(Atch2)_PWS_Atch_E-4_Cannon_AFB_Contractor_Hazmat_Approval.pdf

ATTACHMENT E-4, Cannon AFB Contractor Hazmat Approval Instructions for Completing Attachment E-4

Section 1. Contractor Information

Contractor Name Enter the name of the contracting company performing the work.

Contract Number Enter the contract number.

Project Number Enter the project number.

Estimated Start Date Enter the estimated state date.

Estimated Completion Date Enter the estimated completion date.

Assigned Shop Code, if known You may be assigned a Shop Code for tracking hazmat usage. If you know the Shop Code, enter it here. Otherwise, leave blank.

Section 2. Material Information

Material Name (from SDS) Enter the �material name from the hazmat's SDS.

Material Stock No. (MSN), or These are Air Force tracking numbers. If you know the federal MSN, NSN, or

National Stock No. (NSN) or Local the LSN, enter it here. If unknown, leave blank. Do not enter a contractor's

Stock No. (LSN), if known or manufacturer's stock number.

Container Type Circle the type of the hazmat container. This will be the smallest container that holds the hazmat. For example, if a box contains 12 tubes of caulk, the container type is "tube." For un-containerized bulk loads to be delivere� by truck, such as ready-mix concrete, enter "Un-containerized Bulk Delivery" after "Other (Specify): ."

If completing the form electronically, delete non-applicable container types.

Container Volume or Weight Circle the units of weight or volume measure of the container. For un-containerized bulk loads to be delivered by truck, enter the bulk unit of measure, i.e., cubic yards or tons.

If completing the form electronically, delete non-applicable units.

Total No. of Containers Enter the total number of containers expected to be used under the contract. For un-containerized bulk loads too be delivered by truck, enter "Bulk Delivery."

Container Size Enter the size of the container. For example, if a tube of caulk holds 4 lbs., enter "4 lbs." For un-containerized bulk loads too be delivered by truck, enter "Bulk Delivery."

Total Volume or Weight Multiply the total number of containers times the volume or,weight of each container. For example, for 72 tubes of caulk, with each tube weighing 4 pounds, enter "288 pounds" (72 tubes x 4 pounds). For un-containerized bulk loads to be delivered by truck, enter the total bulk amount and the bulk units.

Contract: Pending Solicitation: FA4855-18-R-0029

LATRINE & PUMPING SERVICE

Performance Work Statement

Attachment E-4 7 June 2018

Section 3. Process Information

Process Type Consult the table at the end of this appendix for a listing of Air Force-defined Environmental Process Types. Enter the number and process type. Enter only aag_process that best describes the process in which the hazmat will be used.

Process Description Enter a brief description of the process in which the hazmat will be used.

Examples may include: "Priming & painting," "Plumbing soldering," "Paving, walkways & parking areas," or "Abate rodent infestation." Avoid very general descriptions, like "Construct building" or "Landscaping."

Section 4. Engineering Controls

Describe process engineering Enter a brief description of any engineering controls to be used in the controls process to mitigate or reduce hazmat risks to human health or the environment. For example, "Ventilate area to reduce concentration of fumes."

Section 5. Personal Protective Equipment (PPE)

Describe process PPE Enter a brief description of any PPE to be used to mitigate or reduce hazmat risks to human health. For example, ''Tyvek coveralls", "Nitrile outer-gloves with latex inner-gloves", "Dust Mask", or "Air Purifying Respirator with Organic Vapor Cartridge".

Section 6. Location Information

Process will be performed on/at Circle the process location.

If completing the form electronically, delete non-applicable locations.

Physical location of process Enter the physical location of the process in which the hazmat will be used.

For example, "Inside Building 355, " "Parking Lot of Building 600," or "Runway 29".

Staging Location of hazmat Hazmats may not be stored11 on Cannon AFB or Melrose AFR. Hazmats may be staged immediately before use. Enter the hazmat staging location. For example, "In carton on pickup truck bed," "Truck materials cabinet," or "Material pallet in parking lot."

11 "Storage" means a non-transitory, semi-permanent or permanent holding, plac�ment, or leaving of material. It does not include a temporary accumulation of a limited quantity of a material used or a waste generated or resulting from authorized activities, such as servicing, maintenance, or repair of Department of Defense (DoD) items, equipment, or facilities. Source: DFARS 252.223-7006.

Contract: Pending Solicitation: FA4855-18-R-0029

LATRINE & PUMPING SERVICE

Performance Work Statement

Section 7. Additional Information

Will a hazardous waste be Circle "Yes", "No", or "TBD"(To Be Determined) depending on whether the generated? process in which the hazmat will be used will generate hazardous waste.

If completing the form electronically, delete non-applicable responses.

Describe method(s) of waste Briefly describe how any waste generated by the process using the hazmat management, transport, and will be disposed. For example "Solid waste will be collected in 10 yd. roll off," disposal "Potentially hazardous waste soil will be stored in covered bins pending analysis."

Section 8. Signature Block

Several Entries Enter the name of the contractor (representative), title, phone number and date in the upper portion of the block.

Enter printed name in the lower portion of the block and sign.

Contract: Pending Solicitation: FA4855-18-R-0029

LATRINE & PUMPING SERVICE

Performance Work Statement

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ATTACHMENT E-4, Cannon AFB Contractor Hazmat Approval Instructions for Completing Attachment E-4

Air Force Environmental Process Types Listing

Adhering/ Bonding/ Sealing 29. Fabric Work 57. Professional/ Technical/ Sampling Administrative 30. Food Service / Preparation / /Surveying/ Training Aids to Navigation Handling/ Cleaning 58. Protective Services -Fire Aircraft/Flight line Operations 31. Fuels (e.g. Combusting, Dispersing, 59. Protective Services -Security Asbestos Work Fuel Cell, Defueling, Distribution) 60. Recreation / Services Brazing/ Soldering/ Welding/ 32. Hazardous Materials/ Hazardous 61. Roads and Ground Maintenance Cutting Waste Handling/ Cleanup/ 62. Search and Rescue Cementing and Related Tasks Recycling/ Reclaiming 63. Semiconductor Manufacturing Civil Disaster Response (FEMA) 33. Housekeeping/ Janitorial / Facility 64. Shipboard Duties Cleaning-Chemical and Maintenance 65. Stone/ Mineral Handling Degreasing 34. HVAC 66. Storage (of Materials, of Waste, Cleaning- Mechanical 35. Hyperbaric Atmospheres ASTs, USTs, Testing of Storage) Cleaning-Other 36. Incinerating 67. Structure Demolition Coating/Paint Removal/ Abrading 37. Insulation/ Man-Made Fibers 68. Structure Fabrication/ renovation;

Coating/ Painting Operations 38. Integrated Solid Waste General Construction Communications Management 69. Supplies/ Materials Handling Composite Work 39. Laboratory Operations 70. Supplies / Materials Handling - Craft s 40. Lead Paint Abatement Assemble/ Disassemble Cultural Resource Management 41. Marine 71. Transportation (e.g., Dispatching, Dental 42. Medical Driving, Rail, Watercraft) Drinking Water System/ Treating; 43. Metal Forming 72. Utility Production/ distribution Water /Wastewater Plant 44. Metal Foundry Operations 73. Vehicle Maintenance/ Repair/ Operations; Water/ Wastewater 45. Metal Machining Testing Treatment 46. Metals Treatment (e.g., Heat 74. Veterinary Services/ Animal Care Drywall/ Plastering Treating/ Hardening; Etching 75. Waterways Electric Arc/ Flame/ HVOF / 47. Miscellaneous Operations 76. Weapons and Ordnance Jhermal / Plasma Spraying 48. Natural Resource Management 77. Weapons and Ordnance - EOD Electrical / Electronics 49. NOC 78. Weapons and Ordnance - Electroplating 50. Non-Destructive Inspection/ Explosive Production Energy Management Testing 79. Weapons and Ordnance -Mixing/ Engine Testing 51. Pest Control or Pesticide Disposal / Bagging/ Handling Environmental and Remediation Mixing/ Storage 80. Weapons and Ordnance - Torpedo Environmental Response 52. Photography/ Graphic Arts 81. Weapons and Ordnance - (Biological, Chemical, Oil, 53. Plastics/ Rubber Processing Weapons/ Small Arms Radiological) 54. Plumbing 82. Woodworking Equipment Installation/ Repair/ 55. Port Security 83. X-Ray Processing Preventative Maintenance/ 56. Printing/ Reproduction Charging/ Recharging/ Lubricating, NOC

Contract: Pending Solicitation: FA4855-18-R-0029

LATRINE & PUMPING SERVICE

Performance Work Statement

Contract: Pending Solicitation: FA4855-18-R-0029

LATRINE & PUMPING SERVICE

Performance Work Statement

Contract: Pending Solicitation: FA4855-18-R-0029

LATRINE & PUMPING SERVICE

Performance Work Statement