JBLE-L_MUHJ_10-4214_100P_DS_AF_Form_66.pdf

AF Form 66 (Computer Generated) Page 1 of 17

APPROVED DISAPPROVED

1 01 11 00 MSDS For Each Item 1.2

01 11 00 State and EPA Region 3 Notifications 1.2

3 01 11 00 Recycling Report 1.2

4 01 11 00 Trip Reports 1.2

01 11 00 Affirmative Procurement Report 1.2

01 11 00 Exemption Form, Annex B to LAFB Affirmative Procurement Plan 1.2

7 01 11 00 32-7080 1.2

01 11 00 All Employees Names and Social Security Numbers 1.2

01 11 00 Work Clearance Requests (AF Form 103) 1.2

10 01 11 00 Quality Control Report 1.2

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ITEM OR DESCRIPTION OF ITEM,

CONTRACT REFERENCE, TYPE OF

SUBMITTAL

NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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AF Form 66 (Computer Generated) Page 2 of 17

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ITEM OR DESCRIPTION OF ITEM,

CONTRACT REFERENCE, TYPE OF

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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11 01 11 00 Survey Report 1.2

12 01 11 00 Metadata 1.2

01 11 00 Deliverables and Final As-builts 1.2

01 11 00 Computer Aided Drafting and Design (CADD) digital final as-built drawings on CD's 1.2

01 11 00 One As-Built (Redline) Drawings 1.2

01 11 00 Warranty of Construction 1.2

01 11 00 Equipment Warranty Certificate 1.2

01 11 00 Equipment Warranty/Guarantee Record 1.2

01 11 00 DD Form 1354 Acceptance and Transfer of Real Property 1

01 12 00 Asbestos Abatement Plan (If Applicable) 1

AF Form 66 (Computer Generated) Page 3 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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01 12 00 Lead-Based Paint Abatement Plan (If Applicable) 1

01 12 00 Hazardous Material Usage Request Forms 1

01 12 00 Green Procurement Planning Use Forms 1

01 12 00 Environmental Management System (EMS) Training Certificates 1

01 12 00 Stormwater Permit (If Applicable) 1

01 12 00 Stormwater Pollution Prevention Plan (If Applicable) 1

27 01 12 00 Clean Soil Certificates 1

01 12 00 Wetland Permits (If Applicable) 1

01 12 00 Monthly Hazardous Materials Usage Report 1

01 12 00 Quarterly Refuse/Recycling Reports 1

AF Form 66 (Computer Generated) Page 4 of 17

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CONTRACT REFERENCE, TYPE OF

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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01 12 00 Generator Permit Information (If Applicable) 1

01 12 00 Green Procurement Exemption Form (If Applicable) 1

01 12 00 Green Procurement Final Usage Report 1

01 12 00 All Return Asbestos Manifest (Signed by Receiving Landfill) (If Applicable) 1

35 Demolition Plan 02 41 00 1.2.1

36 Deconstruction Plan 02 41 00

37 Existing Conditions 02 41 00 1.1

38 Notification 02 41 00 1.6

Notification of Demolition and Renovation Form 02 41 00

40 Receipts 02 41 00

AF Form 66 (Computer Generated) Page 5 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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41 Installation Drawings 03 30 53 1.5

Air-Entraining Admixture 03 30 53 2.2.3.1

43 Accelerating Admixture 03 30 53

Water-Reducing or Retarding Admixture 03 30 53 2.2.3.2

45 Curing Materials 03 30 53 2.2.9

Expansion Joint Filler Strips, Premolded 03 30 53 2.2.6

Batching and Mixing Equipment 03 30 53

Conveying and Placing Concrete 03 30 53 3.2

49 Formwork 03 30 53 2.2.7

50 Mix Design Data 03 30 53 2.3

AF Form 66 (Computer Generated) Page 6 of 17

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CONTRACT REFERENCE, TYPE OF

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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51 Ready-Mix Concrete 03 30 53 2.3

52 Curing Compound 03 30 53 2.4.1

Mechanical Reinforcing Bar Connectors 03 30 53 2.2.5

54 Aggregates 03 30 53 2.2.2

Concrete Mixture Proportions 03 30 53 2.1.3

Compressive Strength Testing 03 30 53 3.8.3

57 Slump 03 30 53 3.8.3

58 Air Content 03 30 53 3.8.3

59 Water 03 30 53 2.2.4

Cementitious Materials 03 30 53 2.2.1

AF Form 66 (Computer Generated) Page 7 of 17

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ITEM OR DESCRIPTION OF ITEM,

CONTRACT REFERENCE, TYPE OF

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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61 Pozzolan 03 30 53

62 Aggregates 03 30 53 2.2.2

63 Delivery Tickets 03 30 53 2.3

64 Curing Compound 03 30 53 2.4.1

Acceptance tests and inspections 26 08 00 3.1

66 Qualifications 26 08 00 1.4.1

Acceptance test and inspections procedure 26 08 00 1.4.3

Pad-mounted transformer drawings 26 12 19.10 1.5.1

Pad-mounted transformers 26 12

19.10 2.2

Acceptance checks and tests 26 12

19.10 3.7.1

AF Form 66 (Computer Generated) Page 8 of 17

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ITEM OR DESCRIPTION OF ITEM,

CONTRACT REFERENCE, TYPE OF

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Transformer Efficiencies 26 12

19.10 2.2.2.1

72 design tests 26 12 19.10 2.8.2 routine and other tests 26 12 19.10 2.8.3

74 Transformer(s) 26 12 19.10 1.6.1

Transformer test schedule 26 12

19.10 2.8.1

76 Circuit breakers 26 20 00

77 Switches 26 20 00 2.8

Surge protective devices 26 20 00 2.15

79 600-volt wiring test 26 20 00 3.5.2

Grounding system test 26 20 00 3.5.3

AF Form 66 (Computer Generated) Page 9 of 17

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ITEM OR DESCRIPTION OF ITEM,

CONTRACT REFERENCE, TYPE OF

SUBMITTAL

NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Lighting and Visual Navigation Aids 26 56 20.00 10 2.1

As-Built Drawings 26 56 20.00 10 1.3.6

Airfield Lighting Layout Plan 26 56

20.00 10 1.3.4

Materials and Equipment 26 56

20.00 10 2.2

3 3

Protection Plan 26 56 20.00 10 1.3.3

86 Training 26 56 20.00 10 3.2

87 Special Tools 26 56 20.00 10 3.2

88 List of Parts 26 56 20.00 10 3.2

Maintenance and Repair 26 56

20.00 10 3.2

Posted Instructions 26 56 20.00 10 3.22

AF Form 66 (Computer Generated) Page 10 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Field Quality Control 26 56 20.00 10 3.18

Visual Inspection 26 56 20.00 10 3.18.3

Qualifications 26 56 20.00 10 1.3.2

Operation and Maintenance Procedures 26 56 20.00 10 3.2

95 Shoring 31 00 00 3.3

Dewatering Work Plan 31 00 00 1.6.3

Utilization of Excavated Materials 31 00 00 3.7

98 Rock Excavation 31 00 00 1.6.1.2

Opening of any Excavation or Borrow Pit 31 00 00 3.2

100 Testing 31 00 00 3.13 3 3

AF Form 66 (Computer Generated) Page 11 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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101 Borrow Site Testing 31 00 00 2.1

Integrated Pest Management Plan 32 05 33 2.4

Local/Regional Materials 32 05 33 1.6.1

104 Fertilizer 32 05 33 2.1

Maintenance inspection report 32 05 33 3.3.1

Plant, Equipment, and Tools 32 11 23 2.1

Waybills and Delivery Tickets 32 11 23 1.1.4

Sampling and Testing 32 11 23 1.5

Field Density Tests 32 11 23 1.5.2.4

Job-Mix Formula (JMF) 32 11 26 2.5.1

AF Form 66 (Computer Generated) Page 12 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Waybills and delivery tickets 32 11 26 1.1.3

Sources of Aggregates 32 11 26 2.2.5

3 3

113 Bituminous Materials 32 11 26 2.3

Sampling and testing 32 11 26 1.4.1

Waybills and Delivery Tickets 32 12 10 1.1.3

Local/Regional Materials 32 12 10 1.4

Sampling and Testing 32 12 10 3.7

Bituminous pavement 32 12 17 1.3.2

119 Job-mix formula 32 12 17 1.3.3

ASPHALT CEMENT BINDER 32 12

17 2.2

AF Form 66 (Computer Generated) Page 13 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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121 MIX DESIGN 32 12 17 2.3

Specific gravity test of asphalt 32 12 17 2.5.1

Coarse aggregate tests 32 12 17 2.5.1

124 Weight of slag test 32 12 17 2.5.1

Percent of crushed pieces in gravel 32 12 17 2.5.1

Fine aggregate tests 32 12 17 2.5.1

Specific gravity of mineral filler 32 12 17 2.5.1

Bituminous mixture tests 32 12 17 2.5.1

129 Aggregates tests 32 12 17 3.5.2.1

Bituminous mix tests 32 12 17 3.5.2.2

AF Form 66 (Computer Generated) Page 14 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Pavement courses 32 12 17 3.5.2.3

Wood cellulose fiber mulch 32 92 19 2.5.1

133 Fertilizer 32 92 19 2.4

Topsoil composition tests 32 92 19 2.2.3

135 seed 32 92 19 2.1

Precast underground structures 33 71 02 1.5.1

Medium voltage cable 33 71 02 2.5

Medium voltage cable joints 33 71 02 2.7

Medium voltage cable terminations 33 71 02 2.6

140 Sealing Material 33 71 02 2.13.2.4

AF Form 66 (Computer Generated) Page 15 of 17

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NUMBER OF COPIES REQUIRED

Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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141 Pulling-In Irons 33 71 02 3.5.3

Manhole frames and covers 33 71 02 2.13.3

Handhole frames and covers 33 71 02 2.13.4

Frames and Covers for Airfield Facilities 33 71 02 2.13.5

Ductile Iron Frames and Covers for Airfield Facilities 33 71 02 2.13.6

Composite/fiberglass handholes 33 71 02 2.13.7

147 Cable supports 33 71 02 2.14

Medium voltage cable qualification and production tests 33 71 02 2.16.2

Field Acceptance Checks and Tests 33 71 02 3.17.1

150 Arc-proofing test 33 71 02 2.16.1

AF Form 66 (Computer Generated) Page 16 of 17

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Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Cable Installation Plan and Procedure 33 71 02 3.3

Cable splicer/terminator 33 71 02 1.5.2

Cable Installer Qualifications 33 71 02 1.5.3

Certificate of Conformance 33 71 02 1.5.4

Fiber Optic Outside Plant 33 82 00 1.6.1.1

156 Wire and cable 33 82 00 2.5

Cable splices, and connectors 33 82 00 2.2

Pre-installation tests 33 82 00 3.5.1

159 Acceptance tests 33 82 00 3.5.2

Outside Plant Test Plan 33 82 00 1.6.3

AF Form 66 (Computer Generated) Page 17 of 17

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Project Title:

Install Textile Brakes / BAK 15, F.7050

Solicitation/Contract Number

FA4890-11-D-0003-F352SCHEDULE OF MATERIAL SUBMITTALS

TO BE COMPLETED BY PROJECT ENGINEER

Project No.

MUHJ 10-4214

TO BE COMPLETED BY CONTRACT ADMINISTRATOR

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Fiber Optic Contractor 33 82 00 1.6.2.1

162 Key Personnel 33 82 00 1.6.2.2

Manufacturer's Qualifications 33 82 00 1.6.2.3

164 Cable tensions 33 82 00 3.1.7.1

Fiber Optic Splices 33 82 00 3.1.8.1

Factory Reel Test Data 33 82 00 2.11.1

Record Documentation 33 82 00 1.8.1

Sheet1