TE-09g Fugitive Dust Control Form 07-Site Preparation.pdf
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- Solicitation number
- W911S6-27-B-A001
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This is a template form for the Dugway Proving Ground Fugitive Dust Control Plan (FDCP) used to document construction and demolition activities involving clearing for site preparation and vacant land clean-up. The form requires contractors and personnel to complete general information fields including location(s), start and end dates, point of contact information, and a description of the site being cleared.
The form mandates selection of at least one best management practice (BMP) for each of three critical mitigation areas: stabilizing surface soils where equipment and vehicles will operate (BMP 07-01 or 07-02), stabilizing disturbed soil immediately after clearing and grubbing activities (BMP 07-03 or 07-04), and stabilizing slopes at completion of activity (BMP 07-05 or 07-06). Available BMPs include pre-watering and maintaining surface soils, applying chemical stabilizers with specified chemical names, watering disturbed soils to form crust, applying soil binders, and maintaining sloping surfaces in crusted condition. If dust suppression is used, a logbook must be maintained documenting the date, time, type of suppression, amount in gallons, purpose, and location applied. The form also requires compliance with Utah Administrative Code R307-205-6(2) regarding trackout prevention on paved roads. Completed forms and applicable logbook entries must be submitted to the Environmental Program's Air Program Manager at boyd.roberts.civ@mail.mil upon completion of operations or annually by calendar year-end, whichever occurs first.
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Environmental Programs FDCP-07 Air Quality Program Revision 0
Dugway Proving Ground Fugitive Dust Control Plan Form 07 Construction & Demolition
Clearing for Site Preparation and Vacant Land Clean-Up Activity Description: The process of clearing materials, brush, and soils to prepare or clean-up site.
General Information
Location(s): Start Date: End Date:
Point of Contact: Email: Phone Number:
Description of site:
Fugitive Dust Emission Control Techniques Select at least one best management practice (BMP) for each critical mitigation area:
Stabilize surface soils where support equipment and vehicles will operate
BMP 07-01 Pre-water and maintain surface soils in a stabilized condition BMP 07-02 Apply and maintain a chemical stabilizer on surface soils. (Name of chemical: )
Stabilize disturbed soil immediately after clearing and grubbing activities.
BMP 07-03 Water disturbed soils to form crust.
BMP 07-04 Apply and maintain a chemical stabilizer on disturbed soils to form crust. (Name of chemical: )
Stabilize slopes at completion of activity BMP 07-05 Stabilize sloping surfaces using soil binders until vegetation or ground cover can effectively stabilize the slope.
BMP 07-06 Apply water and maintain sloping surfaces/wind breaks in a crusted condition.
Logbook Requirement If suppression is used, a logbook is required, at minimum, it must contain: the date, time, type of suppression used (i.e. water/chemical suppressant), amount (in gallons), purpose and location applied.
Trackout Prevention In accordance with Utah Administrative Code R307-205-6(2), any person(s) performing fugitive dust emission activities will to the maximum extent possible, keep material from being deposited onto any paved road other than a designated deposit site. Any such person(s) who deposits materials that may create fugitive dust on a paved road shall clean the road promptly.
*By signing you attest that you have read and understand the requirements of the DPG FDCP and will follow the BMPs you have selected.
Signature Date This form is to be completed and kept on record according to the requirements found in the Dugway Proving Ground (DPG) Fugitive Dust Control Plan (FDCP). Copies of form(s) and corresponding logbook entries (if applicable) shall be provided to EP, Air Program Manager, upon the completion of operation(s) and/or annually at the end of each calendar year whichever occurs first. Submit completed form and applicable logbook entries in hardcopy or electronically, via email to Environmental Program’s (EP) Air Program Manager: boyd.roberts.civ@mail.mil
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