Get AF IMT 103 1994-2023
TYPED NAME AND SIGNATURE OF APPROVING OFFICER Chief of Operations Flight or Chief of Engineering Flight AF IMT 103 19940801 V3 PREVIOUS EDITIONS ARE OBSOLETE. 17a. DATE SIGNED INSTRUCTIONS The BCE work clearance request is used for any work contract or in-house that may disrupt aircraft or vehicular traffic flow base utility services protection provided by fire and intrusion alarm system or routine activities of the installation. This form is used to coordinate the required work with key base activities and keep customer inconvenience to a minimum. It is also used to identify potentially hazardous work conditions in an attempt to prevent accidents. This is a web-optimized version of this form* Download the original full version www. usa-federal-forms. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable DATE PREPARED BASE CIVIL ENGINEERING WORK CLEARANCE REQUEST See Instructions on Reverse 1. Clearance is requested to proceed with work at on Work Order No* Contract No* attached sketch. This area has involving excavation or utility disturbance per has not been staked or clearly marked* 2. TYPE OF FACILITY/WORK INVOLVED A. PAVEMENTS D. FIRE DETECTION PROTECTION SYSTEMS G* AIRCRAFT OR VEHICULAR TRAFFIC FLOW B. DRAINAGE SYSTEMS E* UTILITY OVERHEAD UNDERGROUND H. SECURITY F* COMM I. OTHER 4. DATE OF CLEARANCE C. RAILROAD TRACKS 3. DATE CLEARANCE REQUIRED 5. SIGNATURE OF REQUESTING OFFICIAL ORGANIZATION B A S E 6. TELEPHONE NO. REMARKS Use Reverse for additional comments REVIEWER S NAME AND INITIALS A. ELECTRICAL DISTRIBUTION B. STEAM DISTRIBUTION C. WATER DISTRIBUTION C I V D. POL DISTRIBUTION IL E* SEWER DISTRIBUTION N G R F* ENVIRONMENTAL G* PAVEMENTS/ GROUNDS H. FIRE PROTECTION I. ZONE J* OTHER Specify 9. SECURITY POLICE 10. SAFETY 11. COMMUNICATIONS 12. BASE OPERATIONS 13. CABLE TV 14. COMMERCIAL UTILITY COMPANY TELEPHONE GAS ELECTRIC 16. REQUESTED CLEARANCE APPROVED 17. 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 request must be reprocessed* 18. REMARKS* This section must describe specific precautionary measure to be taken before and during work accomplishment. Specific comments concerning the approved method of excavation hand or powered equipment should be included* REVERSE. This is a web-optimized version of this form* Download the original full version www. usa-federal-forms. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable DATE PREPARED BASE CIVIL ENGINEERING WORK CLEARANCE REQUEST See Instructions on Reverse 1. .
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