Appendix I - Dig Perm (AF 103) 2023.pdf
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- Solicitation number
- FA301625Q0221
About this file
This is a Base Civil Engineering Work Clearance Request form used to coordinate and approve work that may disrupt base operations, utility services, or traffic flow. The form requires detailed information about the proposed work, including the type of facility/work involved (such as pavements, drainage systems, utilities, fire detection systems, or traffic flow), and mandates coordination with multiple base organizations like Electrical Distribution, Storm Drains, Water Distribution, and others. The requesting official must call the Civil Engineering Office (CEO) at 652-5555 upon work completion to schedule a site inspection and update the base's ongoing construction map. Key instructions emphasize the need to identify potentially hazardous work conditions, coordinate with key base activities, and minimize customer inconvenience during the work process.
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BASE CIVIL ENGINEERING WORK CLEARANCE REQUEST DATE PREPARED
1. Clearance is requested to proceed with work at: Building Name of Project ______________________________ Brief description of work _ ______________________________CE Work Order No.________________ Contract No. ____________ involving excavation or utility disturbance per Detailed Sketch on reverse side of form.
Note: Pavement (streets/parking lots) will not be cut unless approved 502CES/ CE2. Requesting Official must call CEO 652- 5555 when work is completed to schedule site visit to inspect for proper grounds restoration and to update base ongoing construction map.
The area involved Has Has not been staked or clearly marked RED = SHOP YELLOW= HG 62 BLUE=CUSTOMER CALLS
2. TYPE OF FACILITY/WORK INVOLVED
A. Pavements D. Fire Detection & Protection Systems G. Aircraft or Vehicular Traffic Flow
B. Drainage Systems E. Utility
Overhead Underground H. Security
C. Railroad Tracks F. Comm Overhead Underground I. Other Site Borings
3. DATE CLEARANCE REQUIRED
4. DATE CLEARANCE TERMINATED
5. CE CLEARANCE CONTROL NUMBER
6. NAME 7. CONTACT NUMBER 8. ORGANIZATION
CLEARANCE REVIEW
ORGANIZATION REMARKS REVIEWER’S NAME AND INITIALS
9. A. ELECTRICAL DISTRIBUTION
652-7616 (Red) Secondary Only
B A
B. STORM DRAINS
652-3310 (Green)
S E
C. WATER DISTRIBUTION
652-3310 (Blue)
C I
D. CATHODIC PROTECTION
652-7616 (Red)
V
E. IRRIGATION SPRINKLERS
L
F. CHILL WATER LINES
N G
G. Other
N
H. MILITARY HOUSING OFFICE
Fence only 652-1840 (Red)
I. Environmental (CEV) 652-4668
HG-62
R
J. High/Grade School 859-1961 Approval required when digging at schools
10 K. GAS DISTRIBUTION
811 (Yellow) CPS
11. American Water: (Water Distribution) Help Desk (210)-965-8574 awjbsaservicedesk@amwater.com
12. Base Communications 652-2881 (Orange) B-379
13. Wing Safety 652-1842 B-171
14. San Antonio River Authority (SARA) SANITARY SEWER (Green) 210-302-4200
15 ELECTRICAL DISTRIBUTION CPS
(811) All High Voltage Systems
16. Commercial Telephone Company 1-800-344-8377 (Orange) (811)
17. Cable TV 1-800-344-8377 (811) (Orange)
18. Base Operations 652-2943 B-8
19. OTHER (SPECIFY)
20. Requested Clearance APPROVED DISAPPROVED
21. Typed Name and Signature of Approving Officer (Chief/Deputy of Operations Flight) 17a. Date Signed mailto:awjbsaservicedesk@amwater.com
INSTRUCTIONS: The BCE work clearance request is used for any work (contract or in-house) that may disrupt aircraft or vehicular traffic flow, base utility services, protection provided by fire and intrusion alarm system, or routine activities of the installation. This form is used to coordinate the required work with key base 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 before starting work. If delays are encountered and the conditions at the job site change (or may have changed) this work clearance must be reprocessed.
21. REMARKS. (This section must describe specific precautionary measure to be taken before and during work accomplishment concerning the approved method of excavation, hand or powered equipment should be included (Provide detailed sketch of excavation in space below)
FORM 103 (REVERSE), MS Word V6.0
| ORGANIZATION |
| B |
| A |
| S |
| C |
| 11. American Water: (Water Distribution) |
| Help Desk (210)-965-8574 awjbsaservicedesk@amwater.com |
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