CDRL A010 Safety and Health Plan.doc

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T-38 Companion Trainer Program (CTP)
Solicitation number
FA4890-10-R-0008A
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CDRL A010 Safety Health Plan

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Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.
B. EXHIBIT
C. CATEGORY:
A
TDP TM OTHER ENVR
D. SYSTEM/ITEM
E. CONTRACT/PR NO.
F. CONTRACTOR

CTP

1. DATA ITEM NO.
2. TITLE OF DATA ITEM
3. SUBTITLE
A010
Environmental Health and Safety Plan (HSP)
SAFETY AND HEALTH PLAN (S&HP)
4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE
6. REQUIRING OFFICE
di-ENVR-81375
PWS Para 2.4.5
HQ ACC AMIC/PCE
7. DD 250 REQ
9.DIST STATEMENT REQUIRED
10. FREQUENCY
12. DATE OF FIRST SUBMISSION

LT

Block 16
90 dac

b. COPIES

8. APP CODE
C
11. AS OF DATE
13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE
Draft
Final

A

BLocK 16
BLOCK 16
Reg
Repro
16. REMARKS:
HQ ACC AMIC/PKC

Block 4: Report shall be provided using MS Office suite and posted on contractor’s website. Contractor shall notify the Government via Email once report is posted.

Block 5: Base-specific plans shall at a minimum include: Confined Space Management, Lock/Out-Tag/Out, Hazardous Communication (HAZCOM), Weapons Safety, Job Safety Training, Safety Inspections, Mishap Notification & Reporting Procedures, Hazard Abatement Procedures, Hazard Prevention & Control Procedures, Safety Supplies and Equipment, Safety Reviews, and Mishap Prevention, Occupational Health Procedures (to include NDI), and Voluntary Protection Plan (VPP) as applicable.

Block 8: The document will be accepted or rejected by the Government within 30 business days after receipt. Contractor shall revise and resubmit the document within 10 business days after receipt unless otherwise directed by the CO.

Block 9: Distribution authorized to U.S. Government agencies and their contractor’s administrative or operational data, 22 May 07. Other requests for this document shall be referred to HQ ACC AMIC/PKC.

Block 10/11/13: The contractor shall review and update their plans IAW with the approved QMS. When a plan is revised it shall be submitted to the CO for Government acceptance NLT 10 business days after revision.

HQ ACC AMIC/PCE

HQ ACC AMIC/PMAM

15. TOTAL

G. PREPARED BY
H. DATE
I. APPROVED BY
J. DATE

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