Appendix E - Offutt AFB Dig Ticket Process.pdf
PDF 328 KB Posted
- Attached to
- SATCOM Milstar Building Maintenance and Repair
- Solicitation number
- FA460026Q0101
About this file
This document is the AF IMT 103, a Base Civil Engineering Work Clearance Request form used by Offutt Air Force Base to coordinate and approve work activities that may disrupt aircraft or vehicular traffic flow, base utility services, fire and intrusion alarm system protection, or routine installation activities. The form is required for contract and in-house work involving excavation or utility disturbance and must be submitted prior to work commencement.
The clearance request process requires requestors to complete the top section of the form with work description, location, date prepared, and required clearance date, then route the form to multiple base organizations for signature approval. Key coordinating agencies include Base Civil Engineering (electrical, drainage, utilities, pavements, sewer, steam distribution, water distribution, gas distribution, cathodic protection, alarm systems), Fire Protection, Safety, SFS Installation Security, SFS Electronic Security, 55 CS Communications, Base Operations Airfield Management, Weather Wing Utilities, and specialized coordinators for specific areas (Rising View housing, Building 1000 BMC, Building 500 BMC, Building 185). All requests must include Nebraska 811 utility locating confirmation prior to any digging. The form expires 30 days from the approving officer's signature date. The Dig Permit Routing Process specifies that AF103 forms are picked up from the CSU office (Building 301D, 2nd floor), routed through all applicable agencies following provided location instructions, and returned to the Approving Officer who enters the signed form into the Dig log. Requestors must verify all NE811 locates have been completed and maintain utility markings throughout digging operations.
View the file
Other files
Show all 24
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
LOG NUMBER
Filled out by CSU or CEO ADMIN
This area HAS HAS NOT been clearly marked by contractor
B. DRAINAGE SYSTEMS E. UTILITY OVERHEAD UNDERGROUND
C. RAILROAD TRACKS F. COMM OVERHEAD UNDERGROUND
8.
20. REQUESTED CLEARANCE
21. TYPED NAME AND SIGNATURE OF APPROVING OFFICER (CHIEF OF OPERATIONS FLIGHT OR CHIEF OF ENGINEERING FLIGHT) 21a. DATE SIGNED (Expires 30 days from this date)
A. ELECTRICAL DISTRIBUTION
402-294-5232 - Building 301
I. PAVEMENTS/GROUNDS
402-294-4830 - Building 301
B. CATHODIC PROTECTION
G. SEWER DISTRIBUTION
E. WATER DISTRIBUTION
D. STEAM DISTRIBUTION / CHILL WATER / WELLS
402-294-9722 - Building 301
C. ALARM SYSTEMS
ORGANIZATION
5. REQUESTING OFFICIALS NAME AND EMAIL
(SEE INSTRUCTIONS ON REVERSE)
2. TYPE OF FACILITY/WORK INVOLVED (Mark all that apply)
G. AIRCRAFT OR VEHICULAR TRAFFIC FLOW
4. DATE CLEARANCE REQUIRED3. DATE PREPARED
7. ORGANIZATION / COMPANY NAME
1. Clearance is reqested to proceed with work, list what and where
H. SECURITY
I. OTHER
REVIEWER SIGNATURE AND DATEREMARKS
6. TELEPHONE NUMBER
A. PAVEMENTS
402-294-3834 - Building 301
402-294-5388 - Building 301
DISAPPROVEDAPPROVED
402-294-5522 - Building 288
K. FIRE PROTECTION
402-294-4087 - Building 301
J. ENVIRONMENTAL
L. AFCEC RESTORATION
COMPLETE THE BACK PAGE FOR WORK TAKING PLACE IN THE FLOOD RECOVERY AREA MILCON SITES
H. GAS DISTRIBUTION
NEBRASKA 811 CONFIRMATION NUMBER: CALL FIRST AND HAVE CONFIRMATION NUMBER(S)19. NEBRASKA 811 CALL: 811 OR 1-800-331-5666
LOCAL UTILITES TELEPHONE, GAS, ELECTRIC, CABLE
B A S E
C I V I L
E N G I N E E R I N G
402-294-4829 or 402-659-7420 - Building 301
402-294-7369 or 402-232-2776 Building 185, Rm 1110
16. Weather Wing Utilies 402-991-9840 - 3116 Lockbourne Dr, Bellevue
15. RISING VIEW - Base housing area
Located in Building 301, Entrance 2, 3rd floor - Operations Flight hall way Expires 30 days from this date
402-294-2793 - Building 29, Airfield Management Rm 111
14. BASE OPERATIONS - Airfield
Call to coordinate, located in Building 456
Located in Building 29 at 513 SAC Blvd. Go upstairs to Rm 201.
Located in Building 1300 - RM 104 check in and let them know you have a dig ticket to be signed off
13. BLANK
402-294-5989 - Building 456
12. 55 CS COMMUNICATIONS
402-294-6357 - Building 29, Rm 201
BLANK
402-294-2433 or 294-6921 - Building 1300
402-294-1387 - Building: 88 Rm 215
11. SAFETY
** Supply map of digging location, fill out top portion of form before going to get signatures **
These Shops meet every Thursday in the CEO conference room from 1000-1100 for Contractors to coordinate dig tickets.
Building 301D
Entrance 2, 2nd floor.
(Bring a copy of your AF103 form and maps to leave with the shops)
Located in Building 301D. Enter the building at Entrance 2 (Envision Store Entrance). When the hallway "T's" in front of the Envision store turn left, at 1st opportunity turn right, it should come up on your left. The sign will read, "CEOFE
Electric Shop"
Located in Building 301D. Enter the building at Entrance 2 (Envision Store Entrance). When the hallway "T's" in front of the Envision store turn right it will be on the other side of the stairway to the right.
Located in Building 301D . Enter at Entrance 2 (Envision Store entrance). When the hallway "T's" turn left. The shop will be on your left. The sign will read, " CEOIH HVAC SHOP"
Located in B301D . Enter at Entrance 2 (Envision Store entrance), when the hallway "T's" turn left. Walk straight past your first right. At your 2nd right turn right. The shop should be right there at the corner. The sign will read, "CEOIU
UTILITY SHOP".
Located in B301D - Enter building at Entrance 6 (by Vehicle Dispatch) drive straight - It will be on your right before you get to the first stop sign. Shop sign will read " CEOHP Pavement and Equipment"
402-294-5232 - Building 301
402-294-4995 or 294-5232 - Building 301
F. POL DISTRIBUTION
402-294-5232 - Building 301
BASE CIVIL ENGINEERING WORK CLEARANCE REQUEST
D. FIRE DETECTION & PROTECTION SYSTEMS
involving excavation or utility disturbance per attached sketch/picture.
Only needed if digging near building 1000 - Call 402-912-4170 or 4171 to coordinate Only needed if digging near building 500 - located in Building 500 room 1B5
17. B1000 BMC - 402-912-4170 or 4171 - call to coordinate
18. B500 BMC - 402-232-7628 or 9395 - B500, Rm 1B5
Located in Building 301D. 2nd floor. Walk down the hall to the first hallway on your right. Turn right and go to the end of the hallway until you get to a big office room with several desks. You are now in CE Environmental.
Only needed if digging near building 185 - Located in Building 185 room 1110
Only needed if digging in Rising View, Coffman Heights, or Generals Row - Located at 3116 Lockbourne Dr, Bellevue, NE 68123 in Capehart Housing Area.
Located in Building 29 at 513 SAC Blvd. Airfield Management desk Rm 111
BLANK
Located in Building 1300 - RM 104 check in and let them know you have a dig ticket to be signed off
Located in Building 88 Rm 214
Located in Building 288. Garland Ave, across from the Commissary. Park in the west side parking lot. Go to main entryway, pick up phone and it'll ring automatically to our Emergency Communication Center. Let the operator know you are in the station with a dig permit for Fire
Prevention.
9. SFS - INSTALLATION SECURITY
402-294-6240 or 294-2396 - Building 1300
10. SFS - ELECTRONIC SECURITY SECTION (ESS)
AF IMT 103 55 CES/CEO 1
SECURITY CAMPUS – Contractor - Mortenson Kyle Broadbent- 406-850-8895 OSS/SERE FACILITY – Contractor - MedVolt Greg Vossler - 816-556-6893 NKO/DSC CAMPUS – Contractor - Turner Dave Audino - 402-980-6153 Connor Hinrichs - 402-239-7091 NC3 ALERT CAMPUS – Contractor - Walsh Colton Chadwick 402-615-1741/ Alton Bailey 402-982-1263 FLOOD RECOVERY AREA - Contractor - MedVolt Greg Vossler - 816-556-6893
20. REMARKS: (This section must describe specific precautionary measures to be taken before and during work accomplishment. Specific comments concerning the approved method of excavation, hand or powered equipment, should be included.)
INSTRUCTIONS
REVIEWER SIGNATURE AND DATEREMARKSORGANIZATION
The Base CE 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 at a minimum. It is 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 request must be reprocessed.
Only needed if digging in these areas. CALL TO
COORDINATE LOCATES
AF IMT 103 55 CES/CEO 2
Sheet1
File details come from the government source that posted it. Updated .