I.A.07_Technical_Exhibit__5__GCR_and_HAZMAT_11MAY17.pdf
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- Attached to
- Demolition Services Federal contract opportunity
- Solicitation number
- W91248-17-Q-A001
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Technical Exhibit #5 GCR and HAZMAT
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This document is owned by the Fort Campbell Environmental Division, Air Quality Program, and is UNCONTROLLED when printed or electronically copied from the Fort Campbell LAN san server SIMS folder.
AQGCRCKLST.1 Issued: 5 September 2009 Revised: 20 March 2009
General Conformity Rule Checklist General Information
Name of Project:
Construction Company:
POC Name:
Phone Number/Email:
Anticipated Start Date: Anticipated End Date:
Construction Equipment Listing
Equipment Type
Qty Hours of
Operation Miles Fuel Type
Bulldozer
Grader
Excavator
Backhoe
Dump Truck
Fuel/Service Trucks
Tractors
Pug Mills (on site)
Concrete Batch Plant (on site)
Scraper
Ready-Mix Truck
Screed, Concrete
Portable Paint Sprayer
Air Compressor
Lay Down Machines
Rollers
Compactors
Water Trucks
Pavement Stripping Machines
Traffic Road Striping
Loaders
This document is owned by the Fort Campbell Environmental Division, Air Quality Program, and is UNCONTROLLED when printed or electronically copied from the Fort Campbell LAN san server SIMS folder.
AQGCRCKLST.1 Issued: 5 September 2009 Revised: 20 March 2009
Generators
Compactors
Curb and Gutter Pavers
Other:
Other:
Emergency Generator Information (This information will be needed for all stationary emergency generators associated with the project, attach a sheet if necessary)
Manufacturer:
Model Number:
Horsepower:
Max. Fuel consumption (gal/hr):
Fuel Type:
Serial number if currently available:
Stationary Fuel Burning Equipment (This information will be needed for all stationary sources such as boilers, hot water heaters, etc that will be installed attach a sheet if necessary)
Type:
Manufacturer:
Model Number:
BTU Value:
Fuel Type:
Serial number if currently available:
Personal Occupancy Vehicle Information
Vehicle Type
Qty Miles driven on
Post Fuel Type
Light Duty Truck
Heavy Duty Truck
Car/SUV/Van
Submitted by: Date:
FTCKY Hazmat Inventory Form
The contractor must complete and submit the FTCKY HAZMAT INVENTORY FORM, to include type and quantity of hazardous materials (HM) to be brought to the post and corresponding material safety data sheets (MSDS), prior to beginning action.
All HM requirements are found in the Fort Campbell Installation Technical Design Guide: See pp. 44-45, 63. As required by the Emergency Planning and Community Right-to-Know Act (EPCRA), the contractor will develop a site specific Environmental Protection Plan, in which "the Contractor will account for the quantity of HM brought to the post, the quantity used or expended during the job, and the leftover quantity which (1) may have additional useful life as HM and shall be removed by the Contractor, or (2) may be hazardous waste" (HW), which shall be removed per Fort Campbell requirements and disposed of offsite according to applicable regulations at the contractor's expense. The contractor shall submit an annual report on the use of HM and generation of HW on post to the Contracting Officer. Per 49 CFR 171-177, all HM transported to Fort Campbell must be properly containerized and labeled.
Work Order/Project No.
Project Hazardous Materials Log (print)
Activity: Contractor: Contract #: Date:
Bldg. #: POC: COR: COR Phone #:
Date
Product Name
Product Manufacturer
FSN/NSN/Product No.
Estimated # of Containers to be
Used
Actual # of
Containers Used
Container Size
(volume)
MSDS Attached?
HMINVTRY.0
Revised:
March 2015
| GCR_CKLST_Mar_15 |
| FTCKY Hazmat Inventory Form |
| FTCKY Hazmat Inventory Form |
File details come from the government source that posted it. Updated .