TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, OR
MANUFACTURER'S CERTIFICATES OF COMPLIANCE
For use of this form, see ER 415-1-10; the proponent agency is CECW-CE.
SECTION I - REQUEST FOR APPROVAL OF THE FOLLOWING ITEMS (This section will be initiated by the contractor)
DATE TRANSMITTAL NO.
TO: FROM: CONTRACT NO. CHECK ONE:THIS IS A NEW TRANSMITTAL
THIS IS A RESUBMITTAL OFTRANSMITTAL ___________
SPECIFICATION SEC. NO. (Cover only one section with each transmittal) PROJECT TITLE AND LOCATION 01-WAD01 and WAD02-Ph I-Misc. ExcTHIS TRANSMITTAL IS FOR: (Check one)FIO GA DA CR DA/CR DA/GA
ITEMNO.
(SeeNote 3)
a.
DESCRIPTION OF SUBMITTAL ITEM(Type size, model number/etc.)
b.
SUBMITTALTYPE CODE
(See Note 8)
c.
NO.OF
COPIES
d.
CONTRACT REFERENCEDOCUMENT
SPEC.PARA. NO.
e.
DRAWINGSHEET NO.
f.
CONTRACTORREVIEWCODE
g.
VARIATIONEnter "Y" ifrequestinga variation
(See Note 6)h.
USACEACTIONCODE
(Note 9)
i.
REMARKS I certify that the above submitted items have been reviewed
in detail and are correct and in the strict conformance with the
contract drawings and specifications except as otherwise
stated.
NAME AND SIGNATURE OF CONTRACTOR
SECTION II - APPROVAL ACTION
ENCLOSURES RETURNED (List by item No.) NAME, TITLE AND SIGNATURE OF APPROVING AUTHORITY DATE
ENG FORM 4025-R, MAR 2012 REPLACES EDITION OF MAR 95, WHICH IS OBSOLETE.
2/6/2019 01 11 00-12
01 11 00 Summary of Work
W912DQ-15-D-3000 0003
Southern New Jersey REO
130 North Broadway
Gloucester City, NJ 08030
APTIM Federal Services LLC
6380 S. Fiddlers Green Circle, Suite 300
Greenwood Village, CO 80111
Welsbach SF Site-Former WelsbachFacility Gloucester City, NJ
X
X
500587 - Welsbach
US Government Inventory (2018)
The inventory was previously issued under Serial Letter S-0037.
4.4 US Government Inventory (2018) SD-01 1 1.7 A
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Mike Ciminera, CQCSM 2/6/2019