JA-3,_AF_Form_66.pdf

U.S. GPO 1987-188-148

PROJECT NUMBER PROJECT TITLE SOLICITATION/CONTRACT NO.

SCHEDULE OF MATERIAL SUBMITTALS FTQW 07-1116

TO BE COMPLETED BY PROJECT ENGINEER TO BE COMPLETED BY CONTRACT ADMINISTRATOR

NO. OF COPIES REQUIRED

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ITEM OR DESCRIPTION

OF ITEM, CONTRACT

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RETURN

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NOTIFIED

CONTRACTOR

RESUBMITTAL FINAL APPROVAL REMARKS

APPROVED DIS-

APPROVED

01 14 00 - SAFETY,

ENVIRONMENTAL PROTECTION,

REGULATIONS, AND CODES

1 Construction Operation and Safety Plan, 01 14 00, 1.6 and 1.7 3 30 days prior to

NTP

2 Safety and Health Program, 1.8 3 30 days prior to

NTP

3 Request for use of Ionizing Radiation (if required), 01 14 00, 1.10 3 30 days prior to

NTP

For Information Only. Submit only if applicable.

4 Request for use of Lasers (if required), 01 14 00, 1.11

3 30 days prior to

NTP

For Information Only. Submit only if applicable.

5 Request for use of Radioactive Materials (if required), 01 14 00, 1.12 3 30 days prior to

NTP

For Information Only. Submit only if applicable.

6 Request for use of Radio Frequency radiation (if required), 01 14 00, 1.13 3 30 days prior to

NTP

For Information Only. Submit only if applicable.

7 Request for use of Ultraviolet Radiation (if required), 01 14 00, 1.14 3 30 days prior to

NTP

For Information Only. Submit only if applicable.

8 Environmental Protection Plan, 01 14 00, 1.20 3 4 wks prior to

NTP

9 Solid Waste Weight Tickets, 01 14 00,

1.20 3 Within 3 days of work

10 Hazardous Materials Inventory (Initial, quarterly & final), 01 14 00, 1.21 3

With Environ'l Protection Plan & Quarterly

11 Hazardous Waste Accumulation Log (Initial, quarterly, & final), 01 14 00, 1.22

With Environ'l Protection Plan & Quarterly

12 Lab Test Results (if required), 01 14 00, 1.22, 1.23 3 28 days prior to excavation

13 NOI and asbestos abatement plan (if required), 01 14 00, 1.26 3 10 working days prior to work start Submit only if applicable

14 Asbestos Waste Manifests (if required), 01 14 00, 1.26 3 Within 3 days of work

15 Signed Certificate of Compliance with Land Use Controls (if required), 01 14 00, 1.30

3 w/in 30 days project start

16 Weight Tickets for All Materials or Complete Checklist for Q Hill Landfill (if required)

3 w/in 3 days of material transfer

17 Storm Water Pollution Prevention Plan (if required), 01 14 00, 1.31 3 w/in 30 days project start For Information only. Submit only if applicable.

REPAIR SEWERLINE ON FLIGHTLINE AVE PH 1 (B9039)

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Page 1 of 2 6/6/2017

REPAIR SEWERLINE ON FLIGHTLINE AVE PH 1

(B9039)

EIELSONAFB,ALASKA

PROJECTNO.:FTQW 07-1116

U.S. GPO 1987-188-148

PROJECT NUMBER PROJECT TITLE SOLICITATION/CONTRACT NO.

SCHEDULE OF MATERIAL SUBMITTALS FTQW 07-1116

TO BE COMPLETED BY PROJECT ENGINEER TO BE COMPLETED BY CONTRACT ADMINISTRATOR

NO. OF COPIES REQUIRED

L I N E

N U M B E R

ITEM OR DESCRIPTION

OF ITEM, CONTRACT

REFERENCE, TYPE OF

SUBMITTAL

C

ER

TI

FI

C A

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N O

F C

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PL

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DATE

DATE

RECEIVED

IN CON-

TRACTING

DATE TO

CIVIL

ENGINEER-

ING

RETURN

SUSPENSE

DATE

FOLLOW-UP

DATE

CONTRACTOR

NOTIFIED

CONTRACTOR

RESUBMITTAL FINAL APPROVAL REMARKS

APPROVED DIS-

APPROVED

REPAIR SEWERLINE ON FLIGHTLINE AVE PH 1 (B9039)

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18 Copy of APDES NOI and ADEC approval (if required), 01 14 00, 1.31 3 w/in 30 days project start For Information only. Submit only if applicable.

19 Copy of APDES NOT and ADEC approval (if required), 01 14 00, 1.31 3 30 days prior to construction For Information only. Submit only if applicable.

20 Evidence of delivery of SWPPP to ADEC (if required), 01 14 00, 1.31 3 w/in 3 days of notice For Information only. Submit only if applicable.

21 FAA Form 7460-1 (if required), 01 14 00, 1.33 3 45 days before project start For Information only. Submit only if applicable.

01 40 00 - Quality Control 22 Testing Laboratory (if applicable), 01

40 00, 1.3 A., B. & C. 3 30 days prior to construction

23 Testing Agency Certifications (if applicable), 01 40 00, 1.3 D. 3 30 days prior to construction

24 Workmen Certifications (if applicable), 01 40 00, 1.3 E. 3 30 days prior to construction

01 70 00 - Record Docs & Closeout

As-built Drawings, 01 70 00, 1.4 F. 3 within 10 days of construction completion

26 Operations and Maintenance Data, 01 70 00, 1.5 3 within 10 days of construction completion

27 Warranty Documentation, 01 70 00,

1.6 3 within 10 days of construction completion

02 00 00 - CIPP Specifications 28 CIPP Product Information, 02 00 00-

1.2A, 1.3, 1.4 3 30 days prior to construction

29 CIPP Installer Certification, 02 00 00- 1.2B 3 30 days prior to construction

Page 2 of 2 6/6/2017

REPAIR SEWERLINE ON FLIGHTLINE AVE PH 1

(B9039)

EIELSONAFB,ALASKA

PROJECTNO.:FTQW 07-1116