FCREG.pdf

FC FORM 2036-E, DEC 2014

REQUEST FOR A FORT CARSON INSTALLATION ACCESS CONTROL CARD (Required for all Pass Requests greater than 24 hours) (DES is the proponent; the approving authority is DTM 09-012, December 8, 2009)

APPLICANT INFORMATION

NAME (Last, First, Middle): GRADE/RANK/STATUS: CTR

DATE OF BIRTH:SSN: GENDER (circle one): MALE / FEMALE

DRIVER'S LICENSE#: ORGANIZATION/UNIT:

ORGANIZATION/UNIT PHONE#: RELATIONSHIP TO SPONSOR:

E-MAIL ADDRESS:

REQUESTED CARD

NON-DOD CONTRACTOR FOREIGN NATIONAL FORT CARSON GOOD NEIGHBOR VENDOR FAMILY CARE PROVIDER

REQUESTED DATE(s) AND TIME(s) OF VISIT:

CONTRACT PERIOD (FROM/TO DATES) (CONTRACTOR/VENDOR USE AS APPLICABLE):

JUSTIFICATION FOR CARD:

SPONSOR INFORMATION

NAME (Last, First, Middle): GRADE/RANK/STATUS:

ORGANIZATION/UNIT: ORGANIZATION/UNIT PHONE#:

E-MAIL ADDRESS:

BDE/BN CDR/XO/DIRECTOR/DEPUTY DIRECTOR/COR CERTIFICATION

I certify that the applicant meets the justification requirements as indicated in Paragraph 2 above for access privileges. Furthermore I certify that the applicant requires an access control card to perform assigned duties or conduct official business on Fort Carson.

Privacy Act Statement

Authority: 10 U.S.C. 3013, Secretary of the Army; Army Regulation 190-13, The Army Physical Security Program and E.O. 9397 (SSN).

Purpose(s): To support Department of the Army physical security and access control programs; Information Assurance program; to record personal data and vehicle information registered with the Department of the Army; to provide a record of security/access badges issued; to restrict entry to installations and activities; to ensure positive identification of personnel authorized access to restricted areas; to maintain accountability for issuance and disposition of security/access badges and for producing installation management reports.

Routine uses: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: The DoD 'Blanket Routine Uses' also apply to this system of records.

Disclosure: Disclosure of SSN and other personal information is voluntary; however, failure provide the requested information can result in denial of access to the military installation.

PRINT CERTIFYING OFFICIAL'S NAME

RANK/PHONE NUMBER CERTIFYING OFFICIAL'S SIGNATURE

INSTALLATION ACCESS CONTROL OFFICE USE ONLY

ISSUING OFFICIAL:

APPROVED / DISAPPROVED

(circle one)

PRINT ISSUING OFFICIAL'S NAME ISSUING OFFICIAL'S SIGNATURE

DATE

FCREG

DEPARTMENT OF THE ARMY

HEADQUARTERS, FORT CARSON

Fort Carson, CO 80913-4143 15 June 2011

*FC Reg 420-19

Facilities Engineering

FORT CARSON SCHEDULED UTILITY OUTAGE REQUESTS (SUOR)

History. This publication is a major revision.

Summary. This regulation provides policy guidance for implementing SUOR procedures, establishes responsibilities for ensuring timely and proper coordination of work projects and utility outages or connections affecting the routine activities of the installation, and enhances the safety and well-being of personnel on the installation.

Proponent and exception authority. The proponent for this regulation is the Directorate of Public Works (DPW). The proponent has the authority to approve exceptions or waivers to this regulation that are consistent with controlling law and regulations.

Applicability. This regulation applies to units and activities assigned and/or attached to Fort Carson (FC), Pinon Canyon Maneuver Site (PCMS), government staff elements, military units, civilian contractors, tenant units and activities located on FC or PCMS, and any other entity interested in utility outages or electrical distribution system work clearances (Hot Line Holds) for work performed on FC and PCMS.

This includes any activities and persons involved in construction and/or repairs to real property facilities or private property facilities that require implementing scheduled utility outages. This does not apply to unscheduled emergency utility outages caused by emergencies, personal negligence, outside agencies, or acts of nature.

Army management control process. This regulation does not contain any management control provisions.

Supplementation. Supplementation of this regUlation and the establishment of command and local forms are prohibited without prior approval from the DPW, AnN: Operations & Maintenance Division (O&MD), 5050 Tevis St, Fort Carson, CO 80913.

Suggested improvements. Users are invited to send comments and suggested improvements on DA Form 2028 (Recommended Changes to Publications and Blank Forms) directly to DPW AnN: Operations & Maintenance Dlvision, 5050 Tevis St, Fort Carson, CO 80913.

(IMWE-CAR-PWO)

FOR THE COMMANDER: ~ ?n~ OFFICIAL: ROBERT F. McLAUGHLIN

COL, FA

.~ ~ison Commander

~~STER

Direcio~an Resources

Distribution. This publication is only available in electronic media.

*This regulation supersedes FC Reg 420-19 dated 15April 2008

Table of Contents

Chapter 1 Introduction 1-1. Purpose 02 1-2. References 02 1-3. Explanation of abbreviations and terms 02

FC REG 420-19 * 15 JUNE 2011

UNCLASSIFIED

Chapter 2

Responsibilities '" 03

Chapter 3

Procedures 04-05

Chapter 4

Emergency Processing Procedures 05

Appendix

References '" 06

Glossary 07

Chapter 1 Introduction

1-1. Purpose.

a. Establishes policies regarding scheduled utility outages, connections, road closures or fire flow testing and the response times required for requests submittals for the SUOR.

b. Sets forth procedural steps for obtaining a SUOR.

c. Establishes the DPW, O&MD as responsible for schedules, utility outages, coordination, and approval.

d. Covers the following special precautionary measures:

(1) Potentially dangerous working conditions.

(2) Disruption of utility services such as vehicular, rail, or aircraft traffic flow, traffic signaling, and/or routine activities of the installation and private entities.

(3) Disruption of other contracted activities on the installation.

(4) Disruption of fire protection services.

e. Establishes a central office and point of contact for the control and coordination of scheduled utility outages.

f. Requires compliance by contractors and private entities performing construction work on the installation.

g. Requires submittal of required action on FC Form 420-E (Fort Carson Utility Outage/Connection Request).

1-2. References.

Required and related publications and prescribed and referenced forms are in the appendix.

1-3. Explanation of abbreviations and forms.

Abbreviations and terms used in this publication are explained in the glossary.

2 FC REG 420-19 * 15 JUNE 2011

Chapter 2 Responsibilities

a. Agencies, activities, and proponents should contact the appropriate project manager (government representative) to coordinate a scheduled utility outage.

b. The DPW will:

(1) Delegate approval authority for scheduled utility outages to the Base Operations and Maintenance (O&M) Contractor.

outages.

(2) Provide necessary resources to the Base O&M Contractor for performing the required utility

(3) Provide necessary funding to support or perform the scheduled utility outage during normal duty hours. This will include relighting of pilot lights, programming sensor units, etc. Requests for outages after normal duty hours or on weekends will be funded by the requestor, unless it is determined by DPW, O&MD necessary to minimize occupant impact.

(4) Appoint project managers within the DPW as follows:

(a) DPW Engineering Division Quality Assurance; DPW projects.

(b) DPW Engineering Division Quality Assurance or Corps of Engineers for Military Construction, Army (MCA), major nonappropriated fund, and major tenant construction contracts.

(c) Troop Construction Office; troop projects.

(d) Housing Division; privatized Family housing contracts.

(e) DPW Base O&M Contractor; in-house repair work.

projects.

(f) DPW Engineering Division Quality Assurance or Troop Construction Office; self-help

(g) The appointed government project manager will initiate, coordinate, notify affected parties and sign the FC Form 420-E.

c. The Base O&M Contractor will perform the following:

(1) A means of scheduling and completing, by date and time, all requested scheduled utility outages and resumption of utilities.

(2) Energize and de-energize all FC and PCMS utilities.

(3) Appoint project managers to perform maintenance, repair, or construction projects for which the Base O&M Contractor is to perform and which will require a FC Form 420-E.

d. The Network Enterprise Center (NEC) will appoint a project manager for coordination of utility outages concerning U.S. West/QWEST, AT&T, FC and PCMS computer server connections, or other communications or cable agencies.

FC REG 420-19 * 15 JUNE 2011 3

Chapter 3 Procedures

a. Project managers will:

(1) Identify the need for a scheduled utility outage, connection, road closure, or fire flow test in the early stages of project development.

(2) Assure an approved DA Form 4283 (Facilities Engineering Work Request) or DD Form 1391 (FY_ Military Construction Project Data) is on file with DPW.

outage.

(3) Coordinate with all installation and tenant staff agencies, and private companies affected by

(4) Ensure a completed SUOR is submitted to the Base O&M Contractor at BLDG 221 no later than three business days prior to the required outage. Normal business hours are 0700 to 1530, Monday through Friday, excluding federal holidays. The completed FC Form 420-E includes a description of the outage, and notification of all affected agencies/customers, and traffic control plan, if applicable. If a utility outage is to be scheduled on a weekend or after normal duty hours, seven working days is required. If a utility outage affects liVing quarters (barracks or housing), five working days is required.

(5) E-mail major subordinate Command Sergeant Majors concerning troop billet outages and facility commanders for other facility outages.

(6) Publish timely notices in the installation newspaper for all outages that will affect medical, dining, installation information, and residential facilities.

(7) Whenever possible, scheduled upcoming utility outages announced at Command and Staff, Town Hall Meetings, Mountain Post Action Council, and Quality Master Planning Meetings.

(8) Notify the Union President of the American Federal of Government Employees for outages that affect bargaining union employees in accordance with Article 7.

(9) When applicable, ensure that a Traffic Control Plan is submitted for review and approval by DPW Traffic Planning and Engineering. Traffic Control Plans will be in accordance with the Manual on Uniform Traffic Control Devices.

(10) Ensure a negative Bacteriological Testing (Bac-T) result. The Bac-T results are valid only five calendar days from the time the sample was taken. Failure to active the water line within five calendar days will require a new Bac-T.

b. The DPW, O&MD will:

(1) Delegate coordination and approval of submitted scheduled utility outages to the Base O&M Contractor.

(2) Coordinate with DPW, Business Operations & Integration Division if outage will affect more than 25% of the post for more than four hours.

(3) Submit any required funding documents for implementation of scheduled utility outages, if applicable.

(4) Provide gUidance and assistance to the Base O&M Contractor as necessary.

4 FC REG 420-19 * 15 JUNE 2011

c. The Base O&M Contractor will:

(1) Provide all required resources to de-energize and re-energize installation utilities and assure all systems are functional. This does not include telephone, computer or cable systems, or other private telecommunications systems.

(2) Provide final labor, material, and equipment costs to O&MD, when required.

(3) Ensure required testing, utility quality and bacteriological testing is completed and acceptable, before the affected utility service is restored.

(4) Provide the Electrical Distribution System Work Clearances (Hot Line Hold) Procedures.

The Hot Line Hold order is an authorization issued by the Base O&M Contractor's High Voltage Supervisor (Switching Authority) to a qualified employee or contractor in charge, allowing work to be done on or near an energized line or piece of equipment.

d. The qualified employee or contractor will:

(1) At a minimum of three working days prior to requested action, contact the High Volt Supervisor with request, to include time and date, work to be accomplished and location.

(2) Stay in radio or phone contact with the switchinq authority to assure hold procedures have been incorporated before starting work.

(3) Notify the switchinq authority when work has been completed and to remove the hold.

e. The SWitching Authority will:

(1) Provide all required resources for requested support.

(2) When protective devises are so equipped, automatic reclosing controls will be deactivated and all controls which can be operated to re-energize the circuit in the event of a trip-out will be tagged with a properly filled-out Hot Line Hold Tags.

Chapter 4 Emergency Processing Procedures

a. In case of emergency situations, such as ruptures/leakage of pipelines, explosions, fires, and similar instances where immediate action is necessary and processing of a FC Form 420-E is not practical, the government project manager will:

(1) Notify the DPW O&MD COR of required corrective actions at 526-9262.

(2) Notify the Base O&M Contractor Repair Order Desk at 526-5345, for service orders.

(3) Provide reimbursement funds to the O&MD, through the Resource Management Office for corrective action costs.

b. The COR will direct the Base O&M Contractor to support the repair as required.

FC REG 420-19 * 15 JUNE 2011 5

Appendix References

Section I Required Publications

AR 420-1

Army Facilities Management

Section II Related Publications

EM 385-1-1

Safety and Health Requirements Manual

TM 5-682

Facility Engineering: Electrical Facility Safety

Manual on Uniform Traffic Control Devices Part 6, Temporary Traffic Control

Section III Prescribed Forms

DA Form 2028 Recommended Changes to Publications and Blank Forms

DA Form 4283 Facilities Engineering Work Request

DO Form 1391 FY_Military Construction Project Data

FC Form 420-E Fort Carson Utility Outage/Connection Request

6 FC REG 420-19 * 15 JUNE 2011

Glossary

Section I Abbreviations

Bac-T Bacteriological Testing

COR

Contracting Officer's Representative

DA

Department of the Army

DPW

Directorate of Public Works

EM

Engineer Manual

FC

Fort Carson

IFS

Integrated Facilities System

MCA

Military Construction, Army

NEC

Network Enterprise Center

OM&D

Operations and Maintenance Division

O&M Operations and Maintenance

PCMS

Pinon Canyon Maneuver Site

SUOR

Scheduled Utility Outage Request

TM

Technical Manual

Section II Terms This section contains no entries.

Section III Special Abbreviations and Terms This section contains no entries.

FC REG 420-19 * 15 JUNE 2011 7

FC FORM 420-E, PREVIOUS EDITIONS ARE OBSOLETE

FORT CARSON UTILITY OUTAGE/CONNECTION REQUEST

(Read instructions on Page 2 of this form. FC REG 420-19 requires that the government receive 3 business days notice on outages performed during normal working hours. If outages require work to be performed during the evening or on weekends; then, 7 days notice is required. Living quarters require a 5 day minimum notice.)

1. Project Contract Numberor Approved Work Request Number:

2. Requester: Name:

FAX:

Company/Unit:

Phone:

Email:

HOT TAP

5. Number of facilities affected:

BLDG#

BLDG#

BLDG#

6. Wll the contractor provide temporary utilities to support this outage?

7. Wll the contractor provide portable latrines to support this outage?

9. Government Representative's Name (print):

Email:

Electric (Primary/Secondary), Fire Sprinkler, and Alarm Systems: Contact: Electrical Services Supervisor Phone: 719-302-0160; BLDG 221 Electric Shop

Water, Sewer, Gas, HTHW, and Chilled Water: Contact: Collection and Distribution Supervisor Phone 719-302-0158; BLDG: 221 Collection & Distribution Shop

Approved:

Approved:

Disapproved

Disapproved

10. Approval Request: Government representative must coordinate and obtain the signature of the appropriate POC for this request to be approved. As-built, red line, or 1 line drawings and traffic control planswill be submitted with this request. A copy of all required testing results (e.g., Bac-T's, pressure tests, etc.) will be provided to the approval POC before any new utility line will be activated or energized. Submit approved form to the Fort Carson Dig Permit Office at BLDG 1225; phone 719-526-

Signature:

Signature:

Signature:

Phone:

Date:

Date:

Date:

Signature:

Signature:

Signature:

(If additional facilities are affected, include information on a separate list and attach to this request. Include BLDG#, POC (printed name), signature, phone number, email, and date.)

BLDG POC NAME:

BLDG POC NAME:

BLDG POC NAME:

Phone:

Phone:

Phone:

Date:Email:

Email:

Email:

Date:

Date:

FIRE FLOW TESTENERGIZEOUTAGE

FIRE PROTECTIONCHILLED WATER

YES

YES

NO

NO

N/A

N/A

ROADSTEAM/HTHWELECTRICGAS

SEWER

OTHER

WATER

3. Work Description:

Location:

Date of Outage or Connection:

4. Type of Outage or Connection:

Time of Outage or Connection:

Page of1 2

8. Does the work require traffic control, detour, or road/lane closure? If yes, DPW, Traffic Engineering Section approval required.

YES NO N/A

Road/Parking lot closure or detour: Contact: DPW, Traffic Engineering Section Phone 719-526-9267; BLDG 1219 Room 117

Approved: Disapproved

Signature: Date:

FC FORM 420-E, (Back)

INSTRUCTIONS

SECTION 1

SECTION 2

SECTION 3

SECTION 4

SECTION 5

SECTION 6

SECTION 7

SECTION 8

SECTION 9

SECTION 10

The Requester provides project name, contract number, and work order number or project number from DA 4283 or DD 1391.

The Requester provides all contact information (e.g., name, office, and cell phones, fax number, e-mail address, and company name/requesting unit).

The Requester provides a detailed description of the work that requires this utility outage, connection, electric energize, hot tap, or other (road closure, fire hydrant flow test, etc.). The date of the outage or connection. The time of the ouage or connection. All outages or connections will be performed during regular business hours 0730 to 1530, Monday through Friday (excluding Federal holidays). Any outages or connections after the times listed will be handled on a case by case basis. Approval/disapproval of this request shall be coordinated with the DPW, Base Operations and Maintenance Contractor, Fort Carson Support Services (FCSS), seven (7) days prior to the scheduled outage or connection.

The Requester identifies the type of outage or connection. Identifies the utility affected by the outage or connection.

The Requester or Project Government Representative provides a list of buildings affected by the outage or connection. Obtain the BLDG POC's name (printed), signature, phone number, and date. Include any requests the buildings to support this outage or connection.

The Requester or Project Government Representative identifies if the contractor will provide temporary utility support to the affected buildings to support this outage or connection.

The Requester or Project Government Representative identifies if the contractor will provide portable latrines to the affected buildings to support this outage or connection.

The Government Representative provides all the information required in Section 9 of this form. The Government Representative shall verify that sections 1 through 8 have been completed before signing this section.

The Government Representative obtains the request approval from the appropriate utility POC by following the directions of Section 10 of this form. As-built, red line, or 1 line drawing will be submitted with the request. Submit approved and completed form to the Fort Carson Dig Permit Office; phone 719-526-3089, Building 1225.

PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 2

The Requester identifies if traffic control, detour, or road/parking lot closure is required. If "Yes" is checked, you must contact the DPW, Traffic Engineering Section for approval. A detailed traffic control plan is required.

FC REG 420-20 * 15 JANUARY 2014 2

Facilities Engineering Dig Permits……………………………..……………………..………………….. 06

Chapter 4 Emergency Processing Procedures……………………………………………………………………… 06-07

Chapter 5 Extended Permit Procedures……………………………………………………………………………… 07

Appendix A References………………………………………………………………………………………………….. 08

Appendix B Dig Permit Process Flow Chart for Other than Training Ranges……………………………………… 09

Glossary……………………………………………………………………………………………………… 10-11

Chapter 1 Introduction

1-1. Purpose.

a. Establishes policies regarding response time requests for locating and marking government-owned utilities, prior to any ground penetrations.

b. Establishes steps for obtaining a Fort Carson Dig Permit (FCDP) for all companies, units, or organizations performing work involving any type of ground penetration at any depth.

c. Provides delegated authority for permit approval from the DPW, O&MD to the Base Operations and Maintenance Contractor’s Dig Permit Coordinator (DPC). The DPC (located in BLDG 1225 at 1649 Evans St) will act as an interface and is responsible for assisting in preparation, processing, and approval of all active dig permits. The DPW, O&MD is responsible for utility outages and road closures. See FC Reg 420-19 (Fort Carson Scheduled Utility Outage Request).

d. Explains utility protection concepts, laws, and the installation implementation of those concepts.

e. Provides concepts for:

(1) Protection of buried utility systems; a major concern of utility owners.

(2) Protection of life and property; a major concern of government. Several states have enacted laws that provide detailed rules and guidance to excavators and utility owners. This regulation is consistent with the concepts of protection of life and property on FC.

f. Covers the following special precautionary measures:

(1) Excavation by hand, mechanical equipment, or explosives.

(2) Potentially hazardous working conditions.

(3) Disruption of utility services, vehicular, rail, aircraft traffic flow, or routine activities on the installation.

(4) Environmental clearance in some cases.

FC REG 420-20 * 15 JANUARY 2014 3

g. Establishes a central office and a point of contact for the control of permits and for coordinating government-owned utility locates.

h. Provides information on commercial utilities known to be on FC and telephone numbers for obtaining clearance.

i. Requires compliance of contractors performing construction work on the installation.

1-2. References.

Required and related publications and prescribed and references forms are listed in Appendix A.

1-3. Explanation of abbreviations and terms.

Abbreviations and terms used in this publication are explained in the glossary.

Chapter 2 Responsibilities

a. The DPW:

(1) Has approval authority for permits published by DPW, Work Control Office to the Base O&MD Contractor.

(2) Will provide necessary resources through the DPW, Base O&MD Contractor for controlling work clearance requests and a locator team for spotting and marking DPW-owned underground utilities.

(3) Will appoint government representatives within DPW for the following:

(a) Sustainment Restoration and Maintenance funded construction projects.

(b) Military Construction projects.

(c) Troop Construction projects.

b. The Directorate of Plans, Training, Mobilization, and Security (DPTMS):

DPTMS, Range Operations is the proponent for Dig Permits for range areas forward of any range firing line and for training lands at both FC and PCMS. DPTMS, Range Operations will approve and provide oversight for Dig Permits in these areas of the installation. Refer to FC Reg 385-63 for more information when requesting a Dig Permit approval on training lands and range areas forward of firing lines. For any utility outage requests or for connecting and disconnecting any utilities for any reason, submit a FC Form 420-E (Fort Carson Utility Outage/Connection Request).

c. The Network Enterprise Center (NEC):

(1) Will appoint a project manager for maintenance, repair, or construction projects to be accomplished by the American Warrior Network, Qwest, American Telephone & Telegraph (AT&T), Cablevision, or other voice and/or data type agencies.

(2) Will provide marking and spotting of NEC-owned underground utilities.

d. The Directorate of Family, Morale, Welfare, and Recreation will appoint a project manager for Non-Appropriated Fund and Army Air Force Exchange Service maintenance, repair, or construction projects requiring a FCDP.

FC REG 420-20 * 15 JANUARY 2014 4

e. The government construction representatives or representatives from the organization performing the work will:

(1) Identify the need for a FCDP or outage request in the early stages of project development.

A DPW approved project DA Form 4283 (Facilities Engineering Work Request) or a U.S. Army Corp of Engineers (COE) contract number is required prior to initiating a FCDP. For organizations that are repairing an existing underground utility, an approved repair service order through their organization can be used in lieu of a DA Form 4283. These organizations include the following:

(a) Housing Contractor.

(b) DPW, O&MD Contractor.

(c) Hospital Maintenance Contractor.

(d) NEC.

(e) AT&T.

(f) Baja Broadband.

(g) Altech Services Inc. (ASI).

(h) American Warrior Network.

(i) Qwest.

(2) Submit a FC Form 86-E (Facilities Engineering Dig Permit Request) no earlier than 30 days or less than 10 working days prior to working on utility locates. For utility outage requests or road closures, see FC Reg 420-19.

(3) Include a map or sketch of the area considered for government utility locate and a copy of the approved DA Form 4283 or COE contract number for all FCDP’s. A DA Form 4283, COE Contract Number, and an approved FCDP are required when any digging is involved with the project. The area of proposed excavation will be pre-marked in white with flags, stakes, etc. The area will not exceed the amount of work that can be accomplished within a 30 day period. This is the limitation of the FCDP. If more time is required, a new FCDP will be needed to accomplish the mission.

(4) Coordinate with all applicable DPW and installation agencies.

(5) Ensure contractors understand the requirements and procedures necessary to obtain a Dig Permit.

(6) Submit a FC Form 86-E to the DPW, O&MD, DPC for final coordination and approval. Call the DPC at 526-3089, if you have any questions. The DPW contractor designates its own coordinating action office for final coordination.

(7) Publish timely notices in the Mountaineer Newspaper for closures or outages. See FC Reg 420-19.

(8) Communicate with affected occupants and customers in case of disruptions, closures, or outages.

f. The DPW, O&MD contractor will:

(1) Receive a completed FC Form 86-E from the government construction representatives.

FC REG 420-20 * 15 JANUARY 2014 5

(2) Receive and record calls from contractors requesting utility locates. Receive copies of plans or sketches of the area and expected work start date from the contractor. Receive completed government utility locates; the DPC will color code utility maps; make copies for distribution; and file the master copy.

(3) Provide copies of ASI’s locate form and map of dig area for the NEC, for timely marking of their owned utilities.

(4) Schedule on-site locating and marking.

(5) Assign a control number, reproduce copies of the approved request, and provide copies to the following:

(a) Contractor; agency performing work.

(b) Government representative.

(c) Locator team for DPW-owned utilities.

(d) Corps of Engineers (COE) construction representative, if the COE performed the inspection.

(e) Project file.

(f) Division engineer.

(6) File the approved original copy of the FCDP.

(7) The locator team for DPW-owned utilities will upon notification, schedule, attempt to locate, and mark by color code, all government utilities which are known to be at the excavation site. The DPW, O&M Contractor is not responsible for locating government-owned utilities for engineering survey data collection requests. Pick-up FC Form 86-E with plans and sketches of the excavation area from the Dig Permit Control Office (DPCO). Annotate applicable blocks on FC Form 86-E. Deliver the completed package to the DPCO for further processing.

g. The contractor (person or company) performing ground penetrating work will:

(1) Initiate a Dig Permit through the DPCO and keep the permit on site for the duration of the work. See Appendix B.

(2) Contact the DPCO a minimum of 10 working days, prior to the work start date, to schedule locating and marking government-owned utilities. Provide the DPC with plans or sketches of excavation areas and work start date. Advise the project manager or construction inspector of these actions.

(3) Contact applicable commercial utilities agencies listed on FC Form 86-E, Page 1 for commercial utilities clearance and obtain signatures on the form or other evidence of clearance.

(4) Sign FC Form 86-E, Page 2 after completion of the commercial/government-owned utility locates.

(5) Maintain a copy of the final approved FC Form 86-E for retention at the work site.

(6) Obtain subsequent clearance through the project manager or construction inspector, as necessary.

FC REG 420-20 * 15 JANUARY 2014 6

Facilities Engineering Dig Permits

a. The FC Form 86-E constitutes a single coordination, review, and approval document for any work on the installation requiring ground penetrations. All FCDP’s will include a map or sketch of the area considered for government utility locates.

b. All utility locates will be accomplished in a timely manner. Turnaround time for government staff utility locates should be within five (5) working days. In an emergency situation, response time for all utility locates will be completed within two (2) hours. Turnaround times may increase based on availability of resources.

c. Locates for government utilities will be scheduled through the DPCO. Changes in timelines will be established between the DPCO and the customer. When necessary, the DPCO will contact the Contracting Officer Representative (COR) for any Dig Permit extensions. The COR will determine the requirements necessary for an extension.

d. The Dig Permit is considered active for 30 days or less as requested. A 30-day Dig Permit time will start on the day the DPCO signs and notifies the customer. The marking of underground facilities will be considered valid as long as the markings are clearly visible, but not more than 30 calendar days. This is not valid if new facilities are added to the dig area after completion of the locate. Exceptions are approved by the DPCO after locator’s review.

e. If excavation work is not completed within the 30 days allowed on the Dig Permit, a new permit must be applied for prior to continuance of work. Extensions are an exception to policy and will not be approved if there are communication lines in the dig area.

f. Verification of information pertaining to Dig Permits is completed prior to locate. Customers must read and sign the statement on FC Form 86-E, Page 2.

g. The DPCO will notify requester of approved Dig Permits.

h. It is the responsibility of the excavator to maintain adequate and accurate information at the job site.

i. Procedures for co-signs to a Dig Permit will be handled on a case by case basis and approved by the DPCO. Dig Permits will only be approved during the first 10 days of an active permit and will be limited to two (2) per Dig Permit.

Chapter 4 Emergency Processing Procedures

a. In emergency situations; such as ruptures or leakage of pipelines, explosions, fires, or similar instances where immediate action is necessary and advance processing of FC Form 86-E is impractical, the project manager will contact the DPCO.

b. The following are procedures performed by the project manager:

(1) In electrical or gas damage, call 911. Take precautions to avoid further damage to underground facilities and notify the government COR as soon as possible of location and extent of damage. The government COR will notify the DPW, O&MD Contractor for emergency repair.

(2) If the excavator finds it necessary to dig without locates, the excavator will take reasonable precautions to avoid damage to underground facilities.

FC REG 420-20 * 15 JANUARY 2014 7

(3) Prepare a FC Form 86-E within the first business day following the emergency. Include the following:

(a) Describe the nature of the emergency situation.

(b) Action taken by the contractor.

(c) The agency performing the work.

(d) The in-house or DPW contractor support provided for the emergency situation.

(4) Turn-in the FC Form 86-E into the DPCO for further processing.

Chapter 5 Extended Permit Procedures

a. Projects longer than the 30-day routine Dig Permit will request an extension during the approval stages of the FCDP.

b. Requests for an extended Dig Permit are the same as a routine Dig Permit.

c. Extension requests must be submitted before the expiration of the original Dig Permit.

Requestors will notify the DPCO of the changes needed for the construction timeline.

d. During the extension, requestors are still responsible for maintaining the utility markings.

e. Only the DPCO can approve an extension.

FC REG 420-20 * 15 JANUARY 2014 8

Appendix A References

Section I Required Publications

FC Reg 385-63 Firing Ammunition for Training, Target Practice, Administration & Control of Ranges and Training Areas

FC Reg 420-19 Fort Carson Scheduled Utility Outage Request

Section II Related Publications

AR 420-1

Army Facilities Management

Corps of Engineers (COE) Manual (EM) 385-1-1 Safety and Health Requirements Manual

Federal Acquisition Regulation (FAR) Clauses 36.507 Permits and Responsibilities

Federal Acquisition Regulation Clauses 36.509 Protection of Existing Vegetation, Structures, Equipment, Utilities, and Improvements

Federal Acquisition Regulation (FAR) Clauses 52.235-7 Permits and Responsibilities

Federal Acquisition Regulation Clauses 52.236-9 Protection of Existing Vegetation, Structures, Equipment, Utilities, and Improvements

Guide for DPW Government Representatives

Section III Prescribed Forms

DA Form 2028 Recommended Changes to Publications and Blank Forms

DA Form 4283 Facilities Engineering Work Request

FC Form 86-E Facilities Engineering Dig Permit Request

FC REG 420-20 * 15 JANUARY 2014 9

Appendix B Dig Permit Process Flow Chart for Other than Training Ranges

Person/company performing the work will obtain an approved work request DA Form 4283, DD Form 1391 (FY ____ MILITARY CONSTRUCTION PROJECT DATA) or approved service order from the utility owner.

Person/company performing the work will pick-up a Dig Permit request package from DPW, O&M Contractor at BLDG 1225.

Person/company performing the work will submit a completed package to the DPCO (BLDG 1225) with a map of the dig site.

The DPCO (BLDG 1225) will staff the request to required agencies. Turn-around time is approximately 5 work days from the date the request was turned in.

The DPCO (BLDG 1225) will contact the person/company performing the work, upon receiving all staffing comments.

Person/company performing the work will pick-up and sign the approved Dig Permit. Permits are good for 30 days from approval. If more time is needed, a new Dig Permit will be required.

FC REG 420-20 * 15 JANUARY 2014 10

Glossary

Section I Abbreviations

ASI

Altech Services Inc.

AT&T

American Telephone & Telegraph

COE

Corps of Engineers

COR

Contracting Officer Representative

DFMWR

Directorate of Family Morale, Welfare, and Recreation

DPC

Dig Permit Coordinator

DPCO

Dig Permit Control Office

DPTMS

Directorate of Plans, Training, Mobilization, and Security

DPW

Directorate of Public Works

FC

Fort Carson

FCDP

Fort Carson Dig Permit

NEC

Network Enterprise Center

O&MD

Operations & Maintenance Division

PCMS

Pinon Canyon Maneuver Site

Section II Terms

Co-Sign - Sharing of an approved and active dig permit by more than one excavating company. A request for a co-sign Dig Permit must follow the policies and procedures of the DPW, Base Operations and Maintenance Contractor’s Dig Permit Office.

Government representative - A designated individual charged with the responsibility for the complete and timely initiation and coordination of a FC Form 86-E for a specific work project.

FC REG 420-20 * 15 JANUARY 2014 11

DPW contractor - An agency awarded a contract to perform certain DPW, non-governmental functions.

Fort Carson Installation - The boundary fence, easements and all real estate inside the fence, which includes the downrange area and the rail line to Kelker Junction.

Pinon Canyon Maneuver Site (PCMS) - The boundary fence, easements, and all real estate within the fence, including downrange and the rail line to the derail on the west side of Colorado State Highway 350.

In-house - The DPW, O&MD work force; government employees.

Person - Any individual, partnership, association, corporation, joint venture, contractor, in-house work force, troop unit, or representative of same.

Section III Special Abbreviations and Terms

This section contains no entries.

FC FORM 86-E, JAN 2015 PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 2

FACILITIES ENGINEERING DIG PERMIT REQUEST

(DPW is the proponent; the approving authority is FC Reg 420-20)

INVOLVING EXCAVATION, UTILITY, OR OTHER DISTURBANCES PER ATTACHED SKETCH.

DIG PERMIT NUMBER:

1. CLEARANCE IS REQUESTED TO PROCEED WITH WORK AT:

RECEIVED DATE: PROJECT NO: CONTRACTOR:

2. TYPE OF FACILITY WORK INVOLVED - EXPLAN THE EXACT LOCATION AND PROPOSED WORK:

3. INSTRUCTIONS: This work clearance request is used for any work (contract or in-house) that may disrupt vehicular, rail, or air traffic flow, utility services, protection provided by fire and intrusion alarm systems or routine activities of the installation. This form is used to coordinate the required work with key installation activities and keep customer inconvenience to a minimum. It is also used to identify potentially hazardous work conditions in an attempt to prevent accidents. The work clearance request is processed just prior to the start of work. If delays are encountered and the conditions at the job site change (or may have changed) this work clearance must be reprocessed. If you have any questions, please call the Dig Permit Coordinator at 526-3089 or the Utility Locator at 524-0892.

4. SIGNATURE OF REQUESTING OFFICIAL: 5. PHONE:

7. DATE DIG PERMIT TERMINATED:6. DATE DIG PERMIT REQUIRED:

ORGANIZATION

10. COMMUNICATIONS (HELP DESK) 526-5232

TICKET NUMBER REVIEWER'S NAME & DATE

8. UNCC 1-800-922-1987

9. CITY OF FOUNTAIN WATER 382-5604

11. ENVIRONMENTAL COMPLIANCE 526-1682

12. BARRACK PHONE (SPRINT) 579-1000

13. GOVERNMENT UTILITIES REMARKS AND INITIALS

a. ELECTRICAL DISTRIBUTION

REVIEWER'S NAME & DATE

b. GAS DISTRIBUTION

c. CATHODIC PROTECTION

d. WATER DISTRIBUTION

e. IRRIGATION SYSTEMS

f. SEWER LINES

g. STORM DRAIN SYSTEM

h. STEAM DISTRIBUTION

i. CHILLED WATER

j. COMPUTER/TRAFFIC

k. OTHER

14. ROAD CLOSURE; IF NEEDED, PLEASE COMPLETE FC FORM 420-E (FORT CARSON UTILITY OUTAGE/CONNECTION REQUEST)

a. MILITARY POLICE

b. MEDDAC AMBULANCE 526-7112

c. FIRE PREVENTION 526-0651

15. RANGE CONTROL 526-5597

16. DPW TRAFFIC CONTROL 526-9267

17. POST AGRONOMIST 526-1666/1696

FC FORM 86-E, JAN 2015 (Back) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 2

CONTRACT PRIOR TO:

1. ANY PROJECT THAT REQUIRES THE PLANTING OR DIGGING UP OF TREES AND BUSHES.

2. ANY PROJECT BEING DONE DOWNRANGE.

3. ANY PROJECT REQUIRING GROUND DISTURBANCE OR GREATER THAN ONE (1) ACRE.

18. REMARKS: THIS SECTION MUST DESCRIBE SPECIFIC PRECAUTIONARY MEASURES TO BE TAKEN BEFORE AND DURING WORK.

SPECIFIC COMMENTS CONCERNING THE APPROVED METHOD OF EXCAVATION, HAND, OR POWERED EQUIPMENT SHOULD BE

INCLUDED. NOTE: BORING: ALL UTILITIES MUST BE EXPOSED BEFORE CROSSING.

19. TROOP CONSTRUCTION:

IMPORTANT - READ BEFORE SIGNING

The undersigned understands that the Fort Carson Base Operations and Maintenance contract locators will attempt to locate the underground utility lines by using electronic detectors, maps, and other available information, but that all such methods may be inaccurate. Therefore, it is expressly understood and agreed between the undersigned and Fort Carson that NO GUARANTEES OR WARRANTIES, EXPRESSED OR IMPLIED, ARE MADE BY FORT CARSON as to the accuracy of any information furnish. Depth of bury, when provided, is never guaranteed. Twenty four inches either side of the stake, paint marks, or flag is considered a correct horizontal location for government owned utilities. When utilities cannot be electronically located, their approximate location will be drawn on the attached Underground Utility Location Map (Form.4.34.003). All identified utilities must be exposed before crossing or paralleling within three feet of the existing utility to determine bury depth. It is the responsibility of the undersigned and/or excavating company to pot hole or hand dig these identified utilities. All damages to any utilities by any person must be reported immediately so an investigation can be made to determine the cause of damage and arrangements made for necessary repairs. WHEN THE GOVERNMENT INVESTIGATOR DETERMINES THAT THE EXCAVATING COMPANY WAS AT FAULT AND DISREGARDED THE ABOVE MENTIONED INSTRUCTIONS, THE DIG PERMIT WILL BE TERMINATED. Locates are good for 30 days, unless extended by the government, and all utilities will be marked once, then it is the contractors responsibility to maintain the marks.

(SIGNATURE)

(DATE)

(PRINT NAME)

APPROVED

(DATE)

(PRINT NAME)

(SIGNATURE)

Hydrant Use Application

Organization: ____________________________________________________

Mailing Address: ___________________________________________________________________

Office Phone: _____________________________ Cell Phone: _____________________________

Hydrant Number: ______________Location:________________________________________

Hydrant Meter #: _________________ Beginning Meter Reading (gallons): _____________

Scheduled Start Date: ____________________ Scheduled Finish Date: ______________________

____ Backflow Preventer Will Be Used ____ Shutoff Valve Will Be Used

Proposed Use of Hydrant Water: _______________________________________________________

Note!! Use only fire hydrant wrenches on the caps or operating nut. No pipe wrenches. Open hydrant valve all to way to establish flow and prevent possible valve damage. Turn hydrant valve completely off at the end of each work day to allow the hydrant to drain and prevent freezing. Contractor WILL be charged for any hydrant valve damage they cause. Call 719-491- 2982 or email vincent.e.guthrie2.civ@mail.mil with your meter reading by the 15TH of each month.

Call the Fort Carson Dig Permit Office at (719) 302-0157 to obtain a work clearance/dig permit if any digging or excavation will be done. Fort Carson requires that a backflow preventer and shutoff valve be used at the connection point to the fire hydrant. The backflow prevention device must be inspected and tested annually by a certified cross-connection technician. The technician shall place a dated label or tag on the backflow preventer indicating compliance. Hydrants may be used for essential purposes only. Essential uses include, but are not limited to, dust mitigation, compaction, and construction site water use. Do not allow water to pool or flow onto the pavement or into gutters/storm sewers. Repair any system breaks and leaks immediately.

Submit application to:

Fort Carson Directorate of Public Works Vince Guthrie, 719-491-2982, vincent.e.guthrie2.civ@mail.mil

Building 1219, Room 127, M-F 0730 – 1600 hours

Name Date

0BFor Office Use Only

Permit Issued: No (see attached explanation) _____ Yes _____

Based on the information provided, a permit is issued authorizing the use of the requested hydrant. Call 719-491-2982 with the final meter reading from the hydrant. Keep a copy of this permit near the hydrant location, in your water truck(s), and/or in your construction trailer.

This permit will expire _______________ day of __________________, 201____.

DPW approval by _____________________________________________________

TYPE OF UTILITY Potable Water Non-Potable Water Wastewater Storm Sewer Gas Main Gas Service Primary Electric Secondary Electric Communication Lines

Potable Water 10 10 10 6 3 10 10 10

Non-Potable Water 10 10 10 6 3 10 10 10

Wastewater 10 10 5 6 3 10 5 5

Storm Sewer 10 10 5 6 3 10 5 5

Gas Main 6 6 6 6 3 6 6 6

Gas Service 3 3 3 3 3 3 1 1

Primary Electric 10 10 10 10 6 3 1 1

Secondary Electric 10 10 5 5 6 1 1 1

Communication Lines 10 10 5 5 6 1 1 1

TYPE OF UTILITY Potable Water Non-Potable Water Wastewater Storm Sewer Gas Main Gas Service Primary Electric Secondary Electric Communication Lines

Potable Water 1.5 1.5 1.5 1 1 1 1 1

Non-Potable Water 1.5 1.5 1.5 1 1 1 1 1

Wastewater 1.5 1.5 1.5 1 1 1 1 1

Storm Sewer 1.5 1.5 1.5 1 1 1 1 1

Gas Main 1 1 1 1 1 1 1 1

Gas Service 1 1 1 1 1 1 1 1

Primary Electric 1 1 1 1 1 1 1 1

Secondary Electric 1 1 1 1 1 1 1 1

Communication Lines 1 1 1 1 1 1 1 1

"The water service must be placed on a solid shelf excavated at one side of the common trench a minimum 1-foot over and above the top of the sewer pipe or non-potable water pipe plus 1-foot lateral separation."

CLEARANCE MATRIX FOR TYPICAL FORT CARSON UNDERGROUND UTILITIES

All separations shown are the clear horizontal distance between two objects measured surface to surface (All dimensions are in feet)

CLEARANCE MATRIX FOR TYPICAL FORT CARSON UNDERGROUND UTILITY CROSSINGS

All separations shown are the clear vertical distance between two objects measured surface to surface (All dimensions are in feet)

Any deviations from the above clearances must be approved by the DPW, Operations and Maintenance Division

** Note: A potable water service line (Less than 3-inch Diameter) may be placed in a common trench with non-potable water/sewer building service under the following condition.

iWATCH Army Training for Contractors “See Something -- Say Something”

Unclassified

Always Ready. Always Alert.

Because someone is depending on you.

Unclassified date

Always Ready. Always Alert.

Because someone is depending on you.

Training Objective

2Unclassified date

• Contractors and all associated subcontractors performing work on Army contracts must receive this training on the local iWATCH Army program.

• The objective of this training is to inform employees of the types of suspicious activity or behavior to watch for and instruct employees to report suspicious activity or behavior to the Contract Officer Representative (COR), military police, or local law enforcement.

• Training should be completed within 30 calendar days of contract award and within 5 calendar days of new employees’ commencing performance on active contracts (in the case of personnel changes).

• The results of the training shall be reported to the COR.

Training Topics

3Unclassified date

• Origin of iWATCH Army

• iWATCH Army Public Service Announcement (PSA)

• Indicators of Suspicious Activity or Behavior

• “See Something Say Something”

• What to Report

• How to Report

• Source for Other Important Information

• Local Point of Contact

Origin of iWATCH Army

4Unclassified date

Origin: Headquarters, Department of the Army, ALARACT Message 110/2010, Army Implementation of iWATCH (Terrorist Watch Program), 15 April 2010

• iWATCH Army is a nation-wide modern version of neighborhood watch designed to encourage and enable members of the Army community to help protect their community by identifying and reporting suspicious activity or behavior that may be associated with terrorist activities.

• The Passive element of iWATCH Army is individual situational awareness of the surroundings.

• The Active element of iWATCH Army involves individuals taking action to report suspicious activity or behavior to military police or local law enforcement for investigation.

IWATCH Army PSA

5Unclassified date

Place cursor inside black screen area. Control/play will appear at the bottom of the screen. Click (Play/Pause) to view the video.

Indicators of Suspicious Activity or Behavior (What to Report)

6Unclassified date

• Individuals drawing pictures or taking notes in an area not normally of interest to a tourist or showing unusual interest in or photographing security cameras, guard locations, or watching security reaction drills and procedures

• Multiple sightings of the same suspicious person, vehicle, or activity, separated by time, distance, or direction

• Individuals who stay at bus or train stops for extended periods while buses and trains come and go

• Individuals who order food at a restaurant and leave before the food arrives or who order without eating

Indicators of Suspicious Activity or Behavior (What to Report)

7Unclassified date

• Joggers who stand and stretch for an inordinate amount of time

• Individuals sitting in a parked car for an extended period of time

• Individuals who don't fit into the surrounding environment because they are wearing improper attire for the location or season

• Individuals who exhibit suspicious behavior, such as staring or quickly looking away from individuals or vehicles as they enter or leave facilities or parking area

• People asking questions about security forces, security measures, or sensitive information

Indicators of Suspicious Activity or Behavior (What to Report)

8Unclassified date

• Briefcase, backpack, suitcase, or package left unattended

• Vehicle parked in NO PARKING ZONES in front of an important building

• People in restricted areas where they are not supposed to be

• Chemical smells or fumes that worry you

• People purchasing supplies or equipment that can be used to make bombs

• People purchasing weapons or uniforms without proper credentials

“See Something Say Something”

9Unclassified date

How to Report:

• Date and time activity occurred

• Where activity occurred

• Physical descriptions of the people involved

• Description of the vehicle(s) involved

• What type of activity

• Describe what you saw or heard

• Provide pictures if you took any

Where to Report:

• Military Police

• Local law enforcement

• Security forces

• Chain of Command

• Army Counterintelligence

• Contracting Officer

Representative

Source for Other Information

10Unclassified date

Army OneSource (AOS) Website (select iWATCH Army / Antiterrorism logo on website) http://www.myarmyonesource.com

Examples of Information:

• Antiterrorism Awareness Training

• Individual Protective Measures

• Individual Awareness Tips

• Insider Threats

• Active Shooter

• Cyber…