AF813.pdf

EIAP #12.035

9 CES/CEAO 9CES/CEP 634-2655

Remove Rubber & Paint, Restripe Airfield, BAEY 040073

Pavement maintenance and repair.

Remove runway rubber deposits from tires as required. Remove old striping as indicated by airfield manager. Restripe/re-mark airfield lines and markings as required. Add some new striping for U-2, RQ-4, and MC-12 as indicated by airfield manager.

Gerald Pannell, Project Engineer 20120214

A2.3.10

CATEX #A2.3.10: "Routine facility maintenance and repair that does not involve disturbing significant quantities of hazardous materials such as asbestos and lead-based paint."

See attached "Continuation of Block #18 - Remarks on AF Form 813, EIAP #12.035" for Required Environmental Protection Measures that must be included in this contract.

Sheri Rolfsness, P.E., GS-11

Report Control Symbol

RCS: REQUEST FOR ENVIRONMENTAL IMPACT ANALYSIS

INSTRUCTIONS: Section I to be completed by Proponent; Sections II and III to be completed by Environmental Planning Function. Continue on separate sheets as necessary. Reference appropriate item number(s).

SECTION I - PROPONENT INFORMATION

1. TO (Environmental Planning Function) 2. FROM (Proponent organization and functional address symbol) 2a. TELEPHONE NO.

3. TITLE OF PROPOSED ACTION

4. PURPOSE AND NEED FOR ACTION (Identify decision to be made and need date)

5. DESCRIPTION OF PROPOSED ACTION AND ALTERNATIVES (DOPAA) (Provide sufficient details for evaluation of the total action.)

6. PROPONENT APPROVAL (Name and Grade) 6a. SIGNATURE 6b. DATE

SECTION II - PRELIMINARY ENVIRONMENTAL SURVEY. (Check appropriate box and describe potential environmental effects + 0 U - Including cumulative effects.) (+ = positive effect; 0 = no effect; - = adverse effect; U= unknown effect)

7. AIR INSTALLATION COMPATIBLE USE ZONE/LAND USE (Noise, accident potential, encroachment, etc.)

8. AIR QUALITY (Emissions, attainment status, state implementation plan, etc.)

9. WATER RESOURCES (Quality, quantity, source, etc.)

10. SAFETY AND OCCUPATIONAL HEALTH (Asbestos/radiation/chemical exposure, explosives safety quantity-distance, bird/wildlife aircraft hazard, etc.)

11. HAZARDOUS MATERIALS/WASTE (Use/storage/generation, solid waste, etc.)

12. BIOLOGICAL RESOURCES (Wetlands/floodplains, threatened or endangered species, etc.)

13. CULTURAL RESOURCES (Native American burial sites, archaeological, historical, etc.)

14. GEOLOGY AND SOILS (Topography, minerals, geothermal, Installation Restoration Program, seismicity, etc.)

15. SOCIOECONOMIC (Employment/population projections, school and local fiscal impacts, etc.)

16. OTHER (Potential impacts not addressed above.)

SECTION III - ENVIRONMENTAL ANALYSIS DETERMINATION

17. PROPOSED ACTION QUALIFIES FOR CATEGORICAL EXCLUSION (CATEX) # ; OR

PROPOSED ACTION DOES NOT QUALIFY FOR A CATEX; FURTHER ENVIRONMENTAL ANALYSIS IS REQUIRED.

18. REMARKS

19. ENVIRONMENTAL PLANNING FUNCTION CERTIFICATION 19a. SIGNATURE 19b. DATE (Name and Grade)

THIS FORM CONSOLIDATES AF FORMS 813 AND 814.

PREVIOUS EDITIONS OF BOTH FORMS ARE OBSOLETE.

PAGE 1 OF PAGE(S) AF IMT 813, 19990901, V1

PANNELL.GERALD.R.1231821

Digitally signed by PANNELL.GERALD.R.1231821208 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=PANNELL.GERALD.R.1231821208 Date: 2012.03.13 09:41:03 -07'00'

ROLFSNESS.SHERI.L.1192

060393

Digitally signed by ROLFSNESS.SHERI.L.1192060393 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=ROLFSNESS.SHERI.L.1192060393 Date: 2012.03.14 14:27:03 -07'00'

4.0 Purpose and need:

5.0 Description of proposed action and alternatives:

- Maintenance and repair of airfield asphalt shoulders.

From SOW:

1. Repair/Patch AC Pavement on airfield shoulders after hours, multiple locations, including sawcutting, excavation, disposal, layout, aggregate base, and all associated work and coordination- approximately 1000 SY.

4. Furnish & place white reflective paint on airfield after hours, including runway markings, numbers, beads, traffic lanes, layout, clean-up, and all associated work and coordination- approximately 25,000 SF.

5. Furnish & place yellow reflective paint on airfield after hours for taxiway lines, including beads, layout, clean-up, and all associated work and coordination- approximately 50,000 SF.

6. Remove runway rubber deposits from airfield concrete surfaces after hours, including disposal, coordination, testing, and clean-up., and all associated work and coordination- approximately 124,000 SF.

7. Remove paint markings and lines from airfield concrete surfaces after hours, including disposal, coordination, testing, and clean-up., and all associated work and coordination- approximately 2500 SF.

5.1 No action alternative:

- The rubber deposition can build up and cause problems with aircraft tires and landing.

V1

AF IMT 813, SEP 99, CONTINUATION SHEET

PAGE OF PAGE(S)

CONTINUATION OF BLOCK #18 -REMARKS ON AF FORM 813,

EIAP # 12.035 (Remove Rubber & Paint, Restripe Airfield, BAEY 04-0073)

Page 1 of 6 EIAP 12_035 (813 Remarks Cont)

The proposed project to remove rubber and paint, restripe (paint markings) and repair asphalt shoulders of the airfield (runway, taxiways, and aprons), qualifies for CATEX # A2.3.10 (Routine facility maintenance and repair that does not involve disturbing significant quantities of hazardous materials such as asbestos and lead-based paint.) The proposed action will use high pressure water to remove the rubber and paint, and water based paint will be applied to re-install markings. A water blasting truck will be used to remove paint and rubber with high pressure water, and it will vacuum up the water and debris into separate containers. The paint and rubber is deposited into drums, tested and taken to a qualified landfill. The water will also be contained and disposed of at a qualified facility. The asphalt shoulders of the runway will also be repaired. This is an annual/bi-annual maintenance requirement.

This CATEX determination is subject to the project meeting all of the Required Environmental Protection Measures below and applies only to work completed on the paved surfaces of the airfield. No work of any type, and no vehicle or equipment traffic, is authorized outside of this work boundary (paved airfield surfaces) by this CATEX.

If this project changes in any way, this document needs to be re-evaluated for changes in the requirements.

Please ensure the following requirements are included in the contract or in-house work plans:

AF FORM 813, SECTION II,

REQUIRED ENVIRONMENTAL PROTECTION MEASURES:

# 7. AIR INSTALLATION COMPATIBLE USE ZONE/LAND USE: Projects on or near the flight line must be coordinated with the Beale AFB Community Planner (9 CES/CEAO). An airfield waiver may be required before this project begins.

# 8. AIR QUALITY: The Contractor shall comply with Feather River Air Quality Management District (FRAQMD) “Standard Mitigation Measures for All Projects” and “Fugitive Dust Control Mitigation Measures” during construction to minimize construction-related air quality impacts. Reference FRAQMD requirements at http://www.fraqmd.org/StandardMitigation.htm.

The contractor must obtain an abrasive blasting permit from FRAQMD for the use of a pressure washer to remove rubber deposits or paint. A copy of the permit will be provided to the Beale’s Air Program Manager, Darren Rector (530-634-2645, darren.rector@beale.af.mil)

Any portable diesel internal combustion engines ≥50bhp require registration documentation from California Air Resources Board (CARB) Portable Equipment Registration Program (PERP). PERP Registration numbers must be provided to 9 CES/CEAN Air Quality Manager (530-634-2645) within three

(3) days of arriving on Beale AFB. The portable equipment will be subject to inspection by Feather River Air Quality Management District (FRAQMD).

California Vehicle Code (CVC), Section 4000, requires any vehicle which is based in California or primarily used on California highways, shall be registered in California. A nonresident owner of any commercial vehicle shall register the vehicle in this state and pay the applicable fees under this code.

Vehicles must be smog tested and registered in CA within 30 days of arriving in the state, even if they have a current registration in another state. Contractors and their employees are advised that failure to have their vehicles smog tested and registered in CA within 30 days of arrival may result in enforcement action by local/state authorities.

This project will not generate or release significant particulate matter provided Feather River Air Quality Management District (FRAQMD) “Standard Mitigation Measures for All Projects” and “Fugitive Dust Control Mitigation Measures” are implemented during construction to minimize construction-related air quality impacts. The contractor shall be required to implement these mitigation measures. No further conformity determination/analysis is required.

http://www.fraqmd.org/StandardMitigation.htm�

Page 2 of 6 EIAP 12_035 (813 Remarks Cont)

# 9. WATER RESOURCES: All equipment and vehicles must be maintained to paved/gravel surfaces.

Ground disturbing work on unpaved areas is not allowed during the wet season (usually November through May).

Permission to work outdoors in November may be requested from 9 CES/CEAN if weather continues to be fair. 9 CES/CEAN will evaluate and approve or disapprove outdoor work requests during this time on a case-by-case basis, depending on weather conditions, weather forecast, and whether or not activities will damage soil or vegetative cover. The only outdoor work allowed for 12 hours before or after a storm event is the inspection, installation and/or maintenance of erosion controls/best management practices (BMP’s).

The contractor is responsible for implementing BMP’s to ensure pollutants are not released or discharged to drainage features or storm drains in project work areas, equipment/material staging areas or parking areas. The contractor shall promptly clean up any spilled materials and report any spill incident to the base Fire Department by dialing 911 from any base phone. If calling by cellular phone, dial (530) 634- 2117. The contractor shall also notify 9 CES Environmental Office at (530) 301-9413. The spill shall also be reported in writing/email to the 9 CES/CEAN within 48 hours.

All equipment, vehicles, and storage of construction material and/or debris must be maintained to paved/gravel surfaces or in the designated work area. All materials, vehicle parking, and designated staging areas shall be located at least 50 feet away from drainages and other wetlands.

If pressure washing will be used to prepare surfaces for painting it must be done in a manner that does not generate runoff and in accordance with the Beale AFB General Industrial Storm Water Permit. Any type of rinse or wash water discharged to Beale’s storm water drainage system is considered an unauthorized non-storm water discharge and is strictly prohibited by the industrial storm water general permit. The general permit does not require dischargers to eliminate the activities that produce rinse and wash waters but it does prohibit the discharge of those rinse or wash waters to storm water drainage systems.

The proposed project involves less than 1 acre of ground disturbance. There is no reason for the contractor to disturb more than one acre of soil to complete this project and he is not authorized to do so.

Therefore, a National Pollutant Discharge Elimination System (NPDES) storm water construction permit will not be required.

A representative of 9 CES Environmental Office will provide on-site storm water training for construction projects. Training will focus on storm water pollution prevention and proper installation and maintenance of BMPs. The contractor is responsible for ensuring that all personnel involved with the project (including subcontractors) have received storm water training and will submit training log(s) to 9 CONS as proof of training. The contractor shall install and maintain erosion control system(s) such as silt fences, straw bale barriers or erosion control/stabilization blankets, as needed to protect drainage features from sedimentation resulting from construction activity. At a minimum, the contractor shall inspect erosion control systems/BMPs daily and will submit inspection logs monthly to 9 CONS to show that inspections are being conducted.

All excess soil and construction debris shall be disposed of off-base. Soils to be disposed of off-base will be tested for contaminants; excess soils from Environmental Restoration Program (ERP) and Military Munitions Response Program (MMRP) sites may require additional analysis. Excess soils that are temporarily stored on-site during construction need to be covered with stabilization blankets to prevent exposure to the elements and to lessen chances of sedimentation due to storm water runoff.

# 10. SAFETY AND OCCUPATIONAL HEALTH: The contractor shall ensure prior to the project start-up, an Air Force (AF) Form 103 (Base Civil Engineer Work Clearance Request, also called a “Digging

Page 3 of 6 EIAP 12_035 (813 Remarks Cont)

Permit”) is coordinated through 9 Civil Engineering Squadron (9 CES). The contractor shall comply with the conditions specified in the approved AF Form 103.

Military Munitions Advisory: Past activities at Beale used a variety of munitions and related materials across most of the base property. Because of the Base’s history, military munitions related material could be encountered within the project area. If any suspected military munitions related material is found, stop work in the area, move personnel away from the site, and contact the Beale Command Post (530-634- 5700) and/or the Explosive Ordnance Disposal (EOD) flight (530-634-9070/530-634-9071, or 911 for emergency). Do not touch or attempt to remove any material suspected to be military munitions related.

If munitions and explosives of concern (MEC) are discovered, Unexploded Ordnance (UXO) technician support will be required before the project can continue.

A Comprehensive Site Evaluation (CSE) has been conducted by the USACE. The CSE supports the MMRP. The Report includes evaluations of Munitions Response Sites (MRS) for related hazards. The Draft Final Report is available for review. There is no further remedial investigation or action recommended for the MRS in the project work area.

All construction personnel with duties involving or supervising intrusive activities (e.g., subsurface utility work, digging, grading, concrete removal, digging out footers, etc.) will be required to complete a Munitions and Explosives of Concern (MEC) awareness and identification training session that enables them to identify potential MEC, other material potentially presenting an explosive hazard (MPPEH) and munitions debris (MD) (e.g., Recognize, Retreat and Report (3R) training). Construction personnel will be strictly prohibited from picking up, moving, or otherwise handling MEC or other MPPEH.

ERP Advisory: This project is located on one or more ERP sites. Personnel working on this project site must be informed of the possibility that contaminated soil, soil vapor, and/or groundwater may be encountered on the job site. If signs of contamination are encountered (smell, stain and/or free product), stop work and contact your Contracting Officer.

ERP UST Advisory: The contractor shall be advised there may be old UST sites (closed or undergoing investigation) on or near the project area. Potential hazards at old tank sites include inconsistent compaction of, and debris in, backfill material.

An ERP waiver is not required prior to construction.

If the project requires the removal of lead-containing materials, the contractor must submit a Health and Safety Plan (HSP) and Abatement Work Plan that includes worker health and safety practices for the removal activities. The HSP must include valid certificates for each worker involved in the work showing they have completed required Cal OSHA training requirements. A copy must be provided to the 9 CES/CEAN Toxics Program Manager.

# 11. HAZARDOUS MATERIALS/WASTE: The contractor must properly dispose of all hazardous and nonhazardous waste generated. All hazardous waste characterization/shipping/disposal must abide with Federal, state, local and military regulations. The Resource Conservation and Recovery Act (RCRA) sets certain minimum standards for waste management. States have more restrictive requirements than

RCRA.

All waste paint/chips/liquid/debris must be properly characterized for hazardous waste properties or constituents (CCR Title 22 metals, toxicity, TPH, or other listed hazardous wastes) and may require disposal as hazardous waste. Hazardous wastes must be controlled to prevent release into the environment.

Proper identification/containerization/labeling for hazardous wastes must occur during all painting, paint removal, blasting, scrubbing and clean-up processes (thinner activities, waste paint activities, dirty rags/debris and all other processes which generate hazardous wastes). Accumulated hazardous wastes must be stored and labeled in accordance with Federal, state, local and military regulations.

Page 4 of 6 EIAP 12_035 (813 Remarks Cont)

Hazardous and non-hazardous wastes (to include liquid wash water) must be contained to prevent release to the environment or sanitary sewer. Rubber debris must be contained and characterized (RCRA, non-RCRA, or non-hazardous), CAM 17 metals may be present in the rubber debris as a result of paint contamination. In the past, removed rubber contained high levels of zinc from the belted U-2 tires, making it a non-RCRA hazardous waste. This may still be an issue.

At completion of work, the contractor will not leave paint, primers or other chemicals behind at the worksite. All chemicals shall be retained by the contractor at completion of work.

Hazardous Waste Disposal: The contractor shall submit a hazardous waste profile to the 9 CES/CEAN for all hazardous wastes generated, before removing them from the installation. At least two working days prior to transporting hazardous wastes off the installation, the contractor shall make an appointment to deliver all hazardous waste manifests to 9 CES/CEAN for checking and signature (phone 530-634- 2644, 530-634-4452 or 530-634-2344). Hazardous waste to be shipped off site shall be inspected by 9 CES/CEAN before leaving base. The contractor shall provide the properly completed hazardous waste manifest to 9 CES/CEAN, 6601 B Street, Beale AFB CA 95903-1708, for signature and mailing to the state. The contractor must follow the same procedures when disposing of non-hazardous waste on “Non- Hazardous Waste Manifests”.

Hazardous Material: All hazardous material use requires prior authorization by 9 CES/CEAN (530-634- 3987) before bringing the hazardous material on base. The Project Owner shall provide an inventory list of ALL chemical products to be used, along with copies of the Material Safety Data Sheet (MSDS) for each chemical product, to Contracting for review by 9 CES/CEAN before bringing any potentially hazardous material onto Beale AFB. "Hazardous material" includes many construction materials for which there is a manufacturer MSDS such as cement, asphalt, and fiberglass or foam insulation; lead acid batteries; and herbicides such as Roundup. Herbicide use must comply with the Beale AFB Integrated Pest Management Plan, must be coordinated in advance with the 9 CES Entomology Shop, and the contractor must provide current certifications for pesticide applicators before bringing herbicide onto the base. The contractor shall not leave any unused hazardous materials on base at completion of contracted work.

Tanks/Oil Bulk Fuel Storage Containers: The project description does not identify any requirements for tanks, oil or bulk fuel storage containers. The contractor is not authorized to bring these onto base or install them without prior written approval from the 9 CES/CEAN Tank Program Manager (530-634-2832).

Bulk storage containers are containers with a capacity of 55 gallons or greater. Oil is oil of any kind, i.e., vegetable, synthetic, animal, ethanol blends containing any petroleum or petroleum products.

# 12. BIOLOGICAL RESOURCES: Work crews must receive environmental awareness training and follow all environmental requirements identified in this AF 813 and any associated permits.

# 14. GEOLOGY AND SOILS: There is no designated or approved soil storage area at Beale Air Force Base (AFB). State regulation (14 California Code of Regulations (CCR) 17381.1) specifies that construction, demolition and inert debris (CDI) stored for more than 30 calendar days that has not been processed and sorted for resale or reuse are deemed to have been disposed of unlawfully. Thus, at Beale AFB all excess soils removed during construction must be reused appropriately on-base or disposed of off-base at an approved disposal, recycling or other authorized facility.

Reuse of excess soils either at the project site or at another site on base shall be considered on a case-by-case basis by 9 CES/CEAN. If reuse of soil from a construction site is intended, the AF Form 813 must state the plans for reuse. Excess construction debris, such as concrete or soil mixed with debris should always be removed as part of the construction project and recycled or disposed of properly off-base. The following assumptions regarding excess soils may be used for project planning purposes:

Page 5 of 6 EIAP 12_035 (813 Remarks Cont)

- If excess soils generated from any construction site are less than 1 cubic yard, the soils may be spread at the project site with proper erosion controls and other environmental protection measures in place.

- If excess soils generated from any construction site are over 1 cubic yard, sampling and analysis will be required and must be coordinated with 9 CES/CEAN. The analytical results will determine whether the soils may be reused at the project site or at another site on-base or whether they must be disposed of off-base.

- If excess soils generated from construction work within an ERP site (or other known contaminated site) are over 1 yard, the soils may not be reused at the project site or anywhere else on-base. Sampling and analysis will be required and must be coordinated with 9

CES/CEAN.

The contractor shall pay for the proper disposal of any excess soils requiring disposal off-base. Excess soils removed from any construction site require characterization (sampling and analysis) for disposal purposes. Excess soils must not be mixed with other debris, and all excess soils must be removed from construction sites within one month of construction completion.

Soil characterization and/or waste characterization/disposal (including hazardous wastes) are the contractor’s responsibilities and must be coordinated with 9 CES/CEAN. Sampling of soils must be conducted by a qualified sampling technician (certified laboratory or environmental firm) and witnessed by a 9 CES/CEAN representative. Laboratory results shall be evaluated by a 9 CES/CEAN representative before disposal off-base. All soils require the following analyses before off-base disposal or on-base re-use: CAM 17 (metals); Total Petroleum Hydrocarbons (TPH) – EPA 5030, 3550 and 8015; Volatile Organic Compounds (VOCs) – EPA 8260. Soils removed from ERP and/or MMRP sites may require additional analyses for site-specific contaminants.

Soil to be disposed of at Ostrom Road Landfill must be coordinated through Recology, Inc. (707-693- 2107). Recology, Inc. requires the contractor to coordinate sampling and analysis directly with them prior to sampling. The minimum sampling frequency accepted by Recology, Inc. is one 4:1 composite sample per 250 cubic yards of material. Recology, Inc. may request additional testing after they review the initial analysis. The contractor shall pay for all sampling.

ERP Infrastructure Advisory: The contractor shall be advised that ERP monitoring wells, conveyance piping, etc. located near the project must be avoided. Damaged or destroyed ERP infrastructure must be replaced by the contractor at no additional cost to the government.

# 16. OTHER: All vegetated areas disturbed by construction shall be re-vegetated with a 9 CES/CEAN approved seed and mulch prescription. All landscaped areas disturbed by construction shall be restored to their original condition or better, e.g., sod, trees and shrubs, mulch replaced along with any irrigation systems, natural or manmade drainage ways.

The contractor must comply with the Beale AFB Integrated Solid Waste Management Plan (ISWMP). The Beale ISWMP requires construction and demolition debris to be recycled, re-used or mulched when possible. Reduction of solid waste through recycling and landfill diversion is mandated by Air Force policy and California law. Disposal of hazardous items (i.e., cleaning products, batteries, drain cleaner, pesticides, herbicides, motor oils, paints, gas, kerosene, etc.) in the solid waste stream is prohibited.

Contractors shall report the amount of construction debris disposed of by landfill, and construction debris diverted from landfill by re-use, or recycling. This does not include material that is placed in receptacles provided by the base refuse disposal contract. Report by category (asphalt, drywall, wood, metal, mixed) the estimated total waste disposed of, and total diverted from landfill, in tons or pounds. Report his information to 9 CES/CEAN (530-634-3176) on a quarterly basis (first week of Jan, Apr, Jul, and Oct).

The contractor must comply with the Beale Green Procurement Program. The Beale Green Procurement Program requires purchase of EPA-designated recycled content products (the CPG List – Comprehensive Procurement Guidelines); Bio-based Products; energy efficient products; Alternatively

Page 6 of 6 EIAP 12_035 (813 Remarks Cont) fueled and fuel efficient vehicles, and alternative vehicle fuels; Non-ozone depleting substances; and elimination/minimization of EPA Priority Chemicals.

Environmental Management System (EMS) Information Requirements: The Air Force has determined that for contracts which include FAR Clause 52.223-5 (Pollution Prevention and Right-to-Know Information) and involve contractor operations on an Air Force installation where the Air Force has implemented an EMS (such as Beale AFB), the Air Force must ensure that alternative paragraph (c)(7) is included in that FAR Clause. Paragraph (c)(7) states “The Contractor shall provide all information needed by the Federal facility to comply with the . . . environmental management system as described in Section 401 of E.O.

13148.” The contract shall include this as a contractor requirement.

EMS Training Requirements: Contractor personnel working on an Air Force installation where the Air Force has implemented its EMS (such as Beale AFB) must complete Air Force-provided initial EMS awareness-level training. Every contract must include the requirement for contractor personnel working on Beale AFB to complete Air Force-provided initial EMS awareness-level training, and must also provide, at a minimum, the following additional implementation guidance: (a) the installation office responsible for providing the EMS training is 9 CES/CEAN, EMS Manager, 530-634-2642; (b) the amount of time the training requires is 5-10 minutes; (c) the employee initial EMS awareness-level training must be completed within 90 days after either the training requirement is placed on contract or a new contract employee begins work on the installation; (d) the contractor will document the employee initial EMS awareness-level training and maintain a training record.

BLASTING OPERATION SUPPLEMENTAL FORM

Section Ι - Facility/Owner Information

1. Business Name: ________________________________________ Facility ID: _______________________

2. Contact Name: ______________________________________________________________________________

Phone No.:________________________ Fax No.:______________________ E-mail: _____________________

Address: ___________________________________________________________________________________

3. Do you claim confidentiality of data? + No + Yes (attach explanation)

Section ΙΙ - Blasting Operation

1. Brief description of blasting operation:

2. Operation Type: a. Confined (enclosed) b. Unconfined (Open)

3. Operating Schedule: ________Hrs/Day________ Days/Week ________ Weeks/Year

Maximum hours of operation per calendar year: __________ Hrs/year

4. Type of Blasting: ___dry ____wet abrasive ____hydroblasting ____vacuum blasting ___other:_____________

5. Type of Medium used:

a. Glass Beads b. Aluminum Oxide c. Steel Shot d. Steel Grit e. Garnet f. Crushed Glass

g. Cut Plastic h. Crushed Nutshell i. other____________________

6. Maximum amount of Medium used: ________lbs/hr _________lbs/day __________lbs/year

7. Equipment: (Please include Manufacturer’s specification for all equipment)

I. Abrasive Blasting Machine:

Manufacturer __________________ Model _______________ Weight Capacity____________________

II. Abrasive Blasting Nozzle:

Manufacturer___________________ Model_______________ Maximum internal diameter____________ inches

III. Propelling Device:

a. Electrically Driven Air Compressor b. internal combustion engine driven air compressor

c. other (please specify):_________________________

Manufacturer_____________________ Model___________________ Serial No. _____________________

BLASTING OPERATION SUPPLEMENTAL FORM

Section ΙΙ - Blasting Operation Maximum horsepower rating________________

Maximum Delivery Rate: _______________ cfm or psig (circle one)

IV. Abrasive Blasting Cabinet: (For Confined Abrasive Blasting Only)

Manufacturer____________________ Model________________________ Serial No. __________________

Associated Emission Control Equipment: (if any)

a. baghouse b. dust collector c. filters d. abrasive re-claimer

e. other (please specify): _________________________

Section III – Receptor Information

1. Description of Nearest Receptor (i.e. Residential Area, business, school, etc.): _____________________________

2. Facility Distance to the Nearest Receptor: ____________feet

3. Name of Nearest School (K-12): __________________________________________________________________

4. Facility Distance to the Nearest School: _____________ feet

Section IV - Applicant Certification Statement

THE ABOVE INFORMATION IS SUBMITTED TO DESCRIBE THE DESIGN AND USE OF THE EQUIPMENT

FOR WHICH APPLICATION FOR AUTHORITY TO CONSTRUCT IS BEING MADE.

SIGNATURE OF RESPONSIBLE

OFFICIAL OF FIRM: _____________________________________________ DATE: _____ /_____ / ______

TYPE OR PRINT NAME AND OFFICIAL TITLE OF PERSON SIGNING THIS DATA FORM

NAME: __________________________________________ TITLE: _____________________________________

APPLICATION / Blasting Operation Part 1-2 pages, 03/27/06

Hazardous Materials Applicable Regulations / Agency:

29 Code of Federal Regulations

1910.1200g (Federal) Federal Acquisition Regulation

Clause 52.223-3 (Federal)

AFI 32-7086, § 2.5.5

Beale AFB HAZMART map & directions on reverse

Compliance Guidelines for Contractors:

Provide the Contracting Office with a list of proposed HazMat that you plan to use on the installation during the performance of the contract on the provided spreadsheet. Include copies of MSDS’s for all products.

Any and all HazMat authorized to bring on base must FIRST be taken to the base HAZMART (Bldg 1013) for inspection, labeling, and entry into the standardized Air Force HazMat Tracking System database. (directions to HAZMART on back of this page)

If the contractor needs to bring a material on the installation that was not included in the original HazMat listing, the contractor must first notify the Contracting Office and then obtain authorization prior to bringing it on base.

Contractor is responsible for removal of all unused HazMat. Any unused HazMat must be reported to the base HAZMART for adjustment of usage data. Leave no excess HazMat or empty containers on site following com-pletion of project.

Base Points of Contact (POC):

HazMat Program Manager:

Jimmy Galloway: (530) 634-3987 (christopher.galloway.ctr@beale.af.mil)

HAZMART:

Joe Gilbert: (530) 634-4007 (joe.gilbert@beale.af.mil)

What is HazMat?

The Air Force requires ALL chemicals to be reviewed and authorized before being brought on base. Determination of whether a product, chemical, or material constitutes a hazardous material is determined by the Environmental Office.

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T is locate d o n A rno ld A ven u e in B u ilding

3.

(O n the right, ju st be fore th e flig ht to w e r)

Item # Manufacturer Name Product Trade Name Container Size Container Type Quantity Needed

How Often Will The Quantity Be Ordered?

For HMMP Use Only example 1 The Clorox Company Clorox Bleach 1 Gallon Plastic Bottle 2 per month example 2 3M Company 3M Dust Remover AV152B-10 10 Ounce Aerosol Can 8 total for entire project

***IMPORTANT! ATTACH A COPY OF THE MSDS FOR EACH ITEM BELOW***

Inventory of Requested Chemicals

Date:Project/Contract Name:

Project or Facility Location/Building Number:

Projected Start Date:

Projected End Date:

BAFB Green Procurement Tracking Form

Instructions:

1. Check for item being purchased in the list below and, if item is listed, continue to step 2.

2. Go to http://www.epa.gov/epawaste/conserve/tools/cpg/products/index.htm and find item

3. The EPA website will list required recycled content percentages for your product and suggest vendors to help your research.

4. After the purchase, fill out Page 1 of this form and submit to:

Project Contracting Officer 9 CES/CEP, Project Manager 9 CES/CEAN, Green Procurement Program Manager: Nolan Swick, 530-634-3176, nolan.swick@beale.af.mil

5. If claiming an exemption from the GP Program, fill out Page 2 of this form (must meet one of the conditions listed).

EPA-Designated Items

___ 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 (traffic markers)

___ Patio blocks ___ Plastic envelopes ___ Delineators(traffic markers)

___ Shower & restroom dividers/partitions

___ Plastic trash bags

___ Flexible delineators

(traffic markers)

___ 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 trimmings or food waste

___ Industrial drums ___ Pallets

___ Modular threshold ramps

___ Non-pressure pipe

___ Bike racks

___ Roofing materials

___ Blasting grit

Item:

Vendor:

Recycled Content (%):

Quantity:

Total Purchase Amount:

Item:

Vendor:

Recycled Content (%):

Quantity:

Total Purchase Amount:

Item:

Vendor:

Recycled Content (%):

Quantity:

Total Purchase Amount:

Company Name:

POC:

Phone:

E-mail:

Project Number:

BAEY __________

Project Title:

BAFB Green Procurement Exemption Form

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

Item: ____________________________________

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

(Need date: _________________ Date available: __________________)

Item fails to meet a performance standard in the specifications.

Explanation: ______________

_____ 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 cost more than non-recycled item).

Price of recycled item: ___________________

Price of non-recycled item: ________________

This determination is made in accordance with FAR 23.404(b).

Procurement Originator Date

9 CES/CEAN Date

Company Name:

POC:

Phone:

E-mail:

Project Number:

BAEY __________

Project Title: