND COORDINATE DIRECTLY WITH FACILITY MANAGERS OF

AFFECTED FACILITIES. CONTRACTOR SHALL OBTAIN ALL REQUIRED

SIGNATURES, INCLUDING FACILITY MANAGERS, ON THE OUTAGE

REQUEST FORM FOR ALL AFFECTED FACILITIES FOR EACH WORK AREA.

THIS WILL ENTAIL PHYSICALLY GOING TO EACH FACILITY TO OBTAIN

SIGNATURES AND SUBMITTING THE OUTAGE FORM TO THE FT. CARSON

DIG PERMITS OFFICE. WORK PERIODS MAY BE ADJUSTED WITH

FACILITY MANAGER APPROVALS AND SIGNATURES.

2.2.2. FIELD PERFORMANCE DAYS: THE MAXIMUM FIELD PERFORMANCE

DAYS SHALL NOT EXCEED 180 DAYS.

2.2.3. HOURS: MONDAY - FRIDAY, 0600 - 1700

2.2.4. EXISTING CONDITIONS: CONTRACTOR SHALL FIELD VERIFY

CONDITIONS PRIOR TO START OF WORK TO CONFIRM PLANS MATCH

EXISTING CONDITIONS.

2.2.5. UTILITY OUTAGE/CONNECTION REQUESTS: THE CONTRACTOR

SHALL DEVELOP AND SUBMIT A FORT CARSON UTILITY

OUTAGE/CONNECTION REQUEST, FC FORM 420-E, FOR ANY CLOSURES

OR UTILITY OUTAGES. THE FORM SHALL BE SUBMITTED IN

ACCORDANCE WITH FORT CARSON REGULATION 420-19. OUTAGES

SHALL BE COORDINATED BY THE CONTRACTOR AND CONTRACTOR

SHALL OBTAIN ALL REQUIRED SIGNATURES ON THE OUTAGE REQUEST.

FORMS SHALL BE TURNED IN TO THE DIG PERMIT COORDINATOR AT

BLDG 1225, 1649 EVANS ST, FORT CARSON, CO, 719-526-5345.

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2.2.6. WORK DURING UTILITY OUTAGES: THE CONTRACTOR SHALL HAVE

CONTINGENCY PLANS FOR CONTINUING WORK DURING UTILITY

OUTAGES CAUSED BY THE CONTRACTOR OR OUTSIDE FORCES. THE

PLAN MUST ALSO INCLUDE PROCEDURES FOR PROMPTLY REPAIRING

UTILITY BREAKS MADE BY THE CONTRACTOR.

2.2.7. TRAFFIC CONTROL: THE CONTRACTOR IS RESPONSIBLE FOR

ESTABLISHING A TRAFFIC CONTROL PLAN IN ACCORDANCE WITH THE

MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (MUTCD) AND

APPROVED BY DPW. TRAFFIC CONTROL IS THE SOLE RESPONSIBILITY

OF THE CONTRACTOR. TRAFFIC CONTROL MEASURES AND PHASING

SHALL ALLOW FOR CONTINUOUS ACCESS TO THE MOTORPOOL (AT

LEAST 1 14’ LANE).

2.2.8. DIG PERMIT REQUEST: EXISTING UTILITIES SHOWN ON DRAWINGS

ARE COMPILED FROM THE BEST AVAILABLE INFORMATION. HOWEVER,

THE SITE PLAN MAY NOT BE INCLUSIVE OF ALL UTILITIES AND THE

DEPICTED LOCATIONS MAY NOT BE ACCURATE. THE CONTRACTOR

SHALL OBTAIN AND PROCESS A FORT CARSON FACILITIES ENGINEER

DIG PERMIT REQUEST, FC FORM 86-E, FOR EACH REQUIREMENT THAT

REQUIRES A DIG PERMIT IN ACCORDANCE WITH FORT CARSON

REGULATION 420-20. CONTRACTOR SHALL OBTAIN ALL REQUIRED

SIGNATURES ON THE OUTAGE REQUEST. THE CONTRACTOR SHALL

VERIFY THE EXACT LOCATION OF ALL INDICATED UTILITY LINES AND

STRUCTURES ON THE DIG PERMIT AND TAKE NECESSARY

PRECAUTIONS TO PROTECT THEM. SHOULD THE CONTRACTOR

DAMAGE ANY SUCH UTILITY LINE OR STRUCTURE, THE CONTRACTOR

SHALL BE RESPONSIBLE FOR THE PROMPT REPAIR OF THAT DAMAGE,

AT THE CONTRACTOR'S EXPENSE. THE CONTRACTOR SHALL CONTACT

THE CONTRACTING OFFICER AND GOVERNMENT INSPECTOR TO

REPORT ANY DAMAGE AND IDENTIFY THE CONTRACTOR'S REPAIR.

FORMS SHALL BE TURNED IN TO THE DIG PERMIT COORDINATOR AT

BLDG 1225, 1649 EVANS ST, FORT CARSON, CO, 719-526-5345.

2.2.9. WORKING WITH OTHER AGENCIES/CONTRACTORS: OTHER

CONSTRUCTION AGENCIES/CONTRACTORS MAY WORKING IN THE

VICINITY OF THE PROJECT. THE CONTRACTOR SHALL CONDUCT WORK

SO AS TO NOT INTERFERE WITH OR HINDER THE PROGRESS OF THE

COMPLETION OF WORK BEING PERFORMED BY OTHER AGENCIES/

CONTRACTORS.

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2.2.10. CONSTRUCTION DEBRIS: UNLESS OTHERWISE NOTED, ALL

CONSTRUCTION DEBRIS, SPOILS, AND REMOVALS SHALL BECOME THE

PROPERTY OF THE CONTRACTOR AND SHALL BE DISPOSED OF OFF

POST.

2.2.11. RESTORATION TO ORIGINAL CONDITIONS: THE CONTRACTOR SHALL

LIMIT CONSTRUCTION ACTIVITIES TO THOSE AREAS WITHIN THE

LIMITS OF DISTURBANCE. ANY DISTURBANCE BEYOND THESE LIMITS

SHALL BE RESTORED TO ORIGINAL CONDITION BY THE CONTRACTOR

AT THE CONTRACTOR'S EXPENSE.

2.2.12. RESTROOMS: CONTRACTOR SHALL PROVIDE PORTABLE

RESTROOMS FOR ALL PERSONNEL. GOVERNMENT FACILITY

RESTROOMS ARE OFF LIMITS.

2.2.13. SAFETY: CONTRACTOR PERFORMING WORK MUST COMPLY WITH

EM 385-1-1, AR 385-10, OSHA 29 CFR 1910/1926, EPA & NFPA STANDARDS,

ALL REHABILITATION/ENVIRONMENTAL LAWS AND REGULATIONS.

2.2.14. FIRE HYDRANTS: THE CONTRACTOR SHALL COORDINATE WITH THE

GOVERNMENT INSPECTOR PRIOR TO MAKING ANY CONNECTIONS. A

BACKFLOW PREVENTER IS REQUIRED TO BE INSTALLED BY

CONTRACTOR WHENEVER A HYDRANT IS USED TO SUPPLY WATER FOR

CONSTRUCTION SITE USE.

2.2.15. HOT WORK PERMIT: THE CONTRACTOR SHALL OBTAIN HOT WORK

PERMITS PRIOR TO CONDUCTING ANY TYPE OF HOT WORK OR WORK

THAT MAY EMIT SPARKS SUCH AS CUTTING METAL, WELDING, ETC.

PERMITS ARE REQUIRED BEFORE WORK MAY BE COMMENCED. IT IS

THE CONTRACTOR'S DUTY TO TIMELY OBTAIN SUCH PERMITS.

2.2.16. ANTITERRORISM-FORCE PROTECTION REQUIREMENTS:

2.2.16.1. GENERAL. CONTRACTOR PERSONNEL PERFORMING WORK

UNDER THIS CONTRACT MUST BE ABLE TO DOCUMENT APPROPRIATE

VEHICLE REGISTRATION AND INSURANCE, AS WELL AS DRIVER

IDENTIFICATION AT TIME OF THE PROPOSAL SUBMISSION, AND MUST

MAINTAIN THE LEVEL OF SECURITY REQUIRED FOR THE LIFE OF THE

CONTRACT. THE CONTRACTOR SHALL MAINTAIN VEHICLE

REGISTRATION, INSURANCE, AND DRIVER CERTIFICATIONS FOR THE

DURATION OF THE CONTRACT.

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2.2.16.2. ACCESS AND GENERAL PROTECTION/SECURITY POLICY AND

PROCEDURES. THIS STANDARD LANGUAGE IS FOR CONTRACTOR

EMPLOYEES WITH AN AREA OF PERFORMANCE WITHIN ARMY

CONTROLLED INSTALLATION, FACILITY, OR AREA. CONTRACTOR AND

ALL ASSOCIATED SUB-CONTRACTORS EMPLOYEES SHALL PROVIDE

ALL INFORMATION REQUIRED FOR BACKGROUND CHECKS TO MEET

INSTALLATION ACCESS REQUIREMENTS TO BE ACCOMPLISHED BY

INSTALLATION PROVOST MARSHAL OFFICE, DIRECTOR OF

EMERGENCY SERVICES OR SECURITY OFFICE. CONTRACTOR

WORKFORCE MUST COMPLY WITH ALL PERSONAL IDENTITY

VERIFICATION REQUIREMENTS (FAR CLAUSE 52.204-9, PERSONAL

IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL) AS DIRECTED

BY DOD, HQDA AND/OR LOCAL POLICY. IN ADDITION TO THE

CHANGES OTHERWISE AUTHORIZED BY THE CHANGES CLAUSE OF

THIS CONTRACT, SHOULD THE FORCE PROTECTION CONDITION

(FPCON) AT ANY INDIVIDUAL FACILITY OR INSTALLATION CHANGE,

THE GOVERNMENT MAY REQUIRE CHANGES IN CONTRACTOR

SECURITY MATTERS OR PROCESSES.

2.2.16.3. AT LEVEL I TRAINING. THE CONTRACTOR EMPLOYEES, TO

INCLUDE SUBCONTRACTOR EMPLOYEES, REQUIRING ACCESS ARMY

INSTALLATIONS, FACILITIES AND CONTROLLED ACCESS AREAS SHALL

COMPLETE AT LEVEL I AWARENESS TRAINING WITHIN 60 CALENDAR

DAYS AFTER CONTRACT START DATE OR EFFECTIVE DATE OF

INCORPORATION OF THIS REQUIREMENT INTO THE CONTRACT,

WHICHEVER IS APPLICABLE. THE CONTRACTOR SHALL SUBMIT

CERTIFICATES OF COMPLETION FOR EACH AFFECTED CONTRACTOR

EMPLOYEE AND SUBCONTRACTOR EMPLOYEE, TO THE COR OR TO THE

CONTRACTING OFFICER, IF A COR IS NOT ASSIGNED, WITHIN 30

CALENDAR DAYS AFTER COMPLETION OF TRAINING BY ALL

EMPLOYEES AND SUBCONTRACTOR PERSONNEL. AT LEVEL I

AWARENESS TRAINING IS AVAILABLE AT THE FOLLOWING WEBSITE:

HTTP://JKO.JTEN.MIL . PER AR 530-1, OPERATIONS SECURITY, NEW

CONTRACTOR EMPLOYEES MUST COMPLETE LEVEL I OPSEC TRAINING

WITHIN 30 CALENDAR DAYS OF THEIR REPORTING FOR DUTY. ALL

CONTRACTOR EMPLOYEES MUST COMPLETE ANNUAL OPSEC

AWARENESS TRAINING.

2.2.16.4. IWATCH TRAINING. THE CONTRACTOR AND ALL ASSOCIATED

SUB-CONTRACTORS SHALL BRIEF ALL EMPLOYEES ON THE LOCAL

IWATCH PROGRAM (TRAINING STANDARDS PROVIDED BY THE

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REQUIRING ACTIVITY ATO). THIS LOCAL DEVELOPED TRAINING WILL

BE USED TO INFORM EMPLOYEES OF THE TYPES OF BEHAVIOR TO

WATCH FOR AND INSTRUCT EMPLOYEES TO REPORT SUSPICIOUS

ACTIVITY TO THE COR. THIS TRAINING SHALL BE COMPLETED WITHIN

60 CALENDAR DAYS OF CONTRACT AWARD AND WITHIN 60 CALENDAR

DAYS OF NEW EMPLOYEES COMMENCING PERFORMANCE WITH THE

RESULTS REPORTED TO THE COR NLT 90 CALENDAR DAYS AFTER

CONTRACT AWARD.

2.2.16.5. ACCESS CARDS. FOR CONTRACTORS THAT DO NOT REQUIRE

CAC, BUT REQUIRE ACCESS TO A DOD FACILITY OR INSTALLATION.

CONTRACTOR AND ALL ASSOCIATED SUB-CONTRACTORS EMPLOYEES

SHALL COMPLY WITH ADJUDICATION STANDARDS AND PROCEDURES

USING THE NATIONAL CRIME INFORMATION CENTER INTERSTATE

IDENTIFICATION INDEX (NCIC-III) THIS IS DONE BY COMPLETING A

REQUEST FOR A FORT CARSON INSTALLATION ACCESS CONTROL

CARD (FC FORM FC FORM 2036-E) AND TERRORIST SCREENING

DATABASE (TSDB) (ARMY DIRECTIVE 2014-05/AR 190-13), APPLICABLE

INSTALLATION, FACILITY AND AREA COMMANDER

INSTALLATION/FACILITY ACCESS AND LOCAL SECURITY POLICIES

AND PROCEDURES (PROVIDED BY GOVERNMENT REPRESENTATIVE),

OR, AT OCONUS LOCATIONS, IN ACCORDANCE WITH STATUS OF

FORCES AGREEMENTS AND OTHER THEATER REGULATIONS. THE

PROCESS FOR OBTAINING AN ACCESS PASS IS AS FOLLOWS: THE COR

WILL PRE‐-FILL OUT FC FORM 2036‐-E REQUEST FOR FORT CARSON

INSTALLATION ACCESS CONTROL CARD, WITH ALL RELEVANT

CONTRACT INFORMATION AND PROVIDE TO THE CONTRACTOR

PROJECT MANAGER OR DESIGNATED POC. THE CONTRACTOR WILL

PROVIDE THE COMPLETED FORM IN PDF FORMAT ELECTRONICALLY

BY EMAIL TO THE COR FOR APPROVAL AND DIGITAL SIGNATURE. (THE

SPONSOR CAN BE A CONTRACTOR EMPLOYEE). THE COR WILL VERIFY

NEED FOR FORT CARSON ACCESS, DIGITALLY SIGN AND EMAIL BACK

TO THE CONTRACTOR EMPLOYEE. CONTRACTORS WILL GO DIRECTLY

TO GATE 1 VISITOR CENTER WITH THEIR SIGNED FC FORM 2036‐-E AND

CREDENTIALS FOR A ONE‐-STOP NCIC III CHECK AND ACCESS CARD

WITH PHOTO ISSUE.

2.2.16.6. 1 DAY PASSES: COMMERCIAL VEHICLES AND VENDORS’ WILL

USE GATE 3 WHERE THE NCIC CHECK WILL BE DONE “IN‐-LANE”AND A

DAY PASS WILL BE ISSUED. FOR VISITOR ACCESS, USE GATE 1 VISITOR

CENTER WHERE THE NCIC CHECK WILL BE DONE AND A DAY PASS

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ISSUED. THIS ALSO APPLIES TO ALL THOSE WHO HAVE A VALID ID,

BUT HAVE TEMPORARILY MISPLACED IT.

3.0 PROJECT REQUIREMENTS

3.1. THE CONTRACTOR SHALL PROVIDE ALL LABOR, MATERIALS,

EQUIPMENT, AND MATERIALS NECESSARY TO COMPLETE THE PROJECT

IAW THE ACCOMPANYING PLANS, SPECIFICATIONS, AND THE

FOLLOWING CDOT SECTIONS.

3.2. CDOT SECTION 106– CONTROL OF MATERIAL

3.2.1. CONDUCT MATERIAL/COMPACTION/QUALITY CONTROL TESTING IN

ACCORDANCE WITH TABLE 106-3 FOR CONCRETE. COSTS OF ALL TESTS

SHALL BE PAID BY THE CONTRACTOR.

3.3. CDOT SECTION 202– REMOVAL OF STRUCTURES AND OBSTRUCTIONS

3.3.1. REMOVE EXISTING HARDSTAND.

3.4. CDOT SECTION 203– EXCAVATION AND EMBANKMENT

3.4.1. REMOVE EXISTING BASE COURSE AND SUBGRADE TO THE

SPECIFIED DEPTH.

3.5. SECTION 250– ENVIRONMENTAL, HEALTH, AND SAFETY MANAGEMENT

3.5.1. REGULATIONS AND REQUIREMENTS: THIS PROJECT IS SUBJECT TO

ALL ENVIRONMENTAL REGULATIONS AND REQUIREMENTS AS

ENUMERATED BY THE FORT CARSON DPW ENVIRONMENTAL DIVISION.

THESE REQUIREMENTS ARE LISTED IN THE MITIGATION

MEASURES/REQUIREMENTS TABLE. THESE REQUIREMENTS SHALL BE

CONSIDERED TO BE PART OF THIS STATEMENT OF WORK, AND

COMPLIANCE WITH THESE REQUIREMENTS IS THE RESPONSIBILITY OF

THE CONTRACTOR.

3.5.2. DISTURBANCE UNDER (1) ACRE: INSTALL ALL SEDIMENT AND

EROSION CONTROL MEASURES UTILIZING BEST MANAGEMENT

PRACTICES (BMP's) AS DIRECTED IN THE STORMWATER MANAGEMENT

PLAN AND CDOT SPECIFICATIONS PRIOR TO COMMENCING WORK. HAY

BALES ARE NOT CONSIDERED BMP's. THE CONTRACTOR SHALL

PROTECT EXISTING STORM DRAINS, WATERWAYS, ETC., IN

ACCORDANCE WITH THE FORT CARSON MS-4 PERMIT, MINIMIZE OFF

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SITE RUNOFF AND SEDIMENT TRANSPORT, AND ENSURE THERE ARE NO

NON-STORMWATER DISCHARGES FROM THE SITE.

3.5.3. THE CONTRACTOR SHALL LIMIT CONSTRUCTION ACTIVITIES TO

THOSE AREAS WITHIN THE LIMITS OF DISTURBANCE AND/OR TOES OF

SLOPES AS SHOWN ON THE PLANS. ANY DISTURBANCE BEYOND THESE

LIMITS SHALL BE RESTORED TO ORIGINAL CONDITION BY THE

CONTRACTOR AT THE CONTRACTOR'S EXPENSE. CONSTRUCTION

ACTIVITIES, IN ADDITION TO NORMAL CONSTRUCTION PROCEDURES,

SHALL INCLUDE THE PARKING OF VEHICLES OR EQUIPMENT, DISPOSAL

OF LITTER, AND ANY OTHER ACTION WHICH ALTER EXISTING

CONDITIONS. ANY STAGING AREAS MUST BE APPROVED BY THE

CONTRACTING OFFICER.

3.5.4. THE CONTRACTOR SHALL PROVIDE ON SITE DUST CONTROL.

3.5.5. WASTE MANAGEMENT: GOVERNMENT POLICY IS TO APPLY SOUND

ENVIRONMENTAL PRINCIPLES IN THE DESIGN, CONSTRUCTION AND

USE OF FACILITIES. AS PART OF THE IMPLEMENTATION OF THAT

POLICY: (1) PRACTICE EFFICIENT WASTE MANAGEMENT WHEN SIZING,

CUTTING, AND INSTALLING PRODUCTS AND MATERIALS AND (2) USE

ALL REASONABLE MEANS TO DIVERT CONSTRUCTION AND

DEMOLITION WASTE FROM LANDFILLS AND INCINERATORS AND TO

FACILITATE THEIR RECYCLING OR REUSE. A MINIMUM OF 10 PERCENT

BY WEIGHT OF TOTAL PROJECT SOLID WASTE SHALL BE DIVERTED

FROM THE LANDFILL.

3.5.6. CONTRACTOR MAY ENCOUNTER MATERIALS THAT ARE

CONTAMINATED WITH PETROLEUM PRODUCTS. IF THE CONTRACTOR

DETECTS CONTAMINATION, CEASE WORK AND CONTACT DPW FOR

TESTING. CDOT SECTION 304– AGGREGATE BASE COURSE

3.6. CDOT SECTION 304– AGGREGATE BASE COURSE

3.6.1. INSTALL AGGREGATE BASE COURSE TO ACHIEVE SPECIFIED

THICKNESS. COMPACT TO 95% MODIFIED PROCTOR AND +/-3%

OPTIMUM MOISTURE CONTENT, WITH A MAXIMUM COMPACTED LIFT

DEPTH OF 3". DEEPER LIFTS MAY BE PERMITTED IF DESIRED

COMPACTION CAN BE DEMONSTRATED FOR THE FULL DEPTH OF THE

LIFT.

3.7. CDOT SECTION 306– RECONDITIONING

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3.7.1. EXPOSE AND RECONDITION EXISTING BASE COURSE OR SUB-

GRADE. SCARIFY TO A DEPTH OF 6 INCHES, SHAPE AND COMPACT TO

95% MODIFIED PROCTOR AND +/- 3% OPTIMUM MOISTURE CONTENT.

3.8. CDOT SECTION 412- PORTLAND CEMENT CONCRETE PAVEMENT

3.8.1. ALL FORMWORK AND SHORING DESIGN SHALL BE THE

RESPONSIBILITY OF THE CONTRACTOR.

3.8.2. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PROTECTION OF

WORK.

3.8.3. COLD WEATHER PLACEMENT SHALL BE DONE IN ACCORDANCE

WITH THIS SECTION.

3.8.4. CONCRETE HARDSTAND REPLACEMENT

3.8.4.1. THE MAXIMUM DOWEL BAR SPACING SHALL BE 12" ON

CENTER.

3.8.4.2. ALL DOWEL BARS SHALL BE EPOXY COATED, INCLUDING

ENDS. IF DOWEL BARS ARE CUT THE ENDS MUST BE COATED WITH

EPOXY AS WELL. ALL DOWEL BARS SHALL BE SMOOTH DOWEL BARS.

ONE HALF (1/2) OF THE LENGTH OF THE DOWELS SHALL BE OILED.

3.8.4.3. DOWEL BARS PARALLEL TO A PLANNED JOINT SHALL NOT BE

PLACED CLOSER THAN 0.6 TIMES THE DOWEL BAR LENGTH FROM THE

PLANNED JOINT.

3.8.4.4. DOWELS MAY EITHER BE PLACED BEFORE CASTING, DRILLED

OR INSTALLED WITH THE FORMWORK. IF THE DOWELS ARE DRILLED,

AN INJECTION GROUT SHALL BE INJECTED INTO THE BACK OF THE

HOLE. THE DOWEL BAR SHALL THEN BE INSERTED AND TWISTED

SIMULTANIOUSLY FOR AT LEAST ONE FULL TWIST OF 360 DEGREES.

BUTTERING OF THE DOWEL BARS IS NOT PERMITTED. A PLASTIC DISK

SHALL BE INSTALLED WITH EACH DOWEL BAR TO PREVENT THE

GROUT FROM RUNNING OUT OF THE HOLE. IF DOWELS BASKETS ARE

USED, DOWEL BASKETS SHALL BE ANCHORED TO BASE COURSE TO

ENSURE PROPER ALIGNMENT/ELEVATION. IF DOWELS ARE INSTALLED

IN THE FORMWORK, MEASURES SHALL BE PUT IN PLACE TO ENSURE

PROPER DOWEL ALIGNMENT.

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3.8.4.5. ALL JOINTS SHALL BE SAWED, CLEANED AND SEALED WITH A

POLYURETHANE JOINT SEALANT. JOINT CLEANING, SIZE AND

PREPARATION SHALL BE IN ACCORDANCE WITH MANUFACTURER'S

INSTRUCTIONS.

3.8.4.6. FOR ALL JOINTS INSTALL A BACKER ROD (ENSURE IT IS

COMPATIBLE WITH THE PROPOSED SEALANT) TO PREVENT THREE

SIDED ADHESION. USE BOND BREAKER TAPE IN JOINTS THAT WILL

NOT ALLOW FOR PROPER BACKER ROD INSTALLATION. INSTALL

BACKER ROD IN ACCORDANCE WITH THE MANUFACTURERS

INSTRUCTIONS.

3.8.4.7. EXPANSION JOINTS TO BE USED AT ALL EXISTING OR

PROPOSED STRUCTURES AND FEATURES PROJECTING THROUGH, INTO,

OR AGAINST THE PAVEMENT.

3.8.4.8. POLYURETHANE JOINT SEALANT SHALL BE WEATHER AND

PETROLEUM PRODUCT RESISTANT.

3.8.4.9. ALL DEBRIS SHALL BE HAULED OFF POST.

3.8.4.10. BEST PRACTICES AND EQUIPMENT SHALL BE EMPLOYED TO

PREVENT MATERIAL SEGREGATION.

3.8.4.11. THE CONTRACTOR SHALL ADJUST ALL MANHOLES, VALVE

BOXES, CATHODIC PROTECTION TEST STATION BOXES, ETC. FLUSH

WITH FINISHED GRADE.

3.8.4.12. WHERE POSSIBLE, CONCRETE JOINT SPACING SHALL MATCH

EXISTING DIMENSIONS.

3.8.5. PARTIAL DEPTH CONCRETE PATCHING

3.8.5.1. PATCHING SHALL BE DONE USING A GOVERNMENT

APPROVED POLYMERIC CONCRETE PATCH MATERIAL DESIGNED FOR

THAT PURPOSE. PRODUCT SHALL BE ON CDOT APPROVED PRODUCTS

LIST. PATCHING SHALL BE DONE IN ACCORDANCE WITH

MANUFACTURER'S WRITTEN INSTRUCTIONS AND UFC 3-270-03

'CONCRETE CRACK AND PARTIAL DEPTH SPALL REPAIR'.

3.8.5.2. REMOVE ALL UNSOUND CONCRETE TO AN APPROXIMATE

DEPTH OF 3". IF CHIPPING IS USED, A BOUNDARY SHALL BE CUT

AROUND AREA TO BE PATCHED USING A CONCRETE OR HAND SAW

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PRIOR TO CHIPPING. REMOVE ANY UNSOUND CONCRETE. MINIMUM

PATCH SIZE SHALL BE 4' X 4'.

3.8.5.3. CLEAN THE REPAIR SURFACES USING WATER BLASTING OR

SAND BLASTING TO REMOVE ANY LOOSE CONCRETE, RUST, OIL, OR

OTHER CONTAMINANTS THAT WOULD INTERFERE WITH A PROPER

BOND. REMOVE DEBRIS FROM AREA TO PREVENT FROM REENTERING

PATCH.

3.8.5.4. IF REQUIRED FOR THE REPAIR MATERIAL, APPLY BONDING

AGENT TO THE SPALL REPAIR SURFACE.

3.8.5.5. EXISTING JOINT LOCATIONS AND WIDTHS SHALL BE

MAINTAINED. MATERIAL SHALL NOT BE ALLOWED TO FILL GAPS

BELOW PATCH IN EXISTING JOINTS. WHERE THE SPALLED AREA

ABUTS A JOINT, AN INSERT OR OTHER BOND BREAKING MEDIUM

SHALL BE USED TO PREVENT BONDING AT THE JOINT FACE.

3.8.5.6. APPLY AND CURE PATCH MATERIAL IN ACCORDANCE WITH

MANUFACTURER'S WRITTEN INSTRUCTIONS.

3.8.5.7. ALL JOINTS SHALL BE SAWED, CLEANED AND SEALED WITH A

POLYURETHANE JOINT SEALANT. JOINT CLEANING, SIZE AND

PREPARATION SHALL BE IN ACCORDANCE WITH MANUFACTURER'S

INSTRUCTIONS.

3.8.5.8. FOR ALL JOINTS INSTALL A BACKER ROD (ENSURE IT IS

COMPATIBLE WITH THE PROPOSED SEALANT) TO PREVENT THREE

SIDED ADHESION. USE BOND BREAKER TAPE IN JOINTS THAT WILL

NOT ALLOW FOR PROPER BACKER ROD INSTALLATION. INSTALL

BACKER ROD IN ACCORDANCE WITH THE MANUFACTURERS

INSTRUCTIONS.

3.8.5.9. POLYURETHANE JOINT SEALANT SHALL BE BE WEATHER AND

PETROLEUM PRODUCT RESISTANT.

3.9. CDOT SECTION 601- STRUCTURAL CONCRETE

3.9.1. PCC COARSE AND FINE AGGREGATE TESTS USED FOR MATERIAL

APPROVAL SHALL BE DATED WITHIN THE PAST 180 DAYS AND INCLUDE

THE FOLLOWING MINIMUM TESTS/REQUIREMENTS. MATERIAL SHALL

MEET CDOT 2017 SPECIFICATIONS UNLESS OTHERWISE NOTED.

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3.9.1.1. AASHTO STANDARD SPECIFICATION FOR FINE AGGREGATE

FOR PORTLAND CEMENT CONCRETE (AASHTO M 6)

3.9.1.2. ALL AGGREGATE TESTS LISTED IN CDOT 2017 SPECIFICATIONS

SECTION 601.05

3.9.2. PCC MIX DESIGN TESTS USED FOR MATERIAL APPROVAL SHALL BE

DATED WITHIN THE PAST 180 DAYS AND INCLUDE THE FOLLOWING

MINIMUM TESTS/REQUIREMENTS. MATERIAL SHALL MEET CDOT 2017

SPECIFICATIONS UNLESS OTHERWISE NOTED.

3.9.2.1. CDOT CLASS P REQUIREMENTS

3.9.2.2. MINIMUM 20% CLASS F FLY ASH SUBSITUTION BY WEIGHT

3.9.2.3. TYPE II CEMENT

3.9.2.4. ALL TRIAL MIX DATA TESTS LISTED IN CDOT 2017

SPECIFICATIONS SECTION 601.05

3.9.3. PATCHING SHALL BE DONE USING A GOVERNMENT APPROVED

POLYMERIC CONCRETE PATCH MATERIAL DESIGNED FOR THAT

PURPOSE. PRODUCT SHALL BE ON CDOT APPROVED PRODUCTS LIST.

3.10. CDOT SECTION 630– CONSTRUCTION ZONE TRAFFIC CONTROL

3.10.1. THE CONTRACTOR IS RESPONSIBLE FOR ESTABLISHING A TRAFFIC

CONTROL PLAN IN ACCORDANCE WITH MUTCD AND APPROVED BY

DPW. TRAFFIC CONTROL IS THE SOLE RESPONSIBILITY OF THE

CONTRACTOR.

3.11. CDOT SECTION 708– PAINTS

3.11.1. ALL PAVEMENT MARKINGS SHALL COMPLY WITH THIS SECTION.

4.0 GOVERNMENT FURNISHED DOCUMENTS

4.1. 60% SITE PLAN

5.0 APPLICABLE DOCUMENTS

5.1. ALL REQUIRED SUBMITTALS WILL BE LISTED ON AF FORM 66 AND

SUBMITTED USING AF FORM 3000, ANY MISSING SUBMITTALS REQUIRED

BY THE SPECIFICATIONS SHALL BE SUBMITTED TO USING AF FORM 3000.

30 November 2017 13 DPW18-999

ALL SUBMITTALS SHALL MEET THE REQUIREMENTS LISTED IN THE

SPECIFICATIONS UNDER EACH SECTION.

6.0 APPLICABLE CODES, PERMITS AND SPECIFICATIONS:

6.1. WORK SHALL BE PERFORMED IN ACCORDANCE WITH THE MOST

CURRENT APPLICABLE FEDERAL, STATE, LOCAL, AND FORT CARSON

LAWS, CODES, REGULATIONS AND STANDARDS AT TIME OF AWARD.

THE CONTRACTOR IS RESPONSIBLE TO RESEARCH ALL APPLICABLE

LAWS, CODES REGULATIONS AND STANDARDS TO MEET CONTRACT

REQUIREMENTS AND PROVIDE A SAFE AND USEABLE FINISHED

PRODUCT. IF THERE IS A CONFLICT BETWEEN THE LAWS, CODES,

REGULATIONS AND STANDARDS AND THE INFORMATION PROVIDED BY

THE GOVERNMENT, THE CONTRACTOR SHALL IMMEDIATELY NOTIFY

THE CONTRACTING OFFICER FOR DIRECTION. APPLICABLE CODES AND

STANDARDS INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:

6.1.1. CDOT M&S STANDARDS (2017)

6.1.2. COLORADO DEPARTMENT OF TRANSPORTATION (CDOT)

STANDARDS SPECIFICATIONS FOR ROAD AND BRIDGE

CONSTRUCTIONS. (2017)

6.1.3. MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (2009)

7.0 POINTS OF CONTACT

PROJECT ENGINEER: WARREN L. WADE, 719.526.9211 OR 727.741.1947

CONSTRUCTION REPRESENTATIVE: WILL BE PROVIDED AT PROJECT KICKOFF

MEETING

8.0 ATTACHMENTS

8.1.1. DRAWINGS/SPECIFICATIONS

8.1.2. SUBMITTAL REGISTER

8.1.3. NEPA MITIGATION MEASURES/REQUIREMENTS

8.1.4. FORT CARSON DOCUMENTS AND FORMS

8.1.4.1. FC FORM 86-E DIG PERMIT REQUEST

30 November 2017 14 DPW18-999

8.1.4.2. HYDRANT APPLICATION

8.1.4.3. FC FORM 2036-E REQUEST FOR A FORT CARSON

INSTALLATION ACCESS CONTROL CARD

END OF DOCUMENT

30 November 2017 DPW18-999

DRAWINGS/SPECIFICATIONS

SUBMITTAL REGISTER

SUBMITTAL REGISTER CONTRACT NO.

(ER 415-1-10)

TITLE AND LOCATION CONTRACTOR SPECIFICATION SECTION

DPW18-99 Repair Hardstand Postwide

CLASSI-

TYPE OF SUBMITTAL FICATION CONTRACTOR CONTRACTOR GOVERNMENT

SCHEDULED DATES ACTION ACTION

I C N E I S S R N G

TRANS- SPECIFICATION T S T T F O

MITTAL ITEM PARAGRAPH DESCRIPTION OF D R C A I O V A R

NO. NO. NUMBER ITEM SUBMITTED R U H T R F S R R E P E APPROVAL MATERIAL SUBMIT

A C E E E I A E M R P V SUBMIT NEEDED NEEDED CODE DATE TO CODE DATE REMARKS

W T D M P C M C A N R I BY BY GOVERN-

D I I U E O A P O T O M O E MENT

A N O L N R T L R I N E V W T G N E T T E E D O L N E E A S S S S S S S S N Y T D R

a. b. c. d. e. f. g. h. i. j. k. l. m. n. o. p. q. r. s. t. u. v. w. x.

Construction Schedule showing Key Milestones and Inspection Points, As Often As Required to Maintain Accuracy x x Bid

2 Quality Control and Safety Plans x x Bid

3 Phasing Plan x x Bid

4 Concrete Mix Design x x NTL 2 Weeks after NTP

5 Proposed Reinforcing Steel x x NTL 2 Weeks after NTP

6 Proposed Landscape Rock x x NTL 2 Weeks after NTP

7 Proposed Base Course x x NTL 2 Weeks after NTP

DPW Approved Outage Requests, Signed by Required Signators x x

NLT 1 week Prior to Outage

9 All Quality Control Test Reports x x

NLT 1 week after Testing Conducted

10 DD1354 x x NLT 2 weeks after CCD

11 As-Builts x x NLT 2 weeks after CCD

ENG TIO

g

_______ (Proponent: CEMP-CE)

NEPA MITIGATION

MEASURES/REQUIREMENTS

MITIGATION MEASURES / REQUIREMENTS TABLE

Proponent Name:

Warren L. Wade Project Number:

DPW18-999

POC Phone:

(719) 526-9211

NEPA Number:

2017-417df

Title:

Repair Hardstand at Bldg 8200

Description:

Repair hardstand at bldg 8200.

AIR

Lana Altepeter 719-526-6601

WASTEWATER/DRINKING WATER

Harold Noonan 719-526-1730

Dan Follett 719-526-2022

STORMWATER

Suzy Rohrs 719-526-1697

Although this is a larger area, it falls into the category of full depth replacements such as roads. As long as appropriate BMPs are used to control contaminated run off, the project does not require a stormwater permit. Concrete sawcut and washout are not allowable discharges to stormwater or the ground. If the stormwater inlets will be replaced as a part of this project, they need to be marked either with a permanent metal placard or a precast manhole cover similar to this:

The following standard comment applies:

The project is located within the permit area of Fort Carson's Municipal Separate Storm Sewer System (MS4) Permit.

The MS4 permit requires that Fort Carson implement best management practices (BMPs) to minimize and eliminate non-stormwater and contaminated or sediment laden stormwater discharges to local drainages or storm drains.

Examples of prohibited discharges include but are not limited to concrete washout water and water from concrete saw cuts; water contaminated with sediment, detergents, or petroleum products; and super-chlorinated water from line flushing. The contractor/construction entity must implement BMPs that prevent these types of discharges from leaving the project area for the duration of the project, regardless of the project size.

ASBESTOS/LEAD/TOXICS

David Martin 719-526-1725

No concerns.

IRP

Updated 11/30/2017 diane.frost1 Highlight

Eric Dunker 719-526-8004 Julia Simmons 719-526-1682

It is possible that POL may be encountered under the existing hardstand during construction. If this occurs, the DPW- Environmental Division must me contacted immediately. There shall be no soil sampling whatsoever, unless authorized and directed by DPW-Environmental. Contact the IRP program with questions at 719-526-8001.

AST/UST/SPILL

Terry Eberle 719-526-9411

No concerns.

RCRA

Cheryl Frischkorn 719-526-1686

Contact the RCRA Program Manager for questions regarding any potential waste characterization, waste accumulation, storage and disposal. 526-1686

INVASIVE PLANTS/PEST MANAGEMENT

Dawn Rodriguez 719-526-1329

Utilize native plants for any vegetative restoration work.

CULTURAL RESOURCES

Pam Miller 719-526-4484

Jennifer Kolise 719-503-6136 (PCMS) Betty Whiting 719-526-3796

This activity is exempted from further Section 106 consultation under the Built Environment Programmatic Agreement. Inadvertent Discovery of Archaeological, Cultural, or Paleontological Materials Standard Operating Procedure applies. (BE 1.A2)

FORESTRY/ARBORIST

Dan Gray 719-526-1692 (Main Post)

Jason Zayatz 719-526-1667 (Down Range)

Any trees within the proposed project area should be retained and incorporated into the landscape to the extent possible. If this is not feasible, the project proponent must contact DPW- Forestry at 526-1667/1692 for guidance PRIOR to any tree pruning or removal to ensure Army Reg. 200-1 and other laws/ guidelines are adhered to.

WATERSHEDS/WETLANDS/404

James Kulbeth 719-526-1685

WILDLIFE

Stephanie Smith-Froese 719-526-8006

Bryan Kluever 719-524-5393 Richard Riddle 719-503-6529 (PCMS)

To minimize Migratory Bird Treaty Act (MBTA) conflicts, removal of small trees and shrubs, mowing or removal of cattails, disturbance/destruction of riparian areas, and/or grading of prairie grass should occur from 1 November to 15 April. Otherwise, prior coordination with DPW-Wildlife is necessary to survey the project area within 2 weeks of starting construction. The primary nesting season for most birds protected by the MBTA occurs between 15 April -15 Sept, annually. If active MBTA nests are found, a 50ft buffer around each nest would be needed or a US Fish & Wildlife Service (USFWS) permit authorizing removal. If active nest(s) are discovered during project work activities, contact DPW-Wildlife immediately to avoid MBTA violation(s). If the scope or location changes, the proponent needs to coordinate with DPW Wildlife prior to beginning any work. The DPW Wildlife Biologist will conduct all surveys for wildlife.

OTHER

diane.frost1 Highlight

NEPA POCs Deb Benford 719-526-4666 Jack Haflett 719-526-6206 Diane Frost 719-526-0896

The Fort Carson NEPA Office must be notified of any change to the scope, location, or size of the project.

Project proponent is responsible to ensure coordination, monitoring, and mitigation requirements listed in this document are implemented.

Further Coordination May Be Required:

Finalized Date:

Click here to sign this section

Signed by FROST.DIANE.J.1147158200 View details on Monday, August 22, 2016 8:15 AM (Mountain Daylight Time)

9/30/2017

** Subject to requirements listed in the Mitigation Measures/Requirements Table. If project is not initiated within 180 days, and/or there is a change in scope of work or location this document becomes null and void. Contact the NEPA Coordinator for re-submittal. Expiration Date:

Any environmental information needed to meet permit requirements (i.e. historic properties, T&E Species, Air Quality.

etc) can be obtained from the Fort Carson Program POCs listed above.

CAUTION: IF THIS FORM IS PROVIDED AS AN ATTACHMENT TO, OR OTHERWISE AS A PART OF, A CONTRACT, THE FOLLOWING APPLIES:

The above information represents assessments from the Fort Carson DPW Environmental Division concerning environmental requirements relating to this project. These assessments are provided for the Contractor’s information only. The Government does not warrant that these assessments are accurate or comprehensive. The Contractor remains responsible to determine and comply with all applicable federal, state, local, and military environmental laws and regulations.

Fort Carson has implemented an Environmental Management System (EMS) as the primary management approach for addressing environmental impacts of its processes, activities, and services. Fort Carson uses the ISO 14001:2004 as the standard for its EMS. All personnel performing work for on behalf of Fort Carson must be aware of and understand Fort Carson's Environmental Policy. For information regarding EMS requirements contact the Fort Carson EMS office at 719- 526-1697.

7/1/2018

Updated 11/30/2017

Inadvertent Discovery of Archaeological, Cultural, or Paleontological Materials

In the event that a cultural resource, item of cultural material, or vertebrate paleontological resource is encountered during an undertaking, it is Fort Carson’s policy to make reasonable efforts to avoid, minimize, or mitigate adverse effects to those resources until the CRM can make a recommended determination of eligibility for inclusion in the NRHP and/or of the significance of the material. This process applies to newly discovered sites, as well as for a discovery on or near previously recorded properties where additional cultural materials or features may have been exposed. Note: A vertebrate paleontological resource is defined as fossil remnants from aquatic vertebrates (fish) to mammals, including birds.

Inadvertent Discovery of Archaeological Materials: Upon discovery, the following actions will be taken:

1. The project proponent, coordinator, or contractor will notify the Cultural Resources Manager (CRM) immediately, and all project work will cease within 30 meters of the site or discovery until otherwise notified by the CRM.

2. The CRM will inspect the site where archaeological materials have been discovered.

3. Documentation of the disturbance will be made, including notes and photographs.

4. The CRM will investigate to determine if the discovery constitutes a site with the potential to be eligible for inclusion in the National Register of Historic Properties (NRHP). If so, the CRM will initiate the Section 106 consultation process using 36 CFR 800.4 through 800.6, as applicable.

Willful Destruction of Archaeological Materials: The willful destruction, unauthorized excavation, removal, damage, or defacement of archeological materials is a violation of the Archaeological Resources Protection Act of 1979 (ARPA, as amended) and may result in a felony prosecution. The Integrated Natural Resource Management Plan (INRMP) provides for implementation of provisions under these laws. It is Fort Carson’s intent to prosecute anyone who vandalizes archeological sites or removes from federal property cultural materials or Native American remains or cultural items. See Section 4.c. Conservation Law Enforcement of the INRMP for details and enforcement procedures.

Native American Human Remains: In the event the find is or is suspected to be Native American human remains or funerary objects that are or may have been associated with human remains, the CRM will follow the stipulations and guidelines outlined in the Fort Carson NAGPRA policy, found within the Comprehensive Agreement between Fort Carson and 11 federally-recognized Native American Tribes.

Project Monitoring: Monitoring by Cultural Resources Management Program (CRMP) personnel may occur for activities or projects that are planned in areas that are known or suspected to have a greater likelihood for subsurface archaeological materials. The CRM will determine the appropriate level of monitoring and coordinate a schedule with the project proponent.

FORT CARSON DOCUMENTS AND FORMS

FC FORM 86-E, JAN 2015 PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 2

FACILITIES ENGINEERING DIG PERMIT REQUEST

(DPW is the proponent; the approving authority is FC Reg 420-20)

INVOLVING EXCAVATION, UTILITY, OR OTHER DISTURBANCES PER ATTACHED SKETCH.

DIG PERMIT NUMBER:

1. CLEARANCE IS REQUESTED TO PROCEED WITH WORK AT:

RECEIVED DATE: PROJECT NO: CONTRACTOR:

2. TYPE OF FACILITY WORK INVOLVED - EXPLAN THE EXACT LOCATION AND PROPOSED WORK:

3. INSTRUCTIONS: This work clearance request is used for any work (contract or in-house) that may disrupt vehicular, rail, or air traffic flow, utility services, protection provided by fire and intrusion alarm systems or routine activities of the installation. This form is used to coordinate the required work with key installation activities and keep customer inconvenience to a minimum. It is also used to identify potentially hazardous work conditions in an attempt to prevent accidents. The work clearance request is processed just prior to the start of work. If delays are encountered and the conditions at the job site change (or may have changed) this work clearance must be reprocessed. If you have any questions, please call the Dig Permit Coordinator at 526-3089 or the Utility Locator at 524-0892.

4. SIGNATURE OF REQUESTING OFFICIAL: 5. PHONE:

7. DATE DIG PERMIT TERMINATED:6. DATE DIG PERMIT REQUIRED:

ORGANIZATION

10. COMMUNICATIONS (HELP DESK) 526-5232

TICKET NUMBER REVIEWER'S NAME & DATE

8. UNCC 1-800-922-1987

9. CITY OF FOUNTAIN WATER 382-5604

11. ENVIRONMENTAL COMPLIANCE 526-1682

12. BARRACK PHONE (SPRINT) 579-1000

13. GOVERNMENT UTILITIES REMARKS AND INITIALS

a. ELECTRICAL DISTRIBUTION

REVIEWER'S NAME & DATE

b. GAS DISTRIBUTION

c. CATHODIC PROTECTION

d. WATER DISTRIBUTION

e. IRRIGATION SYSTEMS

f. SEWER LINES

g. STORM DRAIN SYSTEM

h. STEAM DISTRIBUTION

i. CHILLED WATER

j. COMPUTER/TRAFFIC

k. OTHER

14. ROAD CLOSURE; IF NEEDED, PLEASE COMPLETE FC FORM 420-E (FORT CARSON UTILITY OUTAGE/CONNECTION REQUEST)

a. MILITARY POLICE

b. MEDDAC AMBULANCE 526-7112

c. FIRE PREVENTION 526-0651

15. RANGE CONTROL 526-5597

16. DPW TRAFFIC CONTROL 526-9267

17. POST AGRONOMIST 526-1666/1696

FC FORM 86-E, JAN 2015 (Back) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 2

CONTRACT PRIOR TO:

1. ANY PROJECT THAT REQUIRES THE PLANTING OR DIGGING UP OF TREES AND BUSHES.

2. ANY PROJECT BEING DONE DOWNRANGE.

3. ANY PROJECT REQUIRING GROUND DISTURBANCE OR GREATER THAN ONE (1) ACRE.

18. REMARKS: THIS SECTION MUST DESCRIBE SPECIFIC PRECAUTIONARY MEASURES TO BE TAKEN BEFORE AND DURING WORK.

SPECIFIC COMMENTS CONCERNING THE APPROVED METHOD OF EXCAVATION, HAND, OR POWERED EQUIPMENT SHOULD BE

INCLUDED. NOTE: BORING: ALL UTILITIES MUST BE EXPOSED BEFORE CROSSING.

19. TROOP CONSTRUCTION:

IMPORTANT - READ BEFORE SIGNING

The undersigned understands that the Fort Carson Base Operations and Maintenance contract locators will attempt to locate the underground utility lines by using electronic detectors, maps, and other available information, but that all such methods may be inaccurate. Therefore, it is expressly understood and agreed between the undersigned and Fort Carson that NO GUARANTEES OR WARRANTIES, EXPRESSED OR IMPLIED, ARE MADE BY FORT CARSON as to the accuracy of any information furnish. Depth of bury, when provided, is never guaranteed. Twenty four inches either side of the stake, paint marks, or flag is considered a correct horizontal location for government owned utilities. When utilities cannot be electronically located, their approximate location will be drawn on the attached Underground Utility Location Map (Form.4.34.003). All identified utilities must be exposed before crossing or paralleling within three feet of the existing utility to determine bury depth. It is the responsibility of the undersigned and/or excavating company to pot hole or hand dig these identified utilities. All damages to any utilities by any person must be reported immediately so an investigation can be made to determine the cause of damage and arrangements made for necessary repairs. WHEN THE GOVERNMENT INVESTIGATOR DETERMINES THAT THE EXCAVATING COMPANY WAS AT FAULT AND DISREGARDED THE ABOVE MENTIONED INSTRUCTIONS, THE DIG PERMIT WILL BE TERMINATED. Locates are good for 30 days, unless extended by the government, and all utilities will be marked once, then it is the contractors responsibility to maintain the marks.

(SIGNATURE)

(DATE)

(PRINT NAME)

APPROVED

(DATE)

(PRINT NAME)

(SIGNATURE)

Hydrant Use Application

Organization: ____________________________________________________

Mailing Address: ___________________________________________________________________

Office Phone: _____________________________ Cell Phone: _____________________________

Hydrant Number: ______________Location:________________________________________

Hydrant Meter #: _________________ Beginning Meter Reading (gallons): _____________

Scheduled Start Date: ____________________ Scheduled Finish Date: ______________________

____ Backflow Preventer Will Be Used ____ Shutoff Valve Will Be Used

Proposed Use of Hydrant Water: _______________________________________________________

Note!! Use only fire hydrant wrenches on the caps or operating nut. No pipe wrenches. Open hydrant valve all to way to establish flow and prevent possible valve damage. Turn hydrant valve completely off at the end of each work day to allow the hydrant to drain and prevent freezing. Contractor WILL be charged for any hydrant valve damage they cause. Call 719-491- 2982 or email vincent.e.guthrie2.civ@mail.mil with your meter reading by the 15TH of each month.

Call the Fort Carson Dig Permit Office at (719) 302-0157 to obtain a work clearance/dig permit if any digging or excavation will be done. Fort Carson requires that a backflow preventer and shutoff valve be used at the connection point to the fire hydrant. Hydrants may be used for essential purposes only. Essential uses include, but are not limited to, dust mitigation, compaction, and construction site water use. Do not allow water to pool or flow onto the pavement or into gutters/storm sewers. Repair any system breaks and leaks immediately. Submit application to:

Fort Carson Directorate of Public Works Building 1219, Room 209

Phone: Vince Guthrie 719-526-2927 or 719-491-2982 M-F 0730 – 1600 hours

Name Signature Date

For Office Use Only

Permit Issued: No (see attached explanation) _____ Yes _____

Based on the information provided, a permit is issued authorizing the use of the requested hydrant. Call 719-491-2982 with the final meter reading from the hydrant. Keep a copy of this permit near the hydrant location, in your water truck(s), and/or in your construction trailer.

This permit will expire _______________ day of __________________, 201____.

DPW approval by _____________________________________________________

FC FORM 2036-E, DEC 2014

REQUEST FOR A FORT CARSON INSTALLATION ACCESS CONTROL CARD (Required for all Pass Requests greater than 24 hours) (DES is the proponent; the approving authority is DTM 09-012, December 8, 2009)

APPLICANT INFORMATION

NAME (Last, First, Middle): GRADE/RANK/STATUS: CTR

DATE OF BIRTH:SSN: GENDER (circle one): MALE / FEMALE

DRIVER'S LICENSE#: ORGANIZATION/UNIT:

ORGANIZATION/UNIT PHONE#: RELATIONSHIP TO SPONSOR:

E-MAIL ADDRESS:

REQUESTED CARD

NON-DOD CONTRACTOR FOREIGN NATIONAL FORT CARSON GOOD NEIGHBOR VENDOR FAMILY CARE PROVIDER

REQUESTED DATE(s) AND TIME(s) OF VISIT:

CONTRACT PERIOD (FROM/TO DATES) (CONTRACTOR/VENDOR USE AS APPLICABLE):

JUSTIFICATION FOR CARD:

SPONSOR INFORMATION

NAME (Last, First, Middle): GRADE/RANK/STATUS:

ORGANIZATION/UNIT: ORGANIZATION/UNIT PHONE#:

E-MAIL ADDRESS:

BDE/BN CDR/XO/DIRECTOR/DEPUTY DIRECTOR/COR CERTIFICATION

I certify that the applicant meets the justification requirements as indicated in Paragraph 2 above for access privileges. Furthermore I certify that the applicant requires an access control card to perform assigned duties or conduct official business on Fort Carson.

Privacy Act Statement

Authority: 10 U.S.C. 3013, Secretary of the Army; Army Regulation 190-13, The Army Physical Security Program and E.O. 9397 (SSN).

Purpose(s): To support Department of the Army physical security and access control programs; Information Assurance program; to record personal data and vehicle information registered with the Department of the Army; to provide a record of security/access badges issued; to restrict entry to installations and activities; to ensure positive identification of personnel authorized access to restricted areas; to maintain accountability for issuance and disposition of security/access badges and for producing installation management reports.

Routine uses: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: The DoD 'Blanket Routine Uses' also apply to this system of records.

Disclosure: Disclosure of SSN and other personal information is voluntary; however, failure provide the requested information can result in denial of access to the military installation.

PRINT CERTIFYING OFFICIAL'S NAME

RANK/PHONE NUMBER CERTIFYING OFFICIAL'S SIGNATURE

INSTALLATION ACCESS CONTROL OFFICE USE ONLY

ISSUING OFFICIAL:

APPROVED / DISAPPROVED

(circle one)

PRINT ISSUING OFFICIAL'S NAME ISSUING OFFICIAL'S SIGNATURE

DATE