TE-09p Fugitive Dust Control Form 16-Paving.pdf
PDF 761 KB Posted
- Solicitation number
- W911S6-27-B-A001
About this file
This is a template form for the Dugway Proving Ground Fugitive Dust Control Plan addressing paving and subgrade preparation activities. The form is used to document compliance with air quality requirements when preparing sites for paving streets, parking lots, and similar infrastructure.
The form requires contractors to complete general information fields including project location, start and end dates, point of contact information, and site description. For fugitive dust emission control, at least one best management practice (BMP) must be selected from five options for stabilizing adjacent disturbed soils: applying and maintaining water (BMP 16-01), applying chemical stabilizers (BMP 16-02), vegetation or hydroseeding (BMP 16-03), synthetic cover (BMP 16-04), or documenting that no adjacent soils exist (BMP 16-05). If suppression methods are used, a logbook is mandatory containing minimum documentation of date, time, suppression type, amount in gallons, purpose, and application location. The form also enforces trackout prevention requirements under Utah Administrative Code R307-205-6(2), requiring personnel to prevent material deposit on paved roads except at designated sites and to promptly clean any contaminated 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 operation completion or annually by calendar year end, whichever occurs first.
View the file
Other files
Show all 31
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Environmental Programs FDCP-16 Air Quality Program Revision 0
Dugway Proving Ground Fugitive Dust Control Plan Form 16 Roads, Paved and Unpaved
Paving and Subgrade Preparation Activity Description: Paving and subgrade preparation is to make a site ready for paving streets, parking lots, etc.
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 the critical mitigation area:
Stabilize adjacent disturbed soils following paving activities
BMP 16-01 Apply and maintain water on disturbed soils.
BMP 16-02 Apply and maintain chemical stabilizer on disturbed soils. (Name of chemical: ) BMP 16-03 Stabilize disturbed soils with vegetation or hyrdoseeding.
BMP 16-04 Apply synthetic cover to disturbed soils.
BMP 16-05 There are no soils adjacent to paving activities.
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
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Text5: |
| Text6: |
| Text7: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Text8: |
| Date: |
| Check Box4: Off |
| Check Box5: Off |
File details come from the government source that posted it. Updated .