CDRL_A015_Health_and_Safety_Plan_(Draft_-_24_Oct_14).doc

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War Reserve Materiels (WRM) Federal contract opportunity
Solicitation number
FA4890-15-R-0004
Issued by
Department of the Air Force Air Combat Command

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CDRL A015 - Health and Safety Plan (Draft - 24 Oct 14)

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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

WRM

1. DATA ITEM NO.
2. TITLE OF DATA ITEM
3. SUBTITLE
A-XXX
Health and Safety Plan (H&SP) (RECOMPETE)
HEALTH & SAFETY PLAN (H&SP)
4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE
6. REQUIRING OFFICE

di-ENVR-81375

HQ ACC AMIC/PCE

7. DD 250 REQ
9.DIST STATEMENT REQUIRED
10. FREQUENCY
12. DATE OF FIRST SUBMISSION

LT

aNNUALly
90 dac

b. COPIES

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

SUBMISSION

a. ADDRESSEE
Draft
Final

A

Reg
Repro
16. REMARKS:
HQ ACC AMIC/CO
Block 4: Electronic format shall be compatible with Microsoft Office via the ACC AMIC
HQ ACC AMIC/PCE
LAN electronic mail system.
HQ ACC AMIC/PMS

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, and Hazard Prevention & Control Procedures, Safety Supplies and Equipment, Safety Reviews, and Mishap Prevention as applicable.

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.

15. TOTAL

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

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