Atch_005.pdf

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Locate Underground Utilities
Solicitation number
W9124818Q0025
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General Conformity Rule Checklist

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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:

File details come from the government source that posted it.