Attch33-44.pdf

7/12/2013 5:13 PM Page 1 of 1 Cooper Transformers - 07-12-13

Item Cooper Power System Part Number Size (kVA) 1 Φ or 3 Φ Low Side Voltage

1 0001 CP06 KBRA 75 3 Φ 120/208

2 0001 CP07 KBTA 112.5 3 Φ 120/208

3 0001 CP07 KBWA 112.5 3 Φ 277/480

4 0001 CP08 KBXA 150 3 Φ 120/208

5 0001 CP09 KBYA 225 3 Φ 120/208

6 0001 CP09 KCAA 225 3 Φ 277/480

7 0001 CP10 KCBA 300 3 Φ 120/208

8 0001 CP10 KCDA 300 3 Φ 277/480

9 0001 CP11 KCFA 500 3 Φ 120/208

10 0001 CP11 KCGA 500 3 Φ 277/480

11 0001 CP12 KCHA 750 3 Φ 120/208

12 0001 CP12 KCJA 750 3 Φ 277/480

13 0001 CP13 KCKA 1000 3 Φ 120/208

14 0001 CP13 KCLA 1000 3 Φ 277/480

15 0001 CA64 KCMA 1500 3 Φ 277/480

Valley Electric Association's Delta - Grounded Wye 12.47 kV Transformer List as of July 12, 2013

1239914680C Typewritten Text ATTACHMENT 33 - Cooper Transformers

1239914680C

1239914680C Typewritten Text

1239914680C

ATTACHMENT 34

ATTACHMENT 35 - UG 17-2

STANDARDS

VEA

DESIGN PARAMETERS:

CALL BEFORE YOU DIG.

1-800-227-2600

APPROVED:DATE:

REVISION:

REA UNIT: RUS UNIT:

AUTHOR:GMB

UM3-14

21 June 2013

1239914680C

ATTACHMENT 36 - UM 3-14

DESIGN PARAMETERS:

CALL BEFORE YOU DIG.

1-800-227-2600

APPROVED:DATE:

REVISION:

REA UNIT: RUS UNIT:

AUTHOR:GMB

UG17-2

21 June 2013

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ATTACHMENT 37 - UM17-2

DESIGN PARAMETERS:

CALL BEFORE YOU DIG.

1-800-227-2600

APPROVED:DATE:

REVISION:

REA UNIT: RUS UNIT:

AUTHOR:GMB

UM33

21 June 2013

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ATTACHMENT 38 - UM33

DESIGN PARAMETERS:

CALL BEFORE YOU DIG.

1-800-227-2600

APPROVED:DATE:

REVISION:

REA UNIT: RUS UNIT:

AUTHOR:GMB

UM48-2

MULTI-GROUNDS

21 June 2013

1239914680C

ATTACHMENT 39 - UM48-2 Multi-grounds

ATTACHMENT 40 – VEA Connection Charge Agreement

FA4861-16-R-A200

CONNECTION CHARGE AGREEMENT

THIS CONNECTION CHARGE AGREEMENT between _____________ (Contractor) and Valley Electric Association, Inc. (VEA) (Utility Owner) is entered into as of this ____ day of _____________, 20___.

WHEREAS, Contractor and the United States Government (Government) entered into Contract No. ________________ for construction of ________________ (the Project) located at ___________ Creech Air Force Base and/or Southern Ranges of Nevada Test and Training Range (collectively the “Construction Contract”);

WHEREAS, in accordance with the Department of Defense utilities privatization (UP) program, Utility Owner entered into a utility services contract under Contract No. SPE600-12-C- 8270 (the UP Contract) with the Government to assume ownership, operations and maintenance of the electrical utility systems at the installation, as well as to furnish all necessary labor, management, supervision, permits, equipment, supplies, materials, transportation, and any other incidental services required for the complete ownership, operation, maintenance, repair, upgrade, and improvement of these utility systems in accordance with all terms, conditions, and special contract requirements, specifications, attachments, and drawings contained in the UP Contract or incorporated by reference therein;

NOW, THEREFORE, in consideration of the mutual covenants contained herein as well as other good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, the Parties hereto agree to the following terms and conditions of this Connection Charge Agreement:

1. [Insert Statement of Work for connecting facilities.]

2. [Insert Schedule provisions and penalties for connecting facilities]

3. [Insert Pricing and Payment provisions]

4. [Insert any other special provisions specific to the relationship between the construction contractor and the UP contractor, e.g., disputes, risk allocation, liability, etc.]

5. Any disputes between the Contractor and the Utility Owner shall be resolved by and between the parties to this Agreement and shall not be cognizable under the Disputes provisions of the Construction Contract or the UP Contract.

6. The parties acknowledge that installation of connecting facilities pursuant to a connection charge falls within the utility services provisions of Federal Acquisition Regulation (FAR) Part 41 and thus, is not a construction sub-contract. Therefore, the terms and conditions of the UP Contract shall govern the relationship between the Utility Owner and the Government, including the Utility Owner’s responsibility for compliance with applicable statutes and regulations.

7. Notices: All notices shall be delivered or sent to the respective parties at the respective addresses set forth below or to such different addresses as the respective parties may from time to time designate by notice properly given hereunder.

If to Utility Owner:

If to Contractor:

ATTACHMENT 40 – VEA Connection Charge Agreement

FA4861-16-R-A200

IN WITNESS WHEREOF, this Connection Charge Agreement is signed, sealed and delivered as of as of this ____ day of _____________, 20_______.

[Utility Owner]

By: _______________________________ Name: _______________________________ Title: _______________________________

[Contractor]

By: _______________________________ Name: _______________________________ Title: ____________________________

Valley Electric Association, Inc.

Chris Tomchuk, P.E.

800 E. Highway 372 Pahrump, NV 89048 Tel: 775-513-9625; 775-727-2183 Email: ctomchuck@vea.coop

NEVADA TEST AND TRAINING RANGE VISIT REQUEST/AUTHORIZATION

This form is subject to the Privacy Act of 1974

All badges must be picked up at Nellis AFB, Building 200.

I. SEND TO:

NTTR Security Voice: 702-653-4606 DSN 348-4606 3770 Duffer Drive, Ste. 127 Fax: 702-653-4808 DSN 348-4808 Nellis AFB NV 89191 Email:NTTRSecurity@nellis.af.mil

FROM (Your Name and Phone Number) NTTR Sponsor / NTTR Host / NTTR Project Officer (This block is mandatory, if unknown call 702-653-4606)

Date of visit (DD-MMM-YY) (May not exceed 365 days) Name: FROM: TO:

Phone: (Requests must be forwarded to the NTTR security office, a minimum of 5 working days prior to start of visit.)

AREAS TO BE VISITED:

(Check all that apply)

BUILDING 200

(NTTR, Nellis AFB)

*SOUTHERN RANGES

(Ranges 61, 62, 63, 64, and 65)

CREECH AFB FLIGHT LINE

(This Will Not Allow Access to Creech

AFB)

*TOLICHA PEAK

(Ranges 75 and 76)

*TONOPAH TEST RANGE

(Area 10, EC East, EC West, R71 & R74)

**NORTHERN RANGES (US CITIZENS AND APPROVIED ALLIES ONLY)

PURPOSE OF VISIT IN DETAIL

TYPED NAME AND GRADE OF SECURITY OFFICIAL VERIFYING SECURITY CLEARANCE:

SIGNATURE DUTY PHONE:

DATE:

II. Visitor(s) Name(s): LAST, First, M.I.

(Continue on second page if needed)

Rank

(ENL, OFF, CIV)

Full SSN or Military ID Number Organization Clearance

(TS, S, None, Q, L) Current Country of Citizenship

DOB

(DD-MMM-YY) Country or State of Birth**

**NATURALIZATION NUMBER / DATE / PLACE: (Only required for naturalized citizens needing access to Tolicha Peak / Tonopah Ranges, attach additional pages if needed.)

1.

IF BORN TO U.S. PARENTS WHILE OVERSEAS

U.S. military parents stationed overseas

U.S. civilian parents living overseas

2.

*EOD SAFETY BRIEF IS REQUIRED PRIOR TO ENTERING ANY NUMBERED RANGE / SECURITY BRIEF REQUIRED PRIOR TO ACCESSING THE SOUTHERN RANGES TTR AND TOLICHA PEAK **A Naturalization number is required for naturalized citizens needing access to Tolicha Peak / Tonopah Ranges –If born to U.S. parents while overseas please state so in space provided above.

III. NTTR OFFICE USE ONLY

NTTR APPROVAL AUTHORITY: SIGNATURE: DATE: BADGED:____________________________

FILED / FAXED / SENT: ________________

DATABASED / DND: ___________________

PRIVACY ACT STATEMENT

AUTHORITY: 10 USC 8013

PRINCIPAL PURPOSE: For positive identification for entry into United States Air Force restricted and controlled areas.

ROUTINE USES: None DISCLOSURE IS VOLUNTARY: Furnishing this information is voluntary. If you do not give the required information, you will not be allowed entry into these areas. This form requires the collection and maintenance of information protected by the Privacy Act (PA) of 1974. The authority to collect and or maintain the records prescribed in this instruction is 37 USC 301a. Privacy Act system notice F036 AF PC C, Military Personnel Records System, applies.

NAFB Form O-74 JUNE 21, 2011 (Electronically Generated) Page 1 of 3 mailto:98RANWSecurity@nellis.af.mil� 1239914680C Typewritten Text ATTACHMENT 41 - NAFB 0-74 Range Pass

Visitor(s) Name(s): LAST, First, M.I.

(Continue on second page if needed)

Rank

(ENL, OFF, CIV)

Full SSN or Military ID Number Organization Clearance

(TS, S, None, Q, L) Current Country of Citizenship

DOB

(DD-MMM-YY)

Country or State of

Birth**

**A Naturalization number is required for naturalized citizens needing access to Tolicha Peak / Tonopah Ranges –If born to U.S. parents while overseas please state so in space provided above.

NAFB Form O-74 JUNE 21, 2011 (Electronically Generated) Page 2 of 3

Visitor(s) Name(s): LAST, First, M.I.

(Continue on second page if needed)

Rank

(ENL, OFF, CIV)

Full SSN or Military ID Number Organization Clearance

(TS, S, None, Q, L) Current Country of Citizenship

DOB

(DD-MMM-YY)

Country or State of

Birth**

**A Naturalization number is required for naturalized citizens needing access to Tolicha Peak / Tonopah Ranges –If born to U.S. parents while overseas please state so in space provided above.

NAFB Form O-74 JUNE 21, 2011 (Electronically Generated) Page 3 of 3

Submit to: issam.sebaihi@us.af.mil Phone number: 702-653-3316 State what base is your project?

Nellis/Creech/NTTR?

Name of the Licensee (person or firm proposing to conduct the activities described below):

The approval letter will be sent to:

Attention to (Name & Cell # of POC):

Email address the approval letter will be sent to:

Project #:

Activity to be conducted on the installation: (Well logging, Radiography, Leak testing and Calibration, other specify):

Contract Project #:

Contract # (if it is different from Project # if any):

Project Name:

Project Location where the equipment will be used (address and building #):

Link of onsite MAP (google/other) with arrow showing the location where the use of equipment (or attached a picture)

Radiation Safety Officer(RSO)

RSO on site Name and Cell Phone number:

Alternate RSO Name / Cell #:

REQUEST FOR AUTHORIZATION TO BRING RADIAACTIVE

MATERIALS (RAM) ONTO NELLIS AFB, CREECH AFB, OR THE

NEVADA TEST AND TRAINING RANGE (NTTR)

1239914680C

ATTACHMENT 42 - Nuclear Gauge Form 1

Safety Monitor Name / Cell #:

Onsite Project Mgr Name / Cell#:

Authorized Users 1- Authorized User Name:

User's Certification date:

2-Authorized User Name:

User's Certification date:

3-Authorized User Name:

User's Certification date:

4-Authorized User Name:

User's Certification date:

5-Authorized User Name:

User's Certification date:

6-Authorized User Name:

User's Certification date:

Authorization devices Only one gauge is authorized to be used at one time.

1-Authorized Device Model #:

Authorized Device Manufacturer:

Authorized Device Serial #:

Swipe Test Date:

2-Authorized Device Model #:

Authorized Device Manufacturer:

Authorized Device Serial #:

Swipe Test Date:

3-Authorized Device Model #:

Authorized Device Manufacturer:

Authorized Device Serial #:

Swipe Test Date:

4-Authorized Device Model #:

Authorized Device Manufacturer:

Authorized Device Serial #:

Swipe Test Date:

5-Authorized Device Model #:

Authorized Device Manufacturer:

Authorized Device Serial #:

Swipe Test Date:

6-Authorized Device Model #:

Authorized Device Manufacturer:

Authorized Device Serial #:

Swipe Test Date:

License Company's RAM License #:

Expiration Date:

1- The above items must be submitted 30 days prior using nuclear density gauge on base.

2- You will receive the approval for 3 months, the approval can be extended.

3- Proof of documentation of all the information provided below.

4- Please make sure you fill in all the yellow boxes accordingly

Name: Signature: Date:

4- Written authorization for the installation RSO to conduct periodic assessments.

Please submit the following 1-6 in one single pdf file in order in pdf file format:

Warning: False statements on this request for authorization to bring radio active material onto Nellis, Creech, or NTTR will result in immediate denial of this application or rescinding of your authorization if already issued. Additional, norification will be made imeediately to the Nuclear

Regulatory Commisssion and / or the Agreement State Jurisdictionally resposible for your license. Notification to the NRC or State may result in civil and/or criminal penalties.

5- Applicants holding a license not issued by an Agreement State must submit an NRC form 241.

6- Applicants applying to bring RAM onto NTTR must also submit an approved NRC form 241.

7- A copy of training Certificates for all authorized users listed on this document. Training should be commensurate with the hazard material being used.

8- A copy of a current leak test certificate which meets the requirements of the RAM license.

2- A copy of the USAF contract clause describing work to be performed and date of the work.

3- A copy of the current NRC or Agreement State License.

1- The request for authorization to bring radioactive materials (this Form)

REQUEST FOR AUTHORIZATION TO BRING RADIOACTIVE MATERIALS (RAM) ONTO NELLIS AFB,

CREECH AFB, OR THE NEVADA TEST AND TRAINING RANGE (NTTR)

1. NAME OF LICENSEE (person or firm proposing to conduct the activities described below)

2. TYPE OF REQUEST

INITIAL UPDATE

3. ADDRESS OF LICENSEE (mailing address or other location where licensee may be located)

4. LICENSEE CONTACT AND TITLE

5. PHONE NUMBER

6. WORK CELL NUMBER

7. FAX NUMBER

8. LICENSEE RADIATION SAFETY OFFICER NAME

9. RSO PHONE NUMBER

10. LICENSEE EMAIL ADDRESS

11. ACTIVITES TO BE CONDUCTED ON THE INSTALLATION

Well Logging Leak Testing and/or Calibrations

Portable Gauges Other (specify):

Radiography

12. INSTALLATION WHERE ACTIVITIES WILL BE CONDUCTED

Nellis AFB

Creech AFB

NTTR

13. PRIMARY CONTRACTOR INFORMATION (Name, Address, City, State, Zip Code)

14. ACTUAL PHYSICAL ADDRESS OF WORK LOCATION (Provide GPS coordinates if known)

15. PRIMARY CONTRACTOR PHONE NUMBER 16. WORK LOCATION PHONE NUMBER

Office

Work Cell

Office

Work Cell

17. DATES FOR REQUEST AUTHORIZATION 18. NUMBER OF DAYS

19. ADD

20. DELETE

21. CONTRACT PROJECT NUMBER

FROM:

TO:

WEEKENDS

YES NO

LIST ADDITIONAL WORK SITES ON A SEPARATE SHEET(S) TO INCLUDE ALL INFORMATION CONTAINED IN ITEMS 12-21 ABOVE

22. PROVIDE A DESCRIPTION OF THE TYPE AND SCOPE OF THE ACTIVITIES TO BE PERFORMED

23. MANUFACTURER:

24. MODEL NO:

25. SERIAL NO:

26. RAM License Number:

27. STATE: 28. EXPIRATION DATE:

29. AUTHORIZED USERS: (Last Name, First Name)

This request for authorization must be submitted to the Installation RSO at least 30 calendar days before bringing RAM onto the installation IAW AFI 40-201. Submission of this request for authorization with less than 30 days notice requires a signed letter by the requesting military organization addressing why the requirements of AFI 40-201 could not be met. The letter must also contain a signed acknowledgement from the requesting organization’s group commander.

In addition to this document the following information must be submitted as a part of the request for authorization:

- A copy of the USAF contract clause describing work to be performed at the installation and the inclusive dates of the work.

- A copy of a current NRC or Agreement State license

- Written authorization for the Installation RSO to conduct periodic assessments to ensure contractor personnel are complying with radiation safety practices to prevent exposures to USAF personnel and the general public, as well as, avoiding contamination of government property.

- Applicants holding a RAM license not issued by an Agreement State must also submit an approved NRC Form 241.

- A copy of training certificates for all authorized users listed on this document. Training should be commensurate with the hazard/material being used.

- A copy of a current leak test certificate which meets the requirements of the RAM license.

Failure to submit a complete package containing the aforementioned documents will result in automatic denial of the request.

NOTE: If locations, dates, and times cannot be provided as a result of them being undetermined, written or email notification will be provided to the Installation RSO not later than one day prior to bringing RAM onto the installation. The notification must contain the location, date, and time the activity is to be performed. Failure to comply with this requirement may result in rescinding of the authorization and notification to the NRC and/or State.

WARNING: False statements on this request for authorization to bring radioactive material onto Nellis AFB, Creech AFB, or the NTTR will result in immediate denial of this application or rescinding of your authorization if already issued. Additionally, notification will be made immediately to the Nuclear Regulatory Commission and/or the Agreement State jurisdictionally responsible for your license. Notification to the

NRC or State may result in civil and/or criminal penalties.

ATTACHMENT 43 - Nuclear Gauge Form 2

DATE PREPAREDBASE CIVIL ENGINEERING WORK CLEARANCE REQUEST

(See Instructions on Reverse)

1. Clearance is requested to proceed with work at on Work Order No. , Contract No. , involving excavation or utility disturbance per attached sketch. This area has has not been staked or clearly marked.

2. TYPE OF FACILITY/WORK INVOLVED

G. AIRCRAFT OR VEHICULAR TRAFFIC FLOWA. PAVEMENTS D. FIRE DETECTION & PROTECTION SYSTEMS

H. SECURITYB. DRAINAGE SYSTEMS E. UTILITY OVERHEAD UNDERGROUND

I. OTHERC. RAILROAD TRACKS F. COMM OVERHEAD UNDERGROUND

3. DATE CLEARANCE REQUIRED 4. DATE OF CLEARANCE

5. SIGNATURE OF REQUESTING OFFICIAL 6. TELEPHONE NO. 7. ORGANIZATION

ORGANIZATION REMARKS (Use Reverse for additional comments) REVIEWER'S NAME AND INITIALS 8.

A. ELECTRICAL DISTRIBUTIONB

A

S B. STEAM DISTRIBUTION

E

C. WATER DISTRIBUTION

C I

D. POL DISTRIBUTIONV

I L

E. SEWER DISTRIBUTION

E N

F. ENVIRONMENTAL

G I

G. PAVEMENTS/ GROUNDSN

E

E H. FIRE PROTECTION

R I

I. ZONEN

G

J. OTHER (Specify)

9. SECURITY POLICE

10. SAFETY

11. COMMUNICATIONS

12. BASE OPERATIONS

13. CABLE TV

14. COMMERCIAL UTILITY COMPANY

TELEPHONE

GAS

ELECTRIC

15. OTHER (Specify)

16. REQUESTED CLEARANCE APPROVED DISAPPROVED

17. TYPED NAME AND SIGNATURE OF APPROVING OFFICER (Chief of Operations Flight or Chief of Engineering Flight) 17a. DATE SIGNED

PREVIOUS EDITIONS ARE OBSOLETE.AF FORM 103, 19940801 (IMT-V1)

1239914680C

ATTACHMENT 44 - AF Form 103

* UTILITY OUTAGES MUST BE SUBMITTED 30 DAYS IN ADVANCE.

1. What is the specific address and/or location where the work will be done?

2. Include a map with plain view reference points (building numbers, road names, ect...)?

3. Is this outage a road closure? If so provide detailed detour map.

4. Provide a detailed description of work:

4. What is the requested work directly in support of (facility repair, infrastructure repair, project construction)?

5. Requested outage START DATE & TIME?

Start Date: ________ Start Time: ________

End Date: ________ End Time: ________

6. What facility(s) will be affected by this outage?

7. Will Base Housing area be affected by this outage?

8. Who is the Project Manager or Point of Contact within CE?

9. Are there any reasons why work cannot be done after hours (>1700hrs) and/or over the weekend (Saturday & Sunday)?

Yes No If yes, explain: ______________________________________________________________

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 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.

18. REMARKS. (This section must describe specific precautionary measure to be taken before and during work accomplishment. Specific comments concerning the approved method of excavation, hand or powered equipment, should be included.)

AF FORM 103, 19940801 (IMT-V1) (REVERSE)