Contract_Data_Requirements_List_DD_Form_1423_18RE004.pdf

TREATMENT AND DISPOSAL OF MIXED WASTE

IN SUPPORT OF THE NAVAL NUCLEAR PROPULSION PROGRAM

PR # N4215872719100

Rev 03 05/01/2018

Contract Data Requirements List (CDRL) Table of Contents

ITEM SUBTITLE

A001 RADIOLOGICAL SURVEY RESULTS

B001 GENERATOR WASTE SHIPPING DOCUMENTATION

C001 ANALYSIS REPORT FOR RECEIPT OF WASTE

D001 CERTIFICATE OF TREATMENT

E001 ANALYSIS REPORT FOR TREATMEN OF WASTE

F001 RESIDUAL WASTE SHIPPING DOCUMENTATION

G001 ASBESTOS WASTE DOCUMENTATION

H001 DISPOSAL DOCUMENTATION

J001 GENERATOR WASTE STATUS REPORT

K001 DISPOSAL VOLUME AND CURIE CONTENT STATUS

Rev 03 05/01/2018

CONTRACT DATA REQUIREMENTS LIST

(1 DATA ITEM)

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

N4215872719100

F. CONTRACTOR

1. DATA ITEM NO

A001

2. TITLE OF DATA ITEM

RADIOLOGICAL SURVEY RESULTS

3. SUBTITLE

RADIOLOGICAL SURVEY RESULTS

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20067

5. CONTRACT REFERENCE

SOW, PARA 3.7.1

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

9. DIST STATEMENT

REQUIRED

B (SEE BLK 16)

10. FREQUENCY

ASREQ (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “B”. DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES (FOR OFFICIAL USE ONLY) (8 FEBRUARY 2018). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO LEAD SHIPYARD FOR MIXED MATERIAL, CODE 106.4 BLDG. M-22 RM 317, NORFOLK NAVAL SHIPYARD, PORTSMOUTH, VA 23709-1035.

BLK 10, 12, 13: RADIOLOGICAL SURVEY RESULTS SHALL BE PROVIDED UPON REQUEST BY EITHER THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) OR THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP)

SITE TECHNICAL PERSONNEL.

BLK 14: DISTRIBUTION SHALL BE TO THE COR AND THE NNPP SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY THE GOVERNMENT.

POC(S):

NNSY C106.4 COR: MARK SHOLES, (757) 396-7642, MARK.L.SHOLES@NAVY.MIL

NNSY, C106.4

COR

NNPP SITE 1

15. TOTAL 2

G. PREPARED BY

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

18. ESTIMATED

TOTAL PRICE

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

B

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

B001

2. TITLE OF DATA ITEM

GENERATOR WASTE SHIPPING DOCUMENTATION

3. SUBTITLE

GENERATOR

WASTE SHIPPING DOCUMENTATION

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20065

5. CONTRACT REFERENCE

SOW, PARA 3.7.3

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

A (SEE BLK 16)

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “A”. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED.

BLK 10, 12, 13: COPIES OF SIGNED SHIPPING DOCUMENTATION SHALL BE PROVIDED WITHIN TEN (10) DAYS OF

RECEIPT AT THE TREATMENT FACILITY.

BLK 14: DISTRIBUTION SHALL BE TO THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL

PERSONNEL AS IDENTIFIED ON THE SHIPPING DOCUMENTS AND THE CONTRACTING OFFICER'S

REPRESENTATIVE (COR), AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTROINIC METHOD, AS DIRECTED BY THE GOVERNMENT. DISTRIBUTION OF THE COMPLETED UHWM SHALL BE MAILED VIA HARD COPY TO THE APPLICABLE STATE POC'S (I.E., CA, ME, PA, AND

NY) AT THE FOLLOWING ADDRESSES:

DTSC FACILITY MANIFESTS

P.O. BOX 3000

SACRAMENTO, CA 95812

HAZARDOUS WASTE MANIFEST

BUREAU OF REMEDIATION & WASTE MANAGEMENT

MAINE DEPARTMENT OF ENVIRONMENTAL PROTECTION

17 STATE HOUSE STATION

AUGUSTA, ME 04333

PA DEP

MANIFEST SECTION

P.O. BOX 8550

HARRISBURG, PA 17105-8550

NNYS DEC

DIVISION OF ENVIRONMENTAL REMEDIATION

625 BROADWAY

ALBANY, NY 12233-7252

NNPP SITE 2

APPLICABLE

STATE POC AS

15. TOTAL 4

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

C

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

C001

2. TITLE OF DATA ITEM

ANALYSIS REPORT FOR RECEIPT OF WASTE

3. SUBTITLE

ANALYSIS REPORT FOR RECEIPT OF WASTE

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20061

5. CONTRACT REFERENCE

SOW, PARA 3.7.4

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “B”. DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES (FOR OFFICIAL USE ONLY)(8 FEBRUARY 2018). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO LEAD SHIPYARD FOR MIXED MATERIAL, CODE 106.4 BLDG. M-22 RM 317, NORFOLK NAVAL SHIPYARD, PORTSMOUTH, VA 23709-1035.

BLK 10, 12, 13: ANALYSIS REPORTS FOR THE RECEIPT OF WASTE AT THE TREATMENT FACILITY PRIOR TO

TREATMENT/PROCESSING, SHALL BE PROVIDED UPON REQUEST.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

D

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

D001

2. TITLE OF DATA ITEM

CERTIFICATE OF TREATMENT

3. SUBTITLE

CERTIFICATE OF TREATMENT

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20064

5. CONTRACT REFERENCE

SOW, PARA 3.7.5

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “A”. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED.

BLK 10, 12, 13: THE CERTIFICATE OF TREATMENT (OR EQUIVALENT) SHALL BE PROVIDED WITHIN TEN (10) DAYS AFTER TREATMENT HAS BEEN VERIFIED TO MEET LDR FOR EACH CONTAINER OF WASTE MATERIAL

PROCESSED BY THE CONTRACTOR.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

NNPP SITE 2

15. TOTAL 3

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

E

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

E001

2. TITLE OF DATA ITEM

ANALYSIS REPORT FOR TREATMENT OF WASTE

3. SUBTITLE

ANALYSIS REPORT FOR TREATMENT OF WASTE

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20062

5. CONTRACT REFERENCE

SOW, PARA 3.7.6

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “B”. DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES (FOR OFFICIAL USE ONLY)(8 FEBRUARY 2018). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO LEAD SHIPYARD FOR MIXED MATERIAL, CODE 106.4 BLDG. M-22 RM 317, NORFOLK NAVAL SHIPYARD, PORTSMOUTH, VA 23709-1035.

BLK 10, 12, 13: ANALYTICAL RESULTS CONFIRMING LDR COMPLIANCE SHALL BE PROVIDED UPON REQUEST.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

F

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

F001

2. TITLE OF DATA ITEM

RESIDUAL WASTE SHIPPING DOCUMENTATION

3. SUBTITLE

RESIDUAL WASTE SHIPPING DOCUMENTATION

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20068

5. CONTRACT REFERENCE

SOW, PARA 3.7.7

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

LT*

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

A*

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 7: DRAFT COPIES OF THE SHIPPING DOCUMENTATION SHALL BE PROVIDED FOR REVIEW AT LIST FORTY FIVE (45) WORKING DAYS PRIOR TO SHIPMENT OF WASTE RESIDUAL BETWEEN TREATMENT/PROCESSING FACILITIES OR THE DISPOSAL FACILITY. THE CONTRACTING OFFICER’S REPRESENTATIVE (COR) SHALL PROVIDE ACCEPTANCE TO WITHIN TEN (10) DAYS OF RECEIPT OF DRAFT COPIES. THE CONTRACTOR WILL OBTAIN PERMISSION FROM THE COR PRIOR TO SHIPMENT OF THE WASTE FOR TREATMENT / PROCESSING OR

DISPOSAL.

BLK 8: THE COR SHALL REVIEW THE DRAFT COPY FOR CONTENT/COMPLETENESS AND ACCURACY OF DATA.

ACCEPTANCE CRITERIA WILL BE NO ERRORS IN THE CONTENT/COMPLETENES AND ACCURACY.

BLK 9: DISTRIBUTION STATEMENT “A”. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED.

BLK 10, 12, 13: A SIGNED COPY OF ALL APPLICABLE COMPLETED SHIPPING DOCUMENTS SHALL BE PROVIDED

WITHIN TEN (10) DAYS OF RECEIPT AT THE PROCESSING/DISPOSAL FACILITY.

BLK 14: DISTRIBUTION SHALL BE TO THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS IDENTIFIED ON THE SHIPPING DOCUMENTS AND THE COR AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

1 1 0

NNPP SITE 1 1 0

15. TOTAL 2 2

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

G

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

G001

2. TITLE OF DATA ITEM

ASBESTOS WASTE DOCUMENTATION

3. SUBTITLE

ASBESTOS WASTE DOCUMENTATION

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20063

5. CONTRACT REFERENCE

SOW, PARA 3.7.7.1

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “A”. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED.

BLK 10, 12, 13: APPLICABLE ASBESTOS WASTE SHIPMENT MANIFEST AND RECORDS SHALL BE PROVIDED WITHIN TEN (10) DAYS OF SHIPMENT RECEIPT AT THE DISPOSAL SITE. A SIGNED CERTIFICATE OF DISPOSAL (COD) SHALL ALSO BE PROVDED WITHIN TEN (10) DAYS OF BURIAL OF SUCH ASBESTOS WASTE AND ANY

ASBESTOS CONTAINING DAUGHTER WASTE PRODUCTS.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

H

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

H001

2. TITLE OF DATA ITEM

DISPOSAL DOCUMENTATION

3. SUBTITLE

DISPOSAL DOCUMENTATION

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20066

5. CONTRACT REFERENCE

SOW, PARA’S 3.7.7.2 and 3.7.7.3

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

ASGEN (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “A”. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED.

BLK 10, 12, 13: THE CERTIFICATE OF DISPOSAL (OR EQUIVALENT) AND A COPY OF THE SIGNED UNIFORM LOW- LEVEL RADIOACTIVE WASTE MANIFEST SHALL BE PROVIDED WITHIN TEN (10) DAYS AFTER DISPOSAL HAS OCCURRED. THE SIGNED MANIFEST SHOULD INDICATE THAT THERE WERE NO DISCREPANCIES OBSERVED

DURING THE RECEIPT OF WASTE CONTAINERS PRIOR TO DISPOSAL.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

NNPP SITE 2

15. TOTAL 3

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

J

C. CATEGORY

TDP TM OTHER X1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

J001

2. TITLE OF DATA ITEM

GENERATOR WASTE STATUS REPORT

3. SUBTITLE

GENERATOR WASTE STATUS REPORT

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20071

5. CONTRACT REFERENCE

SOW, PARA 3.7.11

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

B(SEE BLK 16)

MTHLY (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “B”. DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES (FOR OFFICIAL USE ONLY)(8 FEBRUARY 2018). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO LEAD SHIPYARD FOR MIXED MATERIAL, CODE 106.4 BLDG. M-22 RM 317, NORFOLK NAVAL SHIPYARD, PORTSMOUTH, VA 23709-1035.

BLK 10, 11, 12, 13: THE MONTHLY STATUS REPORT SHOULD BE PROVIDED BY THE 10TH DAY OF EACH MONTH

THE CONTRACT IS IN EFFECT.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

Form Approved

OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the

K

C. CATEGORY

TDP TM OTHER X 1

D. SYSTEM/ITEM

MIXED WASTE TREATMENT

E. CONTRACT/PR NO.

K001

2. TITLE OF DATA ITEM

DISPOSAL VOLUME AND CURIE CONTENT STATUS

REPORT

3. SUBTITLE

DISPOSAL VOLUME AND CURIE CONTENT

STATUS REPORT

4. AUTHORITY (Data Acquisition Doc. No)

OT-18-20070

5. CONTRACT REFERENCE

SOW, PARA 3.7.12

6. REQUIRING OFFICE

NNSY, C106.4 (LSMM)

7. DD 250 REQ

N/A

B(SEE BLK 16)

ANNLY (SEE

BLK 16)

12. DATE OF FIRST SUBMISSION

SUBMISSION

SEE BLK 16

ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT “B”. DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES (FOR OFFICIAL USE ONLY)(8 FEBRUARY 2018). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO LEAD SHIPYARD FOR MIXED MATERIAL, CODE 106.4 BLDG. M-22 RM 317, NORFOLK NAVAL SHIPYARD, PORTSMOUTH, VA 23709-1035.

BLK 10, 11, 12, 13: THE ANNUAL SUMMARY REPORT SHALL BE PROVIDED BY JANUARY 5TH OF EACH YEAR THE

CONTRACT IS IN EFFECT.

BLK 14: DISTRIBUTION SHALL BE TO THE CONTRACTING OFFICER'S REPRESENTATIVE (COR) AND THE NAVAL NUCLEAR PROPULSION PROGRAM (NNPP) SITE TECHNICAL PERSONNEL AS SET FORTH IN EACH INDIVIDUAL TASK ORDER. DISTRIBUTION SHALL BE VIA FAX, HARD COPY, OR BY ELECTRONIC METHOD, AS DIRECTED BY

THE GOVERNMENT.

MARK SHOLES

H. DATE

05/02/2018

I. APPROVED BY

SUSANA M SUBER

J. DATE

05/02/2018

17. PRICE

GROUP

DATA ITEM DESCRIPTION

TITLE: ANALYSIS REPORT FOR RECEIPT OF WASTE

Number: OT-18-20061 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Applicable Forms: N/A

Use/Relationship: The laboratory analysis report will provide the government with the hazardous constituents of the waste received at the contractor’s treatment facility prior to treatment.

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

This DID is for one-time use for solicitation N4215872719100. CDG

Requirements:

1. Format. The laboratory analysis report for the receipt of waste shall be in the contractor’s format.

2. Content. The laboratory analysis report for the receipt of waste shall contain the hazardous constituents of the waste as determined by processes set forth in the contract SOW.

End of OT-18-20061. CDG

TITLE: ANALYSIS REPORT FOR TREATMENT OF WASTE

Number: OT-18-20062 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Applicable Forms: N/A

Use/Relationship: The analysis report for treatment of waste will provide the government with verification that the waste meets Land Disposal Restriction requirements after treatment. CDG

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The analysis report for treatment of waste shall be in the contractor’s format.

2. Content. The analysis report for treatment of waste shall contain verification that the treated waste meets Land Disposal Restriction requirements.

End of OT-18-20062. CDG

TITLE: ASBESTOS WASTE DOCUMENTATION

Number: OT-18-20063 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Applicable Forms: N/A

Use/Relationship: Asbestos waste and any asbestos containing daughter waste products originating from asbestos waste, generated within the State of South Carolina shall be tracked until disposed.

Applicable waste shipment records will provide the government with tracking information on the generator’s asbestos waste sent for processing and subsequent disposal.

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The applicable waste shipment records shall be in the

2. Content. All copies of the applicable waste shipment record(s), as required in 40 CFR 61.150, accompanying asbestos waste and any asbestos containing daughter waste products resulting from processing/disposal of asbestos wastes generated within the State of South Carolina shall include the asbestos abatement Project ID number assigned by the Department of Health and Environmental Control (DHEC).

End of OT-18-20063. CDG

TITLE: CERTIFICATE OF TREATMENT

Number: OT-18-20064 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Preparing Activity: SH Project Number:

Applicable Forms: N/A

Use/Relationship: The Certificate of Treatment will provide the government verification that each waste container received at the contractor’s treatment facility has been processed.

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The Certificate of Treatment (or equivalent) shall be in the contractor’s format.

2. Content. The Certificate of Treatment (or equivalent)shall contain documentation that confirms traceability to the original package(s) sent for treatment, such as:

a) Generator's name/site

b) Profile number

c) Manifest number

d) Original container number(s)

e) Residuals container number(s)

f) Statement certifying completion of treatment to Land

Disposal Restriction standards and disposal site criteria, which has been signed and dated.

END of OT-18-20064. CDG

TITLE: GENERATOR WASTE SHIPPING DOCUMENTATION

Number: OT-18-20065 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Applicable Forms: N/A

Use/Relationship: The generator waste shipping documentation for the transportation of the waste material to the treatment facility will provide the government with tracking and waste processing information to the generating site and applicable state (i.e., CA, ME, PA, and NY).

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The generator waste shipping documentation shall be in the

2. Content. The generator waste shipping documentation for the transportation of the waste material to the treatment facility shall contain the following:

a) The completed signed copy of the Uniform Hazardous Waste

Manifest including the Hazardous Waste Report Management Method Codes

b) The signed Uniform Low-Level Radioactive Waste Manifest

c) The signed Asbestos Waste Shipment Record (as applicable)

End of OT-18-20065. CDG

TITLE: DISPOSAL DOCUMENTATION

Number: OT-18-20066 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Use/Relationship: The disposal documentation (i.e., Certificate of Disposal or signed Uniform Low-Level Radioactive Waste Manifests) will provide the government verification that each container of residual waste has been disposed.

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The disposal documentation shall be in the contractor’s format.

2. Content. The disposal documentation shall contain the following:

a) Certificate of Disposal from the Resource Conservation and

Recovery Act Subtitle C Facility (Mixed Waste Cell)

b) A complete signed copy of the Uniform Low-Level Radioactive

Waste Manifests from the Subtitle D Facility (Low-Level Radioactive Waste Cell).

End of OT-18-20066. CDG

TITLE: RADIOLOGICAL SURVEY RESULTS

Number: OT-18-20067 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Applicable Forms: N/A

Use/Relationship: Radiological survey results will provide the government with verification of compliance with conditions and limits of the contractor’s vehicles and equipment used in the transfer of waste materials prior to the departure from the contractor’s facility.

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The radiological survey results shall be in the

2. Content. The radiological survey results shall contain:

a) Verification of compliance with radiological conditions

b) Radiological survey techniques

End of OT-18-20067. CDG

TITLE: RESIDUAL WASTE SHIPPING DOCUMENTATION

Number: OT-18-20068 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number:

Applicable Forms: N/A

Use/Relationship: The residual waste shipping documentation for any outgoing shipment of residual waste to a disposal site or to another one of the contractor’s treatment/processing facilities will allow the government to review shipping documentation and approve outgoing residual waste shipments from the contractor. CDG

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The residual waste shipping documentation shall be in the

2. Content. The residual waste shipping documentation shall contain a draft copy of the shipping manifests (Uniform Hazardous Waste Manifest, the Uniform Low-Level Radioactive Waste Manifest, and the Asbestos waste shipment Record (if applicable)) for shipments of waste residuals between treatment/processing facilities or to the disposal facility.

End of OT-18-20068. CDG

TITLE: DISPOSAL VOLUME AND CURIE CONTENT STATUS REPORT CDG

Number: OT-18-20070 Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number: N/A

Use/Relationship: The Disposal Volume and Curie Content Status Report will provide the government with a report that will summarize disposal volume and curie content for each container of waste received by the contractor. CDG

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The report shall be in the contractor’s format.

2. Content. The report shall contain the following per disposal site:

a) Total volume of waste shipped for burial

b) Total curies of waste shipped for disposal

c) Shipment for disposal manifest number

d) Shipment date for disposal

End of OT-18-20070. CDG

TITLE: GENERATOR WASTE STATUS REPORT

Number: OT-18-20071 CDG Approval Date: 20180417 CDG AMSC Number: N/A Limitation: N4215872719100 DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: SH Project Number: N/A Applicable Forms: N/A

Use/Relationship: The Generator Waste Status Report will provide the government with the status of generator’s waste sent for processing and subsequent disposal. CDG

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The report shall be in the contractor’s format.

2. Content. The report shall contain the following:

a) Date of shipment receipt

b) Incoming manifest number

c) Approved waste profile number for each container

d) Incoming container number

e) Incoming container volume

f) Daughter container number

g) Daughter container volume

h) Total daughter container activity

i) Processing completion date

j) Date of LDR compliance

k) Outgoing manifest number

l) Outgoing shipment destination

m) Outgoing shipment date

End of OT-18-20071. CDG