am_03.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04 EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The Solicitation Repair B56471 Classroom Re-purpose; Fort Hood, Texas is amended as follows.

See SF30 Continuation Sheet(s)

NOTE: Bid receipt date 20 September 2021; at 10:00 a.m.,CT .

1. CONTRACT ID CODE PAGE OF PAGES

J 1 2

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY

16B. UNITED STATES OF AMERICA 15C. DATE SIGNED 15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer) (Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X 9A. AMENDMENT OF SOLICITATION NO.

W9126G21B4574

X 9B. DATED (SEE ITEM 11)

17-Aug-2021

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

16-Sep-2021

CODE

US ARMY ENGINEER DISTRICT, FORT WORTH

ATTN: CESWF-CT

819 TAYLOR ST, ROOM 2A19

P.O. BOX 17300

FORT WORTH TX 76102-0300

W9126G 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODE CODE

EMAIL: TEL:

W9126G21B4574

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

CHANGES TO SOLICITATION W9126G21B4574

1. New Drawings.- The new drawings listed below which accompanythis amendment, bearing the notation W9126G21B4574 0003:

A152

MD102

2. Replacement Drawings.- Replace the drawings listed below with the attached new drawings(s) of the same number, title bearing the notation W9126G21B4574 0003:

G-002

AD101

AD103

AD104

A-101 A-131 A-151 A-201 A-311 A-312 A-521 A-522 A-611

MD101

3. New Attachment: Add the following attacment to the Solicitation, bearing the notation W9126G21B4574 0003:

STANDARD OPERATING PROCEDURES FOR ARMS ROOM LOCKOUT AND RECEIPT OF

MECHANICAL KEYS. For section 01 35 10.00 44 SPECIAL PROJECT PROCEDURES FOR FORT

HOOD

End of Summary of Changes

STANDARD OPERATING PROCEDURE Operations and Maintenance Division NO. DPW-OMD 006 US Army Garrison Ft Hood

STANDARD OPERATING PROCEDURES

FOR ARMS ROOM LOCKOUT AND RECEIPT OF MECHANICAL KEYS

August 1, 2019

1. PURPOSE: To establish policies and procedures for the Directorate of Public Works (DPW), Operations and Maintenance Division (OMD), OMD Lock Shop, and all entities, regarding the Standard Operating Procedures (SOP) for the security of all Arm’s Rooms and the standard practices of receiving mechanical keys (hard keys).

2. REFERENCES: None

3. APPLICABILITY: This SOP applies to all DPW employees, civilians, United States Army Corps of Engineers (USACE), contractors and all entities making changes or additions to all types of mechanical locking devices and associated keys on Real Property, including the security of all Arm’s rooms on Fort Hood. Furthermore, this policy acts as a guide on information that shall be elevated to facility occupants and Senior Management (Supervisors, Division Chiefs, or Director) for the safe utilization of arms rooms on Fort Hood; as well, as receiving and tracking mechanical keys (hard keys).

4. ARMS ROOMS RESPONSIBILITIES:

a. During regular duty hours:

(1) The point of contact (POC) shall initiate a Demand Maintenance Order (DMO) through Work Reception by calling 254-287-2113 (Line is available 24 hours a day).

(2) OMD Locksmith will ensure the POC is authorized access to the arms room.

(a) Military Police (MP) station shall be contacted by the Locksmith and will verify with the MP’s that the POC is on the authorized users list.

(b) MP’s shall be notified by the Locksmith of all actions to be taken. Example information to be communicated is arrival and start time, departure and end time for repairs and any pertinent information regarding alarm notifications. Additional information shall be communicated to include; what repairs are being executed and estimated time frame Locksmith will need for entry.

W9126G21B4574 0003W9126G21B4574 0003

NO. DPW-OMD 006 US Army Garrison Ft Hood

b. After duty hours:

(1) The point of contact (POC) shall initiate a Demand Maintenance Order (DMO) through Work Reception by calling 254-287-2113 (Line is available 24 hours a day).

(2) Prior to the OMD Locksmith arriving to the work site, the Locksmith will contact the MP station, who will dispatch a patrol officer to the location, who will then verify that the point of contact is authorized entry to the arms room.

(3) Work can only begin when the MP’s have reported back to the OMD Locksmith or the Lock Shop Supervisor, or Work Lead, giving notification that the all clear is complete.

(a) MP’s will notify DES and receive appropriate approval from DES personnel in the event that emergency entry is necessary.

5. MECHANICAL KEYS (HARD KEYS) RESPONSIBILITIES:

a. Existing Facilities:

(1) DPW personnel, USACE personnel, and contractors shall provide keys that match the bitting codes and all hardware throughout all existing facilities where locking mechanisms are being installed or replaced. Patented cores will not be used for any locks under any circumstances.

(2) For projects that do not require total replacement of the locking systems for the facility, through written email request the contract COR, may obtain the appropriate facility bitting codes from the OMD Lock Shop located in Building 4616. The purpose of this requirement is to ensure that new or replacement keys are compatible with the respective key systems already installed in a facility.

(3) There shall be five (5) keys provided to Real Property Planning Division (RPPD) consisting of four (4) facility management keys and one (1) key to be used as a board key by the OMD Lock Shop. The keys will be stamped with the building number and room number (or location) in accordance with the marking specifications outlined in paragraph ten (10).

NO. DPW-OMD 006 US Army Garrison Ft Hood

(4) Mechanical, electrical and utility room keys shall be keyed with a 3-1 keyed core. The OMD Lock Shop shall provide 3-1 keys to Real Property Planning Division (RPPD) for the contract COR to issue to the contractor until contract completion. If the project adds one or more mechanical, electrical or utility rooms to the building(s), the contractor will provide the required L keyway blank cores to the contract COR. The COR will provide the blank cores to the OMD Lock Shop and submit a demand maintenance order (DMO) to Work Reception section 254-287- 2113, for the OMD Lock Shop to have the new cores pinned to 3-1 keys. The COR shall ensure that all the 3-1 locks are installed and working properly.

(5) Project COR’s shall be responsible for turning in all car keys/ override keys, key schedules, bitting codes with room numbers/locations to DPW RPPD located in building 4622.

(6) Master key, control bitting, bitting codes, building code and all unused keys must be submitted to DPW RPPD before final payment is approved. DPW RPPD shall forward all keys to the DPW Housing Project Manager to be issue to the Building Managers.

(7) Bitting codes obtained from the manufacturer shall be sent via Registered Mail, to the requestor for control and tracking purposes.

b. New Facilities:

(1) DPW personnel, USACE personnel, and contractors shall provide keys, key schedule, bitting codes with room numbers and location. The following shall also be included next to the bitting codes: master, control bittings, building code with 500 unused bitting codes, hardware list and floor plans for all facilities where locking mechanisms shall be installed. Everything shall be submitted to DPW RPPD located in Bldg. 4622 as soon as possible but no later than 30 days prior to the turn-over of the facility to DPW. If the 30 day suspense date cannot be met, the contract COR will negotiate a new suspense date with Real Property.

(2) A pre-construction meeting of contractors, DPW, USACE and OMD Lock Shop personnel shall determine how locks shall be keyed in sets or subsets as scheduled.

Locks shall be furnished with the manufacturers’ standard construction key system.

Patented cores will not be used for any locks.

NO. DPW-OMD 006 US Army Garrison Ft Hood

(3) The following keys will be provided to OMD Lock Shop and Real Property; Five

(5) change keys per lock set shall be provided for each room or door and each entry and and/or exit door to the facility. The five (5) keys shall consist of four (4) facility manager keys for Real Property and one (1) key to be used as a board key by the OMD Lock Shop. Six (6) master keys and six (6) control/core keys for use by OMD Lock Shop and Emergency Services. The keys will be stamped with the building number and room number or location in accordance with the marking specifications outlined in paragraph Ten (10).

(4) Keys for new facilities shall be provided to DPW RPPD five (5) business days prior to installing the new cylinders or I/C cores. Before keys are turned in, the contractor and COR shall maintain secure control of all keys.

(5) The contract COR or PM will be responsible for turning in all keys, key schedule, bitting codes with room numbers and location. The following shall also be included; next to the bitting codes: master, control bitting, building code and 500 unused bitting codes, and facility floors plans. Everything shall be submitted to DPW Real Property before final payment is made to the contractor. Floor plans shall be in one- half pint size drawings or larger, key designation shall be legible by eye, per paragraph 10. f. Bitting codes obtained from the manufacturer will be sent via Registered Mail for control and tracking purposes, to the requestor.

(6) Bitting codes may not be reused within a facility, with the exception of doors that are keyed alike. The control and master key bitting shall not be reused facility to facility and will be different from each other in every chamber.

(7) All locks, hardware, cores and keying systems shall be installed and serviced by professional personnel that properly licensed under The State of Texas Private Security, Chapter 1702, and Texas Occupation Code under the appropriate sections governing Locksmiths, Electronic Access Devices and Security Alarms.

6. MARKINGS:

a. The four (4) facility manager keys will be marked on the front with the building code and room number or location that corresponds with the placard identifying room or location, IAW the building floor plan.

b. The OMD Lock Shop board key (1) will be marked on the front with the building number and the room number. The board key will not be marked with the code of facility.

NO. DPW-OMD 006 US Army Garrison Ft Hood

c. The six (6) master keys will be marked with the building number and the letter “M”.

d. The six (6) core keys will be marked with the building number and the letter “C”.

e. “US GOVERNMENT/ DO NOT DUPLICATE” will be marked on the back of all provided keys.

f. Key markings will be between 1/16 inch and 1/8 inch and will be legible to the eye, IAW Appendix A.

7. PROPONENT: The proponent for this standing operating procedure is the Chief, Operations and Maintenance Division, Directorate of Public Works, Fort Hood, Texas.

8. THIS POLICY REMAINS IN EFFECT UNTIL IT IS RESCINDED OR SUPERSEDED.

Adam H. Alexander Chief, Operations & Maintenance Division Directorate of Public Works

Directorate of Public Works DISTRIBUTION DPW All Divisions

USACE - CTAO

Appendix A

Standard Key Markings

Appendix A.1

Bitting Codes Turn-in Example

NO. DPW-OMD 006 US Army Garrison Ft Hood

Standard Key Markings

NO. DPW-OMD 006 US Army Garrison Ft Hood

NO. DPW-OMD 006 US Army Garrison Ft Hood

Appendix A.1

NO. DPW-OMD 003 US Army Garrison Ft Hood

INSTALLATION OF ELECTRONIC LOCKS AND

UTILIZATION OF PLASTIC CARD KEYS

STANDARD OPERATING PROCEDURES (SOP)

OPERATIONS AND MAINTENANCE DIVISION (OMD)

August 1, 2019

1. PURPOSE: To establish policies and procedures for the Directorate of Public Works (DPW), Operations and Maintenance Division (OMD),OMD Lock Shop and all entities regarding the performance of, and installation, duplication, fabrication and issuance of, electronic locking devices and associated keys.

2. REFERENCES: None

3. APPLICABILITY: This SOP is applicable to all DPW employees, civilians, United States Army Corps of Engineers (USACE), contractors and any entities making changes or additions to all types of electronic locking devices and associated keys on Real Property on Fort Hood.

4. RESPONSIBILITIES:

a. Existing Facilities:

1) When performing work on existing facilities, DPW personnel, USACE personnel, and contractors shall only provide the electronic locking devices listed below in this paragraph. This shall also include Key Card Encoders that are compatible for the electronic locks installed within the facilities. The Contracting Officer’s Representative (COR) and/or the assigned Project Manager shall ensure the contractor shall provide one (1) key encoder and ensure all of the necessary and updated versions of the software are installed by SAFLOK, Best/Dormakaba, or a Lenel licensed software representative.

The software shall be compatible, updated and appropriate for the respective systems on Fort Hood and shall mirror the other building panels in the system. All locksets shall be programmed. The contractor shall fabricate and label all keys as approved by DPW’s Information System Security Officer (ISSO). A two (2) year warranty shall be provided on the system, all of its components and locksets, be of grade 1 quality, to match the locking systems and hardware in existing facilities and are approved by DPW Lock Shop and DPW Real Property and Planning Division (RPPD)

- SAFLOK model number 6000 on limited remodel or replacement projects to match existing hardware.

NO. DPW-OMD 003 US Army Garrison Ft Hood

- Best/Dormakaba series BASIS G models shall be used on remodel or replacement projects requiring total hardware replacement.

2) For projects where contractors are performing renovations, repairs or maintenance and facility re-keys are necessary; metal override keys shall be supplied on all locking systems for a facility by the contractor. For marking override keys, facility codes shall be obtained from the OMD Lock Shop Supervisor or Work Lead, through a written email request from the COR.

Contractor shall provide three (3) metal override keys per room, two (2) facility manager keys, and one (1) DPW board key unless otherwise designated.

3) On existing facilities, the contractor shall provide the appropriate number of blank key cards as follows:

(a) 100 locks or more – 2,000 blank key cards

(b) 25 to 99 locks - 500 blank key cards

(c) Less than 25 locks – 100 blank key cards

4) On existing facilities with SAFLOK the key cards shall have a smart chip. On existing facilities with BASIS G, the key cards shall have a magnetic strip.

5) Project COR’s shall be responsible for turning in all card keys/override keys, key schedules, bitting codes with room numbers/locations to DPW RPPD located in building 4622.

6) Master key, control bitting, bitting codes, building code and 500 unused bitting codes must be submitted to DPW RPPD before final payment is approved.

DPW RPPD shall forward the blank card keys to the DPW Housing Project Manager to be issued to the Building Managers.

7) Bitting codes obtained from the manufacturer shall be sent via Registered

Mail, to the requestor, for control and tracking purposes.

NO. DPW-OMD 003 US Army Garrison Ft Hood

b. New Facilities:

1) When constructing new facilities, DPW personnel, USACE personnel, and contractors shall provide electronic locking devices by Best/Dormakaba, series BASIS G, including the key card encoder that is compatible for all electronic locks within the facility. The COR and/or the assigned Project Manager shall ensure that extra locksets are provided as spares and one(1) additional encoding station, uninstalled with all necessary and updated versions of the software and licenses as approved by the DPW ISSO. The number of extra locksets to be provided shall be equal to 10% of the total locksets in the facility. A Best/Dormakaba or Lenel software licensed representative shall install the system with all necessary software, ensuring it is compatible and updated, mirrors the other building panels, program all locksets, and make and label all keys. The Best/Dormakaba or Lenel software licensed representative shall provide two (2) 4-hour classes of card encoding station training (to include two copies of training manuals) for DPW personnel.

2) A pre-construction meeting of contractors, OMD Lock Shop and USACE personnel shall be accomplished to determine how the locks shall be keyed or programmed, in sets or subsets, as scheduled. Locks shall be furnished with the manufacturer’s standard construction key system. Patented cores shall not be used for any locks under any circumstances.

3) For new facilities, the contractor shall provide a complete master keyed locking system with metal override keys. Facility codes shall be obtained from the OMD Lock Shop Supervisor or Work Lead through a written email request from the COR. Contractor shall provide three (3) keys per room, two (2) facility manager keys and one (1) DPW board key unless otherwise designated.

4) Bitting codes shall not be reused within a facility, with the exception of doors that are keyed alike. Control and Master key bitting shall not be reused from facility to facility and shall be different from each other in every chamber.

Floor plans on half print size (11X17) or larger, with room numbers, shall be provided by the contractor to the COR and DPW RPPD located in building 4622. The card keys, metal keys, and floor plans are to be provided to RPPD five (5) days prior to the day the facility is scheduled to be turned over to DPW. The contractor/COR shall maintain secure key control of all facilities until they have been turned over to RPPD.

NO. DPW-OMD 003 US Army Garrison Ft Hood

5) Project COR’s shall be responsible for turning in all card keys/override keys, key schedules, bitting codes with room numbers/locations to DPW RPPD located in building 4622.

6) Master key, control bitting, bitting codes, building code and 500 unused bitting codes must be submitted to DPW RPPD before final payment is approved.

DPW RPPD shall forward the blank card keys to the DPW Housing Project Manager to be issued to the Building Managers.

7) Bitting codes obtained from the manufacturer shall be sent via Registered

Mail, to the requestor, for control and tracking purposes.

5. MARKINGS:

a. Metal Override Keys shall be marked as follows:

1) Keys shall be stamped “US Government/ Do Not Duplicate” on one side and shall have the facility code or facility (building) number and room number or location stamped on the opposite side of the key.

2) Key codes shall be obtained from the OMD Lock Shop Supervisor or Work Lead by the COR through a written email request.

3) Key markings and designation shall be between 1/16 and 1/8 inch and be easily legible to the eye.

6. All locks, hardware, cores, keying systems, and related software shall be installed and serviced by personnel that are properly licensed under The State of Texas Private Security Act Chapter 1702, Texas Occupation Code under the appropriate sections governing Locksmith, Electronic Access Devices and Security Alarms.

7. PROPONENT. The proponent for this standing operating procedure is the Chief, Operations and Maintenance Division, Directorate of Public Works, Fort Hood, Texas.

NO. DPW-OMD 003 US Army Garrison Ft Hood

8. THIS POLICY REMAINS IN EFFECT UNTIL IT IS RESCINDED OR SUPERSEDED.

Adam H. Alexander Chief, Operations & Maintenance Division Directorate of Public Works

DISTRIBUTION:

DPW all Divisions

USACE – CTAO

BEST and SAFLOK, Locking Mechanism Examples

Appendix A.1

Key Stamping Example

Appendix A.2

NO. DPW-OMD 003 US Army Garrison Ft Hood

Appendix A, BEST and SAFLOK, Locking Mechanism Examples

Best Lock System with Card

NO. DPW-OMD 003 US Army Garrison Ft Hood

SAFLOK

NO. DPW-OMD 003 US Army Garrison Ft Hood

Appendix A.1, DPW-OMD Key Marking

NO. DPW-OMD 003 US Army Garrison Ft Hood

NO. DPW-OMD 003 US Army Garrison Ft Hood

NO. DPW-OMD 003 US Army Garrison Ft Hood

Appendix A.2 DPW-OMD Bitting Codes Turn-in Example

NO. DPW-OMD 003 US Army Garrison Ft Hood

Glossary:

SOP Standard Operating Procedure

RPPD Real Property and Planning Division

ENG Engineering

USACE United States Army Corps of Engineers

COR Contracting Office Representative

Existing Facility Facility that exist structurally and is already on the property book with RPPD

New Facility a structure recently constructed but not yet on the property book with RPPD

Blank Card key An electronic key card not yet programed to a facility or room.

ISSO Information System Security Officer

Proposed Project Emissions Inventory Questionnaire for New Sources

DPW, ENV Air Emission Inventory Questionnaire Form‐1, Rev date: 21Jul2014

Title V Operating Permit / New Source Review

Purpose: This form is used to capture detailed information about new air emission sources which have the potential to emit pollutants into the atmosphere. Information from this form will be used to address permit requirements such as new applications, notifications, amendments or revisions under Fort Hood’s Title V Air Operating Permit # O-01659. The form shall be completed as soon as required equipment data is known to allow sufficient time to prepare permit applications for new sources prior to startup. Reminder: Some types of emission sources (e.g. boilers, generators and tanks) may also require startup or initial notifications to the Environmental Protection Agency.

Indicate proposed emission source type and complete all applicable fields for each piece of equipment. Complete the questionnaire sheet for each emission source type in this facility. Forms must be returned to the DPW, Environmental Division, Air Quality Program, Bldg 4622, (254) 287-8714 or (254) 286-6262.

Requestor:____________________Date:___/___/_____Phone:________________Project#:_____________________________________

Building#:___________________________ Descriptive Name of Facility:___________________________________________

Location of Facility:______________________ UTM Coordinate: Zone: 14 Northing: Easting:

AUTHORIZATION FOR STARTUP

Authorized by: ____________________ Title: ______________________

Signature: ________________________ Date of Startup: ___/____/________

Received on ____/____/_____ Permitted by _______________________ (Permit By Rule or Permit)

AUTHORIZATION TO PROCEED WITH CHANGE

Authorized by: ____________________ Title: ______________________

Signature: ________________________ Date: ____/_____/_________

ENV Use Only

INTERNAL COMBUSTION UNITS (e.g. Generators, Test Cells, Covered by 30 TAC 106.511 and 30 TAC 106.512 ) Make Model Serial # Power Rating: Kw; Horsepower: HP Engine Type: 4SLB, 4SRB, 2SLB, Other (Circle one) Fuel Type: Natural Gas/Propane/Diesel; Integrated Fuel Tank Capacity: ____gallons Make Model Serial # Power Rating: Kw; Horsepower: HP Engine Type: 4SLB, 4SRB, 2SLB, Other (Circle one) Fuel Type: Natural Gas/Propane/Diesel; Integrated Fuel Tank Capacity: ____gallons Make Model Serial # Power Rating: Kw; Horsepower: HP Engine Type: 4SLB, 4SRB, 2SLB, Other (Circle one) Fuel Type: Natural Gas/Propane/Diesel; Integrated Fuel Tank Capacity: ____gallons Separate Fuel Tank(s): YES / NO (circle one) Complete Separate Questionnaire for Each Tank For Generators provide a copy of the Manufacturer’s Emission Certification

Seasonal Operating Percentage for This Emission Point:

Spring % Summer % Fall % Winter % Note: Total Must Equal 100% Normal Operating Schedule: Start Time hours/day days/week _____weeks/year __ Normal Operating Rate:____gallons or CuFT/yr

FUEL STORAGE TANKS (Covered by 30 TAC 106.473 , 30 TAC 106.478 and 30 TAC Chap 115) Make _______ Model ________________Serial#____________________ Tank Volume: _____gals; Tank Dimensions (ft): Diameter: ____Length:___ Height:______ Make _______ Model ________________Serial#____________________ Tank Volume: _____gals; Tank Dimensions (ft): Diameter: ____Length:___ Height:______ Make _______ Model ________________Serial#____________________ Tank Volume: _____gals; Tank Dimensions (ft): Diameter: ____Length:___ Height:______

Tank Type: Aboveground / Underground (circle one);

Vapor Control Equipped: YES / NO (circle one) Roof Type: Horizontal Fixed Roof / Vertical Fixed Roof / Internal Floating Roof / Pressure Tank External Floating Roof(circle one)

Seasonal Operating Percentage for This Emission Point:

Spring % Summer % Fall % Winter % Note: Total Must Equal 100% Normal Operating Schedule: Start Time hours/day days/week weeks/year Normal Operating Rate: gallons/year Maximum Operating Rate: gallons/hour

EXTERNAL COMBUSTION UNITS (e.g. Boilers & Heaters Covered by 30 TAC 106.102 or

30 TAC 106.183)

Fuel Type: Natural Gas / Diesel (circle one) Make: __ Model:__________Serial#:__________Input Rating:___ MMBTUH

Height of Stack: ___ ft ; Diameter of Stack:____ft; Stack Velocity: __ft / sec Make: __ Model:__________Serial#:__________Input Rating:___ MMBTUH Height of Stack: ___ ft ; Diameter of Stack:____ft; Stack Velocity: __ft / sec

Make: __ Model:__________Serial#:__________Input Rating:___ MMBTUH

Seasonal Operating Percentage for This Emission Point:

Spring % Summer % Fall % Winter % Note: Total Must Equal 100% Normal Operating Schedule: Start Time hours/day days/week _ _ _ _ _ weeks/year

Normal Operating Rate: ________ Cuft or gallons/year

FUEL DISPENSING UNITS (Covered by 30 TAC 106.412) Make:__________Model:_____________Serial#:___________________ Make:__________Model:_____________Serial#:___________________ Make:__________Model:_____________Serial#:___________________ Make:__________Model:_____________Serial#:___________________

Fuel Type: MUR / Diesel / JP-8 / Other (Circle one) Dispensing Type: Retail / Bulk (circle one) Vapor Control Equipped : YES / NO (circle one) Dispenser Pump rate: gallons/minute

Seasonal Operating Percentage for This Emission Point:

Spring % Summer % Fall % Winter % Note: Total Must Equal 100% Normal Operating Schedule: Start Time hours/day days/week weeks/year _______Normal Operating Rate:______gallons/year

SURFACE COATING OPERATIONS (Covered by 30 TAC 106.433 , 30 TAC 106.436 or

30 TAC 116.110)

Attach approved MSDS of each coating and solvent used in process Particulate Matter Control Efficiency of Booth: % Booth Air Flow Rate: scfm Transfer Efficiency of Paint Gun: % Number of Paint Guns:

Associated Heater: YES / NO (circle one) Complete Separate Questionnaire for Each Heater Associated Gun Cleaner: YES / NO (circle one) Complete Separate Questionnaire for Each Cleaner on degreaser section Seasonal Operating Percentage for This Emission Point:

Spring % Summer % Fall % Winter % Note: Total Must Equal 100% Normal Operating Schedule: Start Time hours/day________ days/week_______weeks/year______ Normal Operating Rate: ________gallons/year (each coating and solvent)

REFRIGERATION EQUIPMENT (e.g. Air Conditioning, Freezer) (Covered by 30 TAC 106.103)

Make _______ Model ________________Serial#____________________ No. of compressors:

Refrigerant Type: _____ Amount of Charge:____ lbs; Initial Charge Date:___/___/____

Make _______ Model ________________Serial#____________________ No. of compressors:

Refrigerant Type: _____ Amount of Charge:____ lbs; Initial Charge Date:___/___/____

Make _______ Model ________________Serial#____________________ No. of compressors:

Refrigerant Type: _____ Amount of Charge:____ lbs; Initial Charge Date:___/___/____

Make _______ Model ________________Serial#____________________ No. of compressors:

Refrigerant Type: _____ Amount of Charge:____ lbs; Initial Charge Date:___/___/____

WELDING OPERATIONS (Covered by 30 TAC 106.227)

Attach approved MSDS of each welding rod type used in process Make: __ Model:__________Serial#:_________________

Make: __ Model:__________Serial#:_________________

Make: __ Model:__________Serial#:_________________

Particulate Matter Control Efficiency of hood (if available): _______% Exhaust Fan Ventilation Rate :_ scfm Acetylene on hand:___lbs of gas Oxygen on hand:____lbs of gas

Seasonal Operating Percentage for This Emission Point:

Spring % Summer % Fall % Winter % Note: Total Must Equal 100% Normal Operating Schedule: Start Time hours/day days/week _ _ _ _ weeks/year____ Normal Operating Rate: # of rods/year

DEGREASERS (Covered by 30 TAC 106.454)

Attach MSDS of proposed degreaser solvent Degreaser Type: Parts Cleaner / Paint Gun Cleaner (circle one)

Make:___________Model:________________Serial #:________________

Make:___________Model:________________Serial #:________________

Make:___________Model:________________Serial #:________________

Make:___________Model:________________Serial #:________________

Seasonal Operating Percentage for This Emission Point:

Spring _____% Summer _____% Fall _____% Winter _____% Note: Total Must Equal 100%

Normal Operating Schedule: Start Time_____hours/day _____days/week _____weeks/year____ Normal Operating Rate: _______________gallons/year

FIN, EPN and CIN determination comes from Emissions Inventory Guidelines

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

FIN # _________________ EPN #_________________ CIN #__________________

ENV Use Only

Make Building Number or Location Model Number Date Leak Discovered / Unit Serviced Serial Number Does serviced unit contain more than 50 lbs. refrigerant? Yes / No Refrigerant Type

Location of Leak on Equipment Unit Refrigerant Full Charge Per Circuit 1 2 3

Service Order Number (SO#) Refrigerant Recovered (lbs.oz) Per Circuit 1 2 3 Recovered Refrigerant was: Re-used Taken to C.U.

Recovery Cylinder #

Compressor Serial Number Vacuum Level Achieved (In Hg) Make Refrigerant Added (lbs.oz) Per Circuit 1 2 3 Model Number Refrigerant Added Cylinder # Serial Number Refrigerant Type Vacuum Level Achieved (inches Hg) Amount of Refrigerant Added Amount of Refrigerant Recovered Cylinder # Notes:

Initial Leak Verification (Conducted after repair but before charging) Leak repaired ? Yes / No Date:

Method used for verification If no, what action taken

Make Follow-up Leak Verification (Conducted at normal operating capacity) Model Number Initial Leak repair effective ? Yes / No Date:

Serial Number Method used for verification Refrigerant Type If no, what action taken Amount of Refrigerant Added Amount of Refrigerant Recovered Refrigerant Charge per Circuit 1 2 3 4 Cylinder # Notes:

Printed Name: Certified Technician

Printed Name: Supervisor/Reviewer

November 2015

Signature of Certified Technician

Signature of Supervisor/Reviewer

Fort Hood Refrigerant Equipment Service Log DPW Maintenance Shop #________________

Equipment Maintenance/Service/Repair

Detailed Description of Repairs:

Certified Technician Name

In compliance with the requirements of the Clean Air Act, Section 608, I certify that the refrigerant has been handled in accordance with U.S. EPA regulations at 40 CFR 82.156.

Equipment Duty Type?

Comfort Cooling Commercial Industrial/Process

Equipment Removal/Disposal

New Equipment Installation

Date ____________________________

Location______________________________________________________________________

Refrigeration Unit _____________________________________________________________________________

Type of Refrigerant Vented _________________________ Approx. How Many Pounds Were Vented ___________________________________

Description of Accidental Venting Incident _________________________________________________________________________________

What Was the Cause of the Release? _____________________________________________________________________________________

What Precautions Have Been Taken to Prevent This from Happening Again?

Technician Name/Rank or Grade __________________________________ Certification Number _____________________________

Shop Supervisor Signature_________________________________________________________________________Date _________________

Shop Supervisor Printed Name and Rank ______________________________________________________

Maintain for Record Purposes for 5 Years

Appendix D: Customer Service Inspection Certificate gfedc gfedc gfedc gfedc gfedc gfedc gfedc gfedc gfedc gfedc gfedc gfedc gfedc

Appendix F: Sample Backflow Prevention Assembly Test and Maintenance Report

BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT

SA. DI G OPERATING Directorate of Public Works PROCEDURES 1II Corps and Fort Hood, TX NO. QA 001 Fort Hood, TX 76544-5028

Electrical Geographic Information System

1. PURPOSE: To outline the responsibilities for collecting, updating, and maintaining data required for key electrical point f interest in electric distribution system.

2. OBJECTIVE:

a. To keep GIS electrical data SDFIE compliant, accurate, and up to date to allow for inventory and modeling purpose

b. 0 provide worksheets and responsibilities for collecting data to be in stored in GIS SDF1E tables.

3. APPLICABILITY: This Standard Op rating Procedure (SOP) is applicabl to Contractors, Contracting Officer Representatives (COR), QA Design Team, and any and all entities making changes or additions to Fort Hood's electrical distribution system.

The SOP applies to all facilities. Directorate ofPublic Works (DPW) Engineering has oversight of all contracts and work being executed that impacts the electric distribution system.

4. RESPO SIBILlTY:

on all key electrical points of interest after installation.

11. All data shall be gathered for existing and new electrical points of interest.

turned- in. Applicable information shall be included on as-built drawings.

VI. All worksheets and other required information shall be turned-in to lectrical Champion through COR or Government Proj ct Manager.

additions, made to system via email.

11. Shall complete workshe ts ith basic data (model, manufacture, KVA, type, wattage, date of installation, d scribe of rep ir, class, h ight) on all

STANDING OPERATING Directorate f Public Works PROCED RES IU Corps and Fort Hood TX

NO. QA 001 Fort Hood, TX 76544-5028 repairs, new installations, and modifications made to system and turn worksheets in to Electrical hampion via email.

interest and tum worksheets in to Electrical Champion.

go ernment Maintenance shop.

v. Shall be technical adviser for all worksheets

5. ELECTRlCAL POI TS OF INTERE T:

6. ATTACHM T8

Worksheet for Poles

~Q~

ROBERT D. ERWIN

Chief, Engineering and Services Division

Worksheet for Transformer and Transformer Banks (For new and existing transformer bank)

Contractor shall fill in the following data on all transformers on project

1. Transformer ID ________________________

2. Disposition ________________________

3. Type of Mounting ________________________

4. Primary Voltage ________________________

5. Secondary Voltage ________________________

6. Number of Transformers ________________________

7. Number of Phases ________________________

8. KVA ________________________

9. Total KVA ________________________

10. Substation ID ________________________

11. Date of Installation ________________________

12. Date of Inspection ________________________

13. Condition ________________________

14. Feeder Number ________________________

15. Grid Value ________________________

16. Coordinate X ________________________

17. Coordinate Y ________________________

18. Coordinate Z ________________________

19. Narrative ________________________

1. User ID – First digits will reference 1 to 100 gird Fort Hood ID. Followed by T10# for pad mounted transformer bank and T20# for a pole mounted transformer bank. Each transformer bank ID shall be assigned by Project Manager of the project.

2. Disposition – The status of the subject item (e.g., permanent, temporary, proposed, abandoned, etc.), from lists or entered from field inspections.

Abandoned Permanent Temporary

3. Type of mounting - The type of mounting for the transformer bank.

Pole mounted Pad mounted Wall mounted Ceiling mounted

4. Primary Voltage - The line-to-line voltage of the electrical system that serves as the source for the transformer bank.

5. Secondary Voltage - The line-to-line voltage of the electrical system that the transformer bank serves.

6. Number of Transformers - The number of transformers in the transformer bank.

7. Total number of Phases - The number of phases of transformer group.

8. KVA - The capacity of each transformer in a group. (i.e. 2-50kva / 1-25kva, 50 is the capacity of each transformer in the first group - 25 is the capacity of each transformer in the second group.)

There can be no more than two groups in a bank.

9. Total KVA - The total KVA rate for all transformers attached to the transformer bank.

10. Substation ID - An operator generated identifier locally used to identify the substation feeding this bus group. MF – Main Fort Hood Substation, WF – West Fort Hood Substation, CR- Clark Road Substation, NF – North Fort Hood Substation

11. Date of installation - The date on which the subject item was originally installed. Format for date is

YYYYMMDD (i.e., September 15, 1994 = 19940915).

12. Date of Inspection – The last inspection date of the subject item. Format for date is YYYYMMDD (i.e., September 15, 1994 = 19940915)

13. Condition - The condition of the subject item when last inspected.

14. Feeder Number - An operator generated identifier locally used to identify the feeder to the transformer bank.

15. Grid Value – Grid number based on one to 100 grid system.

16. Coordinate X - The x component of individual coordinate point.

17. Coordinate Y - The y component of individual coordinate point.

18. Coordinate Z - The z component of individual coordinate point.

19. Narrative - A description or other unique information concerning the subject item to include manufacture, model number and serial numbers.

Worksheet for Switches (For new and existing switches)

Contractor shall fill in the following data on switches on project

1. Switch ID ________________________

3. Installation Type ________________________

4. Switch Type ________________________

5. Switch Rating ________________________

6. Voltage ________________________

7. Number of Switches ________________________

8. Number of Phases ________________________

9. Phase Letter ________________________

10. Serial numbers ________________________

11. Switch Position Condition ________________________

12. Switch Weight ________________________

13. Switch Dimension ________________________

14. Substation ID ________________________

15. Manufacture ID ________________________

16. Circuit ID ________________________

17. Grid Value ________________________

18. Coordinate X ________________________

19. Coordinate Y ________________________

20. Coordinate Z ________________________

21. Narrative ________________________

1. Switch ID – First digits will reference 1 to 100 gird Fort Hood ID. Followed by SW10# each switch shall be assigned by Project Manager of the project.

2. Disposition – The status of the subject item (e.g., permanent, temporary, proposed, abandoned,

3. Installation Type - The installation type code.

Circuit breaker Cubicle Fuse Cutout Gang Operated disconnect Pad Mounted Pole Mounted Recloser

4. Switch Type - A label chosen from a standard list of labels indicating the characteristics of a switch.

5. Switch Rating - The maximum continuous amount of current to which the switch should be subjected.

6. Voltage - The system voltage of the electrical line at the point in which the switch is inserted.

7. Number of Switches - The number of phases opened by the switch

8. Number of Phases - The number of phases opened by the switch

9. Phase letter - The letter(s) of the phase(s) for the subject item.

10. Serial Number - The manufacturer's serial, or unique identification number of the subject item.

11. Switch Position Condition - The positional condition of a switch during normal circuit conditions (e.g., normally-open, normally closed).

12. Switch Weight - The force of the switch toward the center of the earth due to the switch's mass.

13. Switch Dimension - A three dimensional description of the amount of space which a switch occupies (e.g., 2 x 1 x 4).

14. Substation ID - An operator generated identifier locally used to identify the substation feeding this bus group. MF – Main Fort Hood Substation, WF – West Fort Hood Substation, CR- Clark Road Substation, NF – North Fort Hood Substation.

15. Manufacture ID – Manufacture name

16. Circuit ID – Feeder number switch is connected to

17. Grid Value - Grid number based on one to 100 grid system for Fort Hood

18. Coordinate X - The x component of individual coordinate point.

19. Coordinate Y - The Y component of individual coordinate point.

20. Coordinate Z - The Z component of individual coordinate point.

21. Narrative - A description or other unique information concerning the subject item, limited to 240 characters.

Worksheet for Risers (For new and existing risers)

Contractor shall fill in the following data on all risers on the project

1. Riser ID ________________________

2. Narrative ________________________

3. Pole ID ________________________

4. Grid ID ________________________

5. Coordinate X ________________________

6. Coordinate Y ________________________

7. Coordinate Z ________________________

8. Voltage ________________________

9. Date of Installation _________________________

Worksheet for Risers

1. Riser ID – First digits will reference 1 to 100 gird Fort Hood ID. Followed by RP#### Riser ID

2. Narrative - A description or other unique information concerning the subject item, limited to 240 characters. Required will be size of conduit and wire of service.

3. Pole ID – Pole ID that riser is attached to

4. Grid ID - Grid number based on one to 100 grid system for Fort Hood

5. Coordinate X - The x component of individual coordinate point.

6. Coordinate Y - The x component of individual coordinate point.

7. Coordinate Z - The x component of individual coordinate point.

8. Voltage - The voltage associated with the riser.

9. Date of Installation - The date of Installation for the subject item. Format for date is YYYYMMDD

Worksheet for Regulators (For new and existing regulators)

Contractor shall fill in the following data on all regulators on the project

1. Regulator ID ________________________

3. Regulator Type ________________________

4. Regulator Usage ________________________

5. Installation Type _________________________

6. Regulator Weigh ________________________

7. Phase Letters ________________________

8. Number of Phases ________________________

9. Primary Voltage ________________________

10. Percentage of tap ________________________

11. Number of Taps ________________________

12. KVA Rating ________________________

13. Fuse Type ________________________

14. Fuse Rating ________________________

15. Cooling Type ________________________

16. Oil Capacity ________________________

17. Manufacture ________________________

18. Model Number ________________________

19. Serial Number ________________________

20. Narrative ________________________

21. Substation ID _________________________

22. Secondary Voltage _________________________

23. Date of Manufacture _________________________

24. Grid Value _________________________

25. Coordinate X _________________________

26. Coordinate Y _________________________

27. Coordinate Z _________________________

1. User ID – First digits will reference 1 to 100 gird Fort Hood ID. Followed by R10# Each Regulator ID shall be assigned by Project Manager of the project.

2. Disposition – he status of the subject item (e.g., permanent, temporary, proposed, abandoned, Abandoned Permanent Temporary

3. Regulator type - The type of voltage regulator.

4. Regulator Usage - An indication of whether the regulator is on a line or in a substation.

5. Installation type - The type installation of the subject item.

6. Regulator Weight - The force of the regulator toward the center of the earth due to the regulator's mass. (lbs)

7. Phase Letters - The letter(s) of the phase(s) for the subject item.

8. Number of phases - The number of phases regulated by this device.

9. Primary Voltage - The voltage on the source side of the regulator with the associated units given.

10. Percentage of Tap - The percentage of the voltage that will be changed by moving the connection up or down one tap.

11. Number of Taps - The number of available points of connection on the regulator which may be used to change the voltage.

12. KVA Rating - The maximum continuous complex power rating of the regulator.

13. Fuse Type - A label chosen from a standard list of labels describing the characteristics of the fuse.

14. Fuse Rating - The current rating of the fuse protecting the regulator. This will be on the primary side.

15. Cooling Type - The method of controlling the temperature of the regulator.

16. Oil Capacity - The manufacturer suggested volume of oil that should be maintained inside the regulator to assure safe and efficient operation. (gallon)

17. Manufacture – Name of the manufacture

18. Model Number - The Model, Product, Catalog, or Item Number of subject item.

19. Serial Number - The manufacturer's serial or unique identification number of the subject item.

20. Narrative - A description or other unique information concerning the subject item, limited to 240

21. Substation ID - Substation ID - An operator generated identifier locally used to identify the substation feeding this bus group. MF – Main Fort Hood Substation, WF – West Fort Hood Substation, CR- Clark Road Substation, NF – North Fort Hood Substation

22. Secondary voltage - The voltage on the load side of the regulator with the associated units given.

23. Date of Manufacture - The date of manufacturer for the subject item. Format for date is

YYYYMMDD (i.e., September 15, 1994 = 19940915)

24. Grid Value - Grid number based on one to 100 grid…