TE 36 Excavation Permit Form.pdf

202 KB Posted

Attached to
BASE OPERATION SUPPORT SERVICES (BASOPS) FOR YUMA PROVING GROUND (YPG)
Solicitation number
W5168W23R0004
Issued by

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Written by GovTribe AI ·

This document is an excavation permit form for Yuma Proving Ground in Arizona. The form requires information on the location, dates, and description of excavation work, as well as acknowledgement that the excavator is responsible for locating all underground utilities through Arizona 811. Relevant details include that excavations in the PM-10 area and Howard Cantonment require contacting Arizona 811 to locate non-YPG owned utilities. The related federal contract opportunity is for base operation support services at Yuma Proving Ground, with a solicitation number of W5168W23R0004 issued by the Department of the Army.

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TECHNICAL EXHIBIT 36

Excavation Permit Form https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907 cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Pen ding%2520Director.aspx&RootFolder=&Web=187bef28-07c4-45ed-92fc-ae55e9a968ef https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Pending%2520Director.aspx&RootFolder=&Web=187bef28-07c4-45ed-92fc-ae55e9a968ef https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Pending%2520Director.aspx&RootFolder=&Web=187bef28-07c4-45ed-92fc-ae55e9a968ef https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Pending%2520Director.aspx&RootFolder=&Web=187bef28-07c4-45ed-92fc-ae55e9a968ef https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Pending%2520Director.aspx&RootFolder=&Web=187bef28-07c4-45ed-92fc-ae55e9a968ef https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Pending%2520Director.aspx&RootFolder=&Web=187bef28-07c4-45ed-92fc-ae55e9a968ef

9/22/22, 11:55 AM Dig Permit - New Item https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/W… 1/3

Dig Permit Full Review Signature Reminder

Send Reminder

Save/Submit

Request Info

Work Request #: Test/Service/Order #:

Title:

Loca�on: High Priority?

Project Engineer:

Project Engineer Phone:

Requestor:

Will be auto-populated a�er submit

Requestor Phone:

Begin Date: End Date:

Method:

Depth: Width: Length:

Descrip�on of Work:

javascript:

javascript:

https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/W… 2/3

Hazards:

Hazards that may be encountered

Comments:

PM-10 Area?

Is the digging being performed in a PM-10 area of YPG?

AZ811 Acknowledgement

The Howard Cantonment Area (Main Post) at YPG houses, and is served by, u�li�es that are not owned or monitored by YPG Public Works personnel, or its contracted employees. For any project, the excavator and/or the excava�ng contractor is solely responsible for arranging AZ-811 locates of the Time-Warner, ComCast and Southwest Gas assets in this area.

Again, contact AZ811 for verifica�on of the presence of, and for the loca�ons of, non-YPG owned, underground u�lity services.

IT IS THE SOLE RESPONSIBILITY OF THE EXCAVATOR TO ASSURE THAT LOCATIONS OF ALL

AFFECTED UNDERGROUND UTILITIES, BOTH YPG AND NON-YPG OWNED, ARE DETERMINED

PRIOR TO DIGGING, AND TO THEN PROTECT SAID UTILITIES FROM ANY AND ALL DAMAGE

THROUGH THE DURATION OF THEIR PROJECT.

Check to acknowledge the above statement. You cannot submit without acknowledging.

AZ811 Acknowledged By: AZ811 Acknowledged Date:

Add A�achments:

Click here to a�ach a file

Dig Permit Extension Request Extension Required?

Extension Begin:

Extension End:

9/22/2022 https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/SiteAssets/ACF419.pdf https://intranet.yuma.army.mil/IMCOM/DPW/WorkRequests/Lists/DigPermit/Item/newifs.aspx?List=d86907cd-b470-45c2-a29d-bb191fd311f7&Source=https%3a//intranet.yuma.army.mil/IMCOM/DPW/W… 3/3

Extension Approved?

Submit

TE #36 Excavation Permit Form
Dig Permit - New Item

File details come from the government source that posted it. Updated .