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Equal Opportunity Employer
BLAST ALL Inc. Industrial Coating • Structural Maintenance • Abrasive Blasting
148
Mill
Roc
k Ro
ad E
ast
•
P.O
. Box
775
•
Old
Say
broo
k, C
T 06
475
•
Tel (
860)
388
-546
4 /
Fax
(860
) 388
-464
4
CT DOT # 0063-0704
Rehab of Br # 00481 Airport Rd Over Rt. 15
Hartford
ITEM# 0020904A: LEAD COMPLIANCE FOR ABRASIVE BLASTING
LEAD COMPLIANCE
FOR ABRASIVE BLAST CLEANING
CT DOT PROJECT NO. 0063-704
Rehabilitation of Bridge No. 00481 Airport Road Over Route 15
Hartford, Connecticut
Contractor Blast All, Inc.
Approved by: _______________ 12-21-2016 Lawrence J. Cannon Date Certified Industrial Hygienist
LEAD COMPLIANCE FOR ABRASIVE BLAST CLEANING
CT DOT PROJECT NO. 0063-0704 Rehabilitation of Bridge No. 00481
Airport Road Over Route 15 Hartford, Connecticut
Contractor
Blast All, Inc.
A. Site Organizational Structure
B. Site Specific Abrasive Blast Cleaning
1. Description of Operations
Site Location Plan Emergency Contacts and Phone Numbers Work Plan including Engineering Controls
2. Employee Training Certificates
3. Name and qualifications of Competent Person
4. Contractors Letter of Assurance of employee medical monitoring, biological monitoring and
respirator fit testing, as required in 29 CFR 1926.62.
5. Construction & Demolition (C&D) waste disposal facility
6. Scrap Metal Recycling Facility
7. Hazardous Waste Disposal Facility
8. Hazardous Waste Transporter Certifications
9. Negative Exposure Assessment
Attachments B1 Qualifications of the Industrial Hygiene Firm
B2 Employee Certificates
B3 Competent Person and Qualifications
B4 Assurance Letter of Medical Monitoring and Respirator Fit Testing
B5 Non Hazardous Construction and Demolition Waste Disposal Facility
B6 Scrap Metal Recycling Facility
B7 Hazardous Waste Disposal Facility
B8 Hazardous Waste Transporter USDOT Certificates of Registration
B9 Negative Exposure Assessment
A. SITE ORGANIZATIONAL STRUCTURE
1
The site organizational structure, provided below has been established to ensure that overall responsibilities for employee health and safety are addressed. This chain of command will be utilized for reporting conditions that may lead to accidents, failure of containment systems, or exposure to hazardous materials.
Contractor Blast All, Inc. 148 Mill Rock Road
Old Saybrook CT 06475
Industrial Hygiene EnviroMed Services Inc. Firm 470 Murdock Avenue Meriden, CT 06450
This Abrasive Blast Cleaning Plan will cover all contractor and subcontractor employees performing work tasks that pose a potential lead exposure risk. The Work Plan will include all noted services, equipment, facilities, testing and other associated work for up to three (3) Connecticut Department of Transportation (CONN DOT) project representatives. Work Plan services provided to any CONN DOT project representatives in excess of three (3) representatives will be measured for payment in accordance with Article 1.09.04 – “Extra and Cost-Plus Work”. This directive for CONN DOT representatives will apply to all applicable sections of this Work Plan document.
Overall responsibility for employee Lead Health and Safety rests with the site's Competent Person. The Competent Person has the authority to implement the required health and safety programs, initiate any needed disciplinary actions, and to stop any operation, which has not been adequately evaluated or controlled. The Competent Person has the authority to call for outside assistance from local police, fire and emergency medical departments in the event that their services are required. Prior to beginning any abatement activities, Blast All, Inc. (the Contractor) will designate an individual as the competent person on this site. The Competent Person will be on site during all operations affecting the lead-based paint on the structure.
Each supervisor of contractor and any subcontractor employees is responsible to follow the directives of the Competent Person and to ensure that the employees under his/her supervision follow appropriate procedures as identified in site specific programs and described during site training programs. In addition the Competent Person will also ensure that all employees exposed to airborne lead above the Action Level (30 µg/m3) sign in and out daily on the provided log sheet. At the end of each month, a report consistent with the requirements of the Work Plan will be submitted to the CONN DOT and/or their representative. Under the Work Plan, the Competent Person has the authority to implement the required health and safety programs, initiate any needed disciplinary actions, and to stop any operation, which has not been adequately evaluated or controlled.
A. SITE ORGANIZATIONAL STRUCTURE
2
Personnel Assigned to Project
Listed below are the personnel to date assigned to this project: Blast All, Inc. Alex Burchardt EnviroMed Services, Inc. Industrial Hygienists (one or more of these persons may be used). Trevor Cazlan Dominick Fiore Ryan Lafleur Alexander O’Farrell James Sserunjogi Industrial Hygienists listed above have a minimum of two years of experience working on projects related to the Lead in Construction Standard. Trainers (one or more of these persons may be used) Lawrence Cannon, MPH, CIH, CSP, RS Thomas Neil, RS All trainers utilized by EnviroMed have a minimum of ten (10) years experience with Occupational Safety and Health Administration (OSHA) Lead training as well as prior experience and assignments on lead-related CONN DOT Projects. Our instructors have completed numerous courses such as: - C3/C5 – Supervisor/Competent Person Training for De-leading of Industrial Structures - OSHA 4 Hour Lead Awareness - OSHA 10 Hour Training - OSHA 40 Hour Training - Lead Inspector/Risk Assessor Training - Lead Planner/Project Designer Training
A copy of the OSHA Lead in Construction Standard (29 CFR 1926.62) is located on site and available upon request from the Competent Person.
B. SITE SPECIFIC ABRASIVE BLAST CLEANING
3
1. Work Plan and Description of Operations Rehabilitation of Bridge No. 00481 Airport Road Over Route 15, Hartford, Connecticut Item 0020904A – Lead Compliance for Abrasive Blast Cleaning Description - Work under this item shall include special handling measures and work practices required for abrasive blast cleaning activities, principally involved in bridge coating removal /painting operations, which impact materials containing or covered by lead paint. Lead paint includes paint found to contain any detectable amount of lead by Atomic Absorption Spectrophotometry (AAS) or X-Ray Fluorescence (XRF). Lead paint is identified on the painted structural steel/metal bridge components of Bridge No. 00481. The XRF readings of the tan/beige paint ranged from 9.8 to 21.7 mg/cm2. The tan/beige paint exists on the Girders, Cross Beams, Beam Ends, Bearings, Rockers, Diaphragms, etc. The TCLP waste stream sampling/analysis of the paint associated with the structural steel/metal bridge component surfaces of the bridge characterized the paint waste as RCRA hazardous waste. The paint debris from the structural steel/ metal bridge component surfaces had a TCLP result of 480 mg/l. The Engineer has characterized the projected abrasive blast debris associated with the structural steel/bridge components as RCRA/CTDEEP Hazardous Waste, which shall be handled and disposed of in accordance with USEA/CTDEEP Hazardous Waste Regulations and 0603222A-Disposal of Lead Debris from Abrasive Blast Cleaning.
Specific lead related construction operations for Bridge No. 00481, include Abrasive Blasting of lead paint, and HEPA vacuum needle scaling of lead paint to assist with torch cutting and hot work, and other operations that will impact existing painted steel. Torch cutting through steel may be performed for this project. All lead based paint within 6 inches of the hot cut line must be removed from the steel structure prior to torch cutting operations. Construction Plan and Containment of Debris In meeting the requirements of these specifications, Blast All, Inc., shall supply all necessary equipment for the inspection of environmental controls and conditions. The containment and collection of debris shall be done in strict conformance with current federal Environmental Protection Agency (EPA) and Connecticut Department of Environmental Protection (CTDEEP) regulations and SSPC Guide 6 – Guide for Containing Debris Generated During Paint Removal Operations. The containment(s) shall be designed and erected to contain, as well as facilitate the collection of debris from the paint removal operations. Drawings and details of the containment(s) shall meet the requirements of the project specification. Engineering and Work Practice Controls Blasting of Steel Components When blasting operations are performed on any steel structures, containments under negative pressure ventilation and control are required to minimize any emission of lead-containing particulates are required.
Needle-Gunning/Grinding When needle-gunning or grinding is implemented, the following engineering methods/controls are required to be utilized. Steel structures coated with lead paint and scheduled to be removed will be cleaned of suspected lead paint through the use of needle guns or grinders with HEPA vacuum attachments. This will contain lead dust and minimize employee exposure during this phase and during cutting operations. As described above, control of lead exposure during cutting operations will be accomplished by removing paint from surfaces
B. SITE SPECIFIC ABRASIVE BLAST CLEANING
4
prior to this operation. Paint will be removed from surfaces within 6” (inches) of the spot to be cut on the front and back sides if both are painted.To reduce the potential spread of contaminated debris, all surface preparation debris will be collected with the use of HEPA filtered vacuum systems. The barrels will be properly stored and remain closed and covered except during placement, sampling or disposal of the debris.
Cutting of Steel Components When operations involving torch cutting and/or burning of the steel are used on any of the steel beams and components, which are coated with suspected lead paint, will be de-leaded. As customary suspected lead paint will be removed from surfaces within 6” inches of the spot to be cut on the front and back side if both are painted. The potential for lead exposure is high during this phase of the operation. All personnel who may be exposed to lead fume and dust created by these operations will be included in the employee protection and medical surveillance program. Welding of Steel Components Any of the components, which are coated with suspected lead based paint coatings on steel components, require appropriate paint removal prior to any welding. The potential for lead exposure is high during this phase of the operations. As customary suspected lead paint will be removed from surfaces within 6” inches of the spot to be cut on the front and back side if both are painted. All personnel who may be exposed to lead fume and dust created by these operations will be included in the employee protection and medical surveillance program.
Facilities A standard hygiene facility with shower shall be provided for this project for work activities expected to be at or above the action level of 30 ug/m3 as required by the CONN DOT specification. A hand wash station will be located near the work area for decontamination of employees prior to breaks and lunch. Specifications shall be as follows for the hand wash and decontamination facilities:
Hand-Wash Facility: The number of facilities to be provided will be dictated by the site(s) and approved by the Engineer. Each facility shall be equipped with hot and cold clean water, hand soap or similar cleansing agents and individual hand towels or sections made of cloth or paper, warm air blowers or clean individual sections of continuous cloth toweling which the workers will use to wash and dry their hands, face and any exposed skin prior to eating, drinking, smoking or applying cosmetics. Each facility shall be located as close to the work site as is physically possible. Ownership of and liability for the facility shall remain with the Contractor throughout the duration of the project. The facility shall comply with 29 CFR Part 1926.51. Each portable hand wash facility shall be trailer, skid or cart-mounted and have a minimum of one (1) sink with a fresh water tank, and a holding tank. The facility shall also be equipped with hot water heater, eye wash station, storage cabinets, lights for night use, an electric or pneumatic water pump, and lead filtration system. Containers for the collection and disposal of refuse generated at the facility shall also be provided. Each facility shall be kept in a sanitary condition and clean as defined in the most recent OHSA requirements. At a minimum, the facility shall be cleaned after every shift in which it is used. Decontamination Facility: The number of facilities to be provided will be dictated by the site(s) and approved by the Engineer. Each facility shall consist of a “clean” area where workers can remove and store clean street clothing when they arrive on site for work, shower room with hot and cold running water, soap and towels and a “dirty” area where work clothing and personal protective equipment may be stored. The showers shall be located between the two areas. The facility shall have adequate clean storage for all employees who are required to use the facility to store their non-work clothing. The facility shall be located as close to the work site as is physically possible. If the Contractor is unable to locate the decontamination
B. SITE SPECIFIC ABRASIVE BLAST CLEANING
5
facility close to specific work areas, a designated shuttle vehicle shall be provided. This vehicle shall be classified as contaminated and shall remain at the job site in the decontamination zone. This vehicle shall be operated and maintained to eliminate any possibility of cross contamination with the support zone. The vehicle shall be cleaned as defined in the most recent OSHA protocols. Ownership of and liability for the facility and shuttle vehicle shall remain with the Contractor throughout. The facility shall comply with CFR Part 1926.51. The Contractor shall equip each facility with an adequate and safe climate controlled system including all necessary fuel; adequate waterproof lighting fixtures and water proof electrical outlets. All electrical circuits shall be ground fault protected. The Contractor shall also provide exterior illumination of each decontamination facility site. The minimum illumination level shall be two foot candles for a minimum distance of ten feet on each side of the facility. The Contractor shall provide proper trash receptacle(s) and disposal.
Waste Containment Storage, Handling and Disposal
Hazardous Waste Disposal Lead dust and other lead related waste should be handled, stored and disposed of in accordance with the federal, state and local regulations. Other organic and inorganic solvent or solid wastes should be handled, stored and disposed of in accordance with the appropriate standards. Fifty-five gallon barrels shall be stored together in two rows of five or an approved roll-off dumpster. The Contractor shall maintain a minimum lane clearance of 36 inches between each barrel lot of 10. The Contractor will maintain a secure storage site, which will be large enough to handle all debris. The Contractor will store debris only in the secured storage site. During cleaning operations, all surface preparation debris will be vacuum collected from the containment enclosure. The Contractor will account for all coating debris conveyed to the secured storage site and all coating debris transported from the project for disposal. The secure storage site shall consist of a fenced-in area within the project’s approved staging area. Container storage shall be in areas that are properly drained and runoff water shall not be allowed to pool and shall be out of the 100-year flood plain. The containers shall be placed on pallets or other approved material and not directly on the ground. Containers will be secure with bolted lids at all times except during placement, sampling and disposal of debris.
Scrap steel will be disposed at an approved waste facility. Non-hazardous debris will be disposed at an approved waste facility. Hazardous lead debris will be disposed at an approved waste facility.
Wastewater Testing The wastewater generated from decontamination practices and wetting down demolition debris may contain lead. Any wastewater generated shall be tested prior to disposal in accordance with regulatory requirements.
Daily On-Site Inspections by the Competent Person
Periodic inspections shall be conducted daily while work-impacting lead is occurring, but shall be as frequent as necessary to maintain Contractor compliance with the OSHA Lead Construction Standards. The Contractor’s Competent Person shall be on-site at all times that the work impacting lead is being performed and shall be capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous or dangerous to employees, and has authorization to take prompt corrective measures to eliminate them. Name and qualifications of the Contractor’s Competent Person, as defined under 29 CFR 1926.62, who will be on site at all times that the work impacting lead paint is being performed are provided as
B. SITE SPECIFIC ABRASIVE BLAST CLEANING
6
part of this documentation. Personal Exposure Monitoring Personal exposure monitoring is required when lead removal is taking place, when the Contractor is on site to establish and provide an ongoing assessment of exposure. Exposure monitoring assessments will be performed when on site. In addition when the specific work practices change these new or altered work practices will be monitored to establish levels of lead exposure. Sampling pumps will be calibrated prior to their use to achieve a fixed flow rate during sampling. A flow rate of approximately 2 liters per minute will be used to ensure that the maximum volume of 1,200 liters is not exceeded during an 8-hour work shift. Samples will be collected on cellulose ester membrane filters with a 0.8-micron pore size. Samples are placed in employees breathing zones to obtain the most representative exposure data. Upon completion of sampling, samples are transported to an American Industrial Hygiene Association (AIHA) accredited laboratory for analysis. The employees must receive sampling results (in writing) within 5 working days of receipt of sample results from the lab. All airborne lead monitoring results will be included in the monthly compliance report. Ambient Air Monitoring The Contractor will use ambient air-monitoring stations at locations selected around the site to collect baseline ambient TSP lead data to determine pre start and ambient conditions. During the lead removal, additional sets of monitoring stations will be used to collect ambient lead samples. Ambient monitoring periodic sampling is utilized to document any ambient TSP lead levels during actual lead work operations. Surface Dust Sampling The performance of Pre and Post surface dust sampling is required when lead removal is taking place, when the Contractor is on site and is utilized as a QA/QC measure to ensure that all equipment, hygiene facilities, and respirators are free from lead dust contamination after cleaning. Examples of categories to be sampled for lead contamination are: First the equipment being used on or around the work site such as tools (prior to leaving site), vehicles (work and personal), and office trailers (includes floors, tables & benches). The second group is Respirators including half-face air purifying respirators and powered air-purifying respirators (PAPR's). Hygiene facilities are the third category that covers areas like lunch areas (food coolers, water coolers, lunch tables), decontamination trailers, wash areas and storage trailers. Hand Wipes Personnel will participate in sampling the hands and faces of employees, when lead removal is taking place when on site. The hand wipes are an effective tool in illustrating the need for full compliance with the hand and face washing requirements of the hygiene program. There is currently no OSHA post wash cleanliness requirement for hands. To reduce employee exposure, a concentration of no more than 50 micrograms per square foot (µg/ft2) is suggested. Both the pre-wash and post-wash samples are to be collected. Sampling will be collected on a periodic basis from representatives of all job classifications on site exposed to lead contamination at the action level. Samples are to be analyzed by an AIHA accredited laboratory, following National Institute of Occupational Safety and Health (NIOSH) method 7082. Hand wipe samples are reported in grams and not in micrograms per unit area (e.g. g/ft2). This is due to the individual variation in surface area of the hands.
Periodic On-Site Inspections by the Industrial Hygienist
Inspections shall be performed weekly, at a minimum, while lead-impacting work is occurring, but shall be at the frequency necessary to maintain contractor compliance with the OSHA Lead in Construction Standard (29
B. SITE SPECIFIC ABRASIVE BLAST CLEANING
7
CFR 1926.62). Any exceptions to the Lead in Construction Standard shall be reported to the Contractor and the engineer prior to the Industrial Hygiene (IH) firm personnel leaving the site and corrected immediately. All findings of such periodic inspections shall be documented in writing to the Engineer as they become available. At a minimum, the inspection report shall document the following:
1. Description of work activities. 2. Description of containment, engineering controls, and Regulated Areas being implemented. 3. Description of Personal Protective Equipment (PPE) being utilized. 4. Description of visual review of containment system effectiveness. 5. Results of all air sampling received since date of last report. 6. Narrative interpreting sample results and making recommendations as necessary. 7. Description of waste management practices being utilized. 8. Description of exceptions noted and corrective action taken.
The report shall include a signature from the IH firm employee that performed the site inspection verifying that the Contractor’s work practices are in compliance with 29 CFR 1926.62 and the previously submitted and accepted Lead Compliance Plan. The CIH shall sign verifying their concurrence. Once per week site inspections are performed by EnviroMed Services, Inc.'s Industrial Hygienist and will focus on the following areas:
a) Adequacy of housekeeping practices b) Hygiene Facilities & Practices c) Use of Protective Equipment
Procedures for Weekly Inspections by the Industrial Hygiene Firm
The CIH provides written procedures to all field industrial hygienists to require field-testing and verification of on-site conditions. Specifically, the field industrial hygienist is required to review the condition of the personal protective equipment utilized on site. Such review will include the visual assessment of respirators, decontamination facilities training documentation, as well as the proper storage and disposal of PPE. The CIH and the Field Industrial Hygienists will review site conditions and field reports regarding proper testing, training, cleaning/storage or replacement and disposal of the utilized articles to evaluate the level of conformance 29 CFR Parts 1926.62 (f) and (g), especially 29 CFR Parts 1926.62 (g)(2)(ii-viii). The site industrial hygienists shall observe and document the selection and use of respiratory equipment and protective clothing during on-site surveillance and monitoring inspections. The site industrial hygienists will conduct weekly inspections and the CIH will certify that the respirators are being cleaned properly. The duties of field industrial hygienists shall include the wipe testing of respirators, employee hands/face and various tools and equipment utilized by site personnel. Attachment B1 Qualifications of the Industrial Hygiene Firm CIH Qualifications, Employee Training Certificates, dated within 12 months, relating to OSHA lead awareness and SSPC Training Programs along with hazard communication training in the use of lead-safe work practices. This information shall be updated and resubmitted annually, or as information changes, for the duration of the activities impacting lead to verify continued compliance Attachment B2 Employee Certificates includes copies of all employee certificates, dated within the previous 12 months, relating to OSHA lead awareness and SSPC Training Programs along with hazard communication training in the use of lead-safe work practices. This information shall be updated and resubmitted annually, or as information changes, for the duration of the activities impacting lead to verify continued compliance.
B. SITE SPECIFIC ABRASIVE BLAST CLEANING
8
Attachment B3 Competent Person and Qualifications Qualifications of competent person assigned to this project, along with current OSHA lead awareness and SSPC Training Programs along with hazard communication training in the use of lead-safe work practices. This information may be updated and as information changes, for the duration of the activities impacting lead to verify continued compliance.
Attachment B4 Assurance Letter of Medical Monitoring and Respirator Fit Testing Documentation from the Contractor, typed on Company letterhead and signed by the Contractor, certifying that all employees listed therein have received the following items:
• Medical Monitoring and Respirator Fit within the previous 12 months. • Biological Monitoring within the previous 6 months.
Attachment B5 Non Hazardous Construction and Demolition Waste Disposal Facility Names of proposed non-hazardous construction and demolition (C&D) lead debris bulky waste disposal facility (CT DEEP – permitted Solid Waste Landfill). This information shall be updated and resubmitted annually, or as information changes, for the duration of the activities impacting lead to verify continued compliance.
Attachment B6 Scrap Metal Recycling Facility Name of proposed scrap metal recycling facility that is able to accept lead-painted scrap metal. This information shall be updated and resubmitted annually, or as information changes, for the duration of the activities impacting lead to verify continued compliance. Attachment B7 Hazardous Waste Disposal Facility Name of proposed hazardous waste disposal facility (selected from the Department approved list provided in section #0020903A), and copies of each facilities acceptance criteria and sampling frequency requirements. This information shall be updated and resubmitted annually, or as information changes, for the duration of the activities impacting lead to verify continued compliance. Attachment B8 Hazardous Waste Transporter USDOT Certificates of Registration Copies of proposed hazardous waste transporters current USDOT Certificates of Registration for Hazardous Waste Transporter Permits for the State of Connecticut and the waste destination State. This information shall be updated and resubmitted annually, or as information changes, for the duration of the activities impacting lead to verify continued compliance. Attachment B9 Negative Exposure Assessment
SUBSET TITLE
Plans For
SUBSET NO.
DRAWING TITLE
DISTRICT 1 DISTRICT 2
DISTRICT 3
DISTRICT 4
LOCATION PLANNOT TO SCALE
GENERAL NOTES:
DRAWING NO.
WOODSTOCK
THOMPSON
ASHFORD EASTFORD
POMFRET
BROOKLYN
HAMPTONCHAPLINMANSFIELD
PUTNAM
STERLINGPLAINFIELD
CANTERBURYSCOTLAND
WINDHAM
LEBANON
HEBRON
EAST
HAMPTON COLCHESTER
GRISWOLD
STONINGTON
STONINGTONNORTH
LEDYARD
WATERFORD
MONTVILLE
BOZRAH
FRANKLIN
EASTLYME
SALEM
SPRAGUE
LISBON
EAST HADDAM
LYMECHESTER
ESSEX
OLD
CLINTON
COLUMBIA
HADDAM
KILLINGWORTH
WESTBROOK
DEEP RIVER
LYME
MARLBO
ROU
GH
VOLUNTOWN
PORTLAND
PRESTON
REDDING
NEWFAIRFIELD
BETHEL
NEWTOWN
BROOKFIELD
ROXBURY
SOUTHBURY
OXFORD
WOODBURY
SHERMAN
NEWMILFORD
KENT
SHARON GOSHEN
WARREN
WASHINGTONBETHLEHEM
MORRIS
LITCHFIELD
HARWINTON
WATERTOWN
CANAAN
NORTH
NORFOLK
CORNWALL
COLEBROOK
WINCHESTER
HARTLAND
BARKHAMSTED
NEWHARTFORD
CANTON
GRANBY
SUFFIELD
EAST
GRANBY
SIMSBURY
AVON
SEYMOUR
ANSONIA
DERBY
PROSPECT
PLYMOUTH
BURLINGTON
FARMINGTON
CANAAN
RIDGEFIELD
SALISBURY
WO
OD
BRID
GE
BETHANY
HAMDEN
SHELTON
MONROE
EASTON
WESTON
WILTON
CANAANNEW
GREENWICH
DARIEN
WESTPORT
FAIRFIELD
TRUMBULLORANGE
MILFORD
STR
ATF
OR
DBRIDGEPORT
EAST
HA
VEN
BRANFORD
GUILFORD
NORTH
BRANFORDHAVENNORTH
NAUGATUCK
MIDDLEBURY
MADISON
NORWALK
WEST
HA
VEN
SAYBROOK
OLD
LONDONNEW
WATERBRIDGE-
FALLS
BEACON
MIDDLETOWN
MERIDEN
CHESHIRE
SOUTHINGTONWOLCOTT
BRISTOL PLAINVILLE
CROMWELLBERLIN
BOLTON
GLASTONBURY
ANDOVER
MANCHESTER
HARTFORD
BRITAIN
NEW
HARTFORD
WEST EAST
BLOOMFIELD
WINDSORSOUTH
WINDSOR
WINDSOREAST
ENFIELD SOMERS STAFFORD UNION
WILLINGTONTOLLAND
ELLINGTON
VERNON
COVENTRY
DURHAM
NE
WIN
GT
ON
LOCKS
WINDSOR
CONNECTICUT DEPARTMENT OF TRANSPORTATION
WETHERSFIELD
SHEET COUNT*SUBSET
Plans For
LIST OF SUBSETS
CONNECTICUT
DE
PA
RT
ME
NT
O F TRANS
PO
RT
ATI
ON
AND CHANGE ORDERS NOT INCLUDE ADDENDUMS SHEET COUNT DOES *THE INITIAL SUBSET
STATE OF CONNECTICUT
LENGTHRESPONSIBILITYROADMAINTENANCE
SUBSET 01 - GENERALLIST OF DRAWINGS
N
DE
PA
RT
ME
N
TOF TRANS
PO
RT
ATI
ON
C
ONNECTICUT
M A S S A C H U S E T T S
RH
OD
E
IS
LA
ND
N
E
W
Y
O
R
K
DRAWING NO.
SHEET NO.
STATE PROJECT NO.
TORRINGTON KILLINGLY
GROTON
STAMFORD
DANBURY
WATERBURY
G-1
STANDARD CONVENTIONS
Edge Of Road
Concrete Pavement
Dirt Road
B.C.L.C.
Granite Curb
Guide Rail
Concrete Median Barrier
Bit. Walk
Conc. Sidewalk
Railroad Tracks
Chain Link Fence
Rustic Fence
Pipe Fence
Board Fence
Water Edge
Stream
Ditch
Swamp
Building
TOWN LINE
Highway Line
Street Line
Property LinePL
Lot Line
STATE LINE
Easement Line
Limit Of Marsh
Stone Wall
Ledge Outcrop
Inland Wetland Limits
Power Line
Transmission Tower
Riprap
Retaining Wall
Evergreen Tree
Shrub
Tree Line
Hedge Row
Grid ArrowNorth Arrow W/No. Coor.
. .
Deciduous Tree
PROJECT # F.A.P. #
City of
City
STATE OF CONNECTICUT
LOCATIONPROJECT
DETAIL ESTIMATE SHEETS
TITLE SHEET G-1
DET-01 TO DET-02
3GENERAL01
102
8HIGHWAY03
2304
9TRAFFIC05
REVISIONS
STRUCTURE
PROJECT LOCATION
0063-0704
WALLINGFORD
FIELDMIDDLE-
06 11
15
150
LOCATIONPROJECT
N
ROUTE 15 (WILBUR CROSS HWY)AIRPORT ROAD OVER
REHABILITATION OF BRIDGE No. 00481
HARTFORD
ROUTE 15
SR 530 (AIRPORT RD) STATE OF CONNECTICUT
CITY OF HARTFORD
ROUTE 15 (WILBUR CROSS HWY)AIRPORT ROAD OVER
REHABILITATION OF BRIDGE No. 00481
HARTFORD
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STREET
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ST
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MEADOW
STREET
STREET
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STREET
STREET
STREET
STREET
STREET
STREET
ST.
STREET
STREET
ST.
ST.
ST.
BODWELL
WAYLAND
# 2
STANDISH
REDDING
BLISS
MC
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AN
MC
KIN
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STREET
STREET
STREET
ST. # 2
ST. # 2
STREET
PLYMOUTH
GOODRICH
EATON
BOLTON
ROADFR
AN
KLIN
LEDYAR
DW
ET
HE
RS
FIE
LD
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BU
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ST
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ROAD
RO
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HW
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RAIL
RO
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155
91
27
28530
530
ELLIOTT
AIRPORT
HARTFORD - BRAINARD
WE
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LD
86
87
89
86
87
28
27
MURPHY
BR
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RO
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RAIL
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91
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RAIL
RO
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ECIVRES
.D
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#
TOWN OF WINDSOR
SOUTH WINDSOR
TOWN OF
EAST HARTFORD
TOWN OF
WETHERSFIELD
TOWN OF
NEWINGTON
TOWN OF
EAST HARTFORD
TOWN OF
BLOOMFIELDTOWN OF
6
84
91
515
515
91
2
91
44
SIGN STRUCTURES
1,373.00 FEET
480.00 FEET
N
0063-07046063(007)
10
9
CTDOT HIGHWAY STANDARDS
CTDOT TRAFFIC STANDARDS
7. ADT: 24,300 (2012)
6. FUNCTIONAL CLASSIFICATION: URBAN MINOR ARTERIAL
5. DESIGN SPEED: 40 MPH
4. VERTICAL DATUM BASED ON NGVD 1929
CONNECTICUT COORDINATE SYSTEM SYSTEM N.A.D. 83/96
3. SURVEY PRODUCED BY CTDOT. 400 FOOT GRID BASED ON
Supplemental Specifications, dated July 2015; and Special Provisions
for Roads, Bridges and Incidental Construction, Form 816, dated 2004;
Connecticut Department of Transportation, Standard Specifications
2. CONSTRUCTION SPECIFICATIONS:
1. FEDERAL AID PROJECT NO. 6063(007)
44
2027
7
44
6
8
1
5
2027
6
9
2
91
95
95
95
84
395
84
84
HAVENNEW
HARTFORD
NORWICH
THOMASTON
HILLROCKY
01.01
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
LOCJECTPRO-POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $DAMAGE TO RENTEDEACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
$
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
INSRLTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF(MM/DD/YYYY)
POLICY EXP(MM/DD/YYYY) LIMITS
PERSTATUTE
OTH-ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe underDESCRIPTION OF OPERATIONS below
(Mandatory in NH)OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTOALL OWNED SCHEDULED
HIRED AUTOSNON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)PROPERTY DAMAGE $
$
$
$
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSDADDL
WVDSUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE(A/C, No, Ext):
PRODUCER
ADDRESS:E-MAIL
FAX(A/C, No):
CONTACTNAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
3/14/2016
Strategic Insurance Partners492 Franklin Avenue
Nutley NJ 07110
Maria Plasencia(973)667-2600 973-798-0941
IWT Transport Inc., Industrial WasteTechnologies Inc, United Waste Technologies306 Ramapo Valley Road, Suite #2Oakland NJ 07436
Starr Indemnity & Liability Co. 38318Federal Insurance Co. 20281Essex Insurance Company 39020
Master Cert
AX
XX POLLUTION LIABILITYX PROFESSIONAL LIABILITY
X X
1000065454161 3/16/2016 3/16/2017
1,000,00050,0005,000
1,000,0001,000,0001,000,000
A X
X MCS-90 X CA-9948
SISIPCA08323316 3/16/2016 3/16/2017
1,000,000
single limit
AX
X 10,000 1000336400161 3/16/2016 3/16/2017
5,000,0005,000,000
B N 0044727923 3/16/2016 3/16/2017
X1,000,0001,000,0001,000,000
C MOTOR TRUCK CARGO IMN12767 3/16/2016 3/16/2017 Single Conveyance $100,000Deductible $1,000
Coverages are subject to Terms, Conditions and Exclusions on the policy(s).
Mark Grossbard/MPL
EVIDENCE OF INSURANCE
Public Burden Statement OMB NO: 2126-0008 A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection ofinformation subject to the requirements for the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Numberfor this information collection is 2126-0008. Public reporting for this collection of information is estimated to be approximately 2 minutes per response, including the time for reviewinginstructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send commentsregarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, FederalMotor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590
Form MCS-90 (page 1 of 3 )
U.S. Department of TransportationFederal Motor CarrierSafety Administration
ENDORSEMENT FORMOTOR CARRIER POLICIES OF INSURANCE FOR PUBLICLIABILITY UNDER SECTIONS 29 AND 30 OF THE MOTOR
CARRIER ACT OF 1980
Issued to IWT Transport, Inc. of 360 Ramapo Valley Road, Oakland, NJ 07436
Dated at New York, New York____ this __16th _ day of March____, 2016____
Amending Policy No. SISIPCA08323316 Effective Date 3/16/2016___________
Name of Insurance Company
Starr Indemnity & Liability Company Countersigned by
Authorized Representative The policy to which this endorsement is attached provides primary or excess insurance, as indicated by “[X],” for thelimits shown: [X ] This insurance is primary and the company shall not be liable for amounts in excess of $ 1,000,000. for each
accident. [ ] This insurance is excess and the company shall not be liable for amounts in excess of $___ for each accident in excess
of the underlying limit of $ _ for each accident. Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish theFMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by anauthorized representative of the FMCSA, to verify that the policy is in force as of a particular date. The telephonenumber to call is: (215) 399-2939 Cancellation of this endorsement may be effected by the company of the insured by giving: (1) thirty-five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice ismailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is subject to the FMCSA’s registrationrequirements under 49 U.S.C. 13901, by providing thirty (30) days notice to the FMCSA (said 30 days notice tocommence from the date the notice is received by the FMCSA at its office in Washington, D.C.).
Form MCS-90 (page 2 of 3)
DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions or which results in bodily injury, property damage, orenvironmental damage which the insured neither expected nor intended. Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or semi-trailer propelled or drawn by mechanicalpower and used on a highway for transporting property, or any combination thereof. Bodily Injury means injury to the body, sickness, or disease to any person, including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. Environmental Restoration means restitution for the loss, damage, or destruction of natural resources arising out of theaccidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, ofany commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measurestaken to minimize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. Public Liability means liability for bodily injury, property damage, and environmental restoration. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended toassure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Motor Carrier Safety Administration(FMCSA). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company)agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for publicliability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financialresponsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not eachmotor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in anyterritory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does notapply to injury to or death of the insured's employees while engaged in the course of their employment, or propertytransported by the insured, designated as cargo. It is understood and agreed that no condition, provision, stipulation, orlimitation contained in the policy, this endorsement, or any other endorsement thereon, or violation thereof, shall relievethe company from liability or from the payment of any final judgment, within the limits of liability herein described,irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions, andlimitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between theinsured and the company. The insured agrees to reimburse the company for any payment made by the company onaccount of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that thecompany would not have been obligated to make under the provisions of the policy except for the agreement containedin this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against theinsured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction againstthe company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately to each accidentand any payment under the policy because of any one accident shall not operate to reduce the liability of the company forthe payment of final judgmentsresulting from any other accident. THE SCHEDULE OF LIMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE. The limitsshown in the schedule are for information purposes only.
Form MCS-90 (page 3 of 3)
SCHEDULE OF LIMITS--PUBLIC LIABILITY
Type of carriage
Commodity transported
Jan. 1, 1985
(1) For-hire (In interstate orforeign commerce, with agross vehicle weight rating of10,000 or more pounds).
(2) For-hire and Private (Ininterstate, foreign orintrastate commerce, with agross vehicle weight ratingof 10,000 or more pounds).
(3) For-hire and Private (Ininterstate or foreigncommerce, in any quantity,or in intrastate commerce,in bulk only; with a grossvehicle weight rating of10,000 or more pounds). (4) For-hire and Private (Ininterstate or foreigncommerce, with a grossvehicle weight rating of lessthan 10,000 pounds).
Property (nonhazardous)
Hazardous substances, as defined in 49 CFR 171.8,transported in cargo tanks, portable tanks, or hopper-type vehicles with capacities in excess of 3,500water gallons; or in bulk Division 1.1., 1.2, and 1.3materials. Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403.
Oil listed in 49 CFR 172.101; hazardous waste, hazardous materials, and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101, but not mentioned in (2) above or (4) below. Any quantity of Division 1.1, 1.2, or 1.3 material; anyquantity of a Division 2.3, Hazard Zone A, or Division6.1, Packing Group 1, Hazard Zone A material; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403.
$ 750,000
$5,000,000
$1,000,000
$5,000,000
Public Burden Statement OMB NO: 2126-0008 A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection ofinformation subject to the requirements for the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Numberfor this information collection is 2126-0008. Public reporting for this collection of information is estimated to be approximately 2 minutes per response, including the time for reviewinginstructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send commentsregarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, FederalMotor Carrier Safety Administration, MC-RRA, Washington, D.C. 20590
Form MCS-90 (page 1 of 3 )
U.S. Department of TransportationFederal Motor CarrierSafety Administration
ENDORSEMENT FORMOTOR CARRIER POLICIES OF INSURANCE FOR PUBLICLIABILITY UNDER SECTIONS 29 AND 30 OF THE MOTOR
CARRIER ACT OF 1980
Issued to IWT Transport, Inc. of 360 Ramapo Valley Road, Oakland, NJ 07436
Dated at New York, New York____ this __16th _ day of March____, 2016____
Amending Policy No. 1000336400161 Effective Date 3/16/2016___________
Name of Insurance Company
Starr Indemnity & Liability Company Countersigned by
Authorized Representative The policy to which this endorsement is attached provides primary or excess insurance, as indicated by “[X],” for thelimits shown: [ ] This insurance is primary and the company shall not be liable for amounts in excess of $ _____ for each accident. [X ] This insurance is excess and the company shall not be liable for amounts in excess of $ _4,000,000.__ for each
accident in excess of the underlying limit of $ _ for each accident. Whenever required by the Federal Motor Carrier Safety Administration (FMCSA), the company agrees to furnish theFMCSA a duplicate of said policy and all its endorsements. The company also agrees, upon telephone request by anauthorized representative of the FMCSA, to verify that the policy is in force as of a particular date. The telephonenumber to call is: (215) 399-2939 Cancellation of this endorsement may be effected by the company of the insured by giving: (1) thirty-five (35) days notice in writing to the other party (said 35 days notice to commence from the date the notice ismailed, proof of mailing shall be sufficient proof of notice), and (2) if the insured is subject to the FMCSA’s registrationrequirements under 49 U.S.C. 13901, by providing thirty (30) days notice to the FMCSA (said 30 days notice tocommence from the date the notice is received by the FMCSA at its office in Washington, D.C.).
Form MCS-90 (page 2 of 3)
DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions or which results in bodily injury, property damage, orenvironmental damage which the insured neither expected nor intended. Motor Vehicle means a land vehicle, machine, truck, tractor, trailer, or semi-trailer propelled or drawn by mechanicalpower and used on a highway for transporting property, or any combination thereof. Bodily Injury means injury to the body, sickness, or disease to any person, including death resulting from any of these. Property Damage means damage to or loss of use of tangible property. Environmental Restoration means restitution for the loss, damage, or destruction of natural resources arising out of theaccidental discharge, dispersal, release or escape into or upon the land, atmosphere, watercourse, or body of water, ofany commodity transported by a motor carrier. This shall include the cost of removal and the cost of necessary measurestaken to minimize or mitigate damage to human health, the natural environment, fish, shellfish, and wildlife. Public Liability means liability for bodily injury, property damage, and environmental restoration. The insurance policy to which this endorsement is attached provides automobile liability insurance and is amended toassure compliance by the insured, within the limits stated herein, as a motor carrier of property, with Sections 29 and 30of the Motor Carrier Act of 1980 and the rules and regulations of the Federal Motor Carrier Safety Administration(FMCSA). In consideration of the premium stated in the policy to which this endorsement is attached, the insurer (the company)agrees to pay, within the limits of liability described herein, any final judgment recovered against the insured for publicliability resulting from negligence in the operation, maintenance or use of motor vehicles subject to the financialresponsibility requirements of Sections 29 and 30 of the Motor Carrier Act of 1980 regardless of whether or not eachmotor vehicle is specifically described in the policy and whether or not such negligence occurs on any route or in anyterritory authorized to be served by the insured or elsewhere. Such insurance as is afforded, for public liability, does notapply to injury to or death of the insured's employees while engaged in the course of their employment, or propertytransported by the insured, designated as cargo. It is understood and agreed that no condition, provision, stipulation, orlimitation contained in the policy, this endorsement, or any other endorsement thereon, or violation thereof, shall relievethe company from liability or from the payment of any final judgment, within the limits of liability herein described,irrespective of the financial condition, insolvency or bankruptcy of the insured. However, all terms, conditions, andlimitations in the policy to which the endorsement is attached shall remain in full force and effect as binding between theinsured and the company. The insured agrees to reimburse the company for any payment made by the company onaccount of any accident, claim, or suit involving a breach of the terms of the policy, and for any payment that thecompany would not have been obligated to make under the provisions of the policy except for the agreement containedin this endorsement. It is further understood and agreed that, upon failure of the company to pay any final judgment recovered against theinsured as provided herein, the judgment creditor may maintain an action in any court of competent jurisdiction againstthe company to compel such payment. The limits of the company's liability for the amounts prescribed in this endorsement apply separately to each accidentand any payment under the policy because of any one accident shall not operate to reduce the liability of the company forthe payment of final judgmentsresulting from any other accident. THE SCHEDULE OF LIMITS SHOWN ON THE REVERSE SIDE DOES NOT PROVIDE COVERAGE. The limitsshown in the schedule are for information purposes only.
Form MCS-90 (page 3 of 3)
SCHEDULE OF LIMITS--PUBLIC LIABILITY
Type of carriage
Commodity transported
Jan. 1, 1985
(1) For-hire (In interstate orforeign commerce, with agross vehicle weight rating of10,000 or more pounds).
(2) For-hire and Private (Ininterstate, foreign orintrastate commerce, with agross vehicle weight ratingof 10,000 or more pounds).
(3) For-hire and Private (Ininterstate or foreigncommerce, in any quantity,or in intrastate commerce,in bulk only; with a grossvehicle weight rating of10,000 or more pounds). (4) For-hire and Private (Ininterstate or foreigncommerce, with a grossvehicle weight rating of lessthan 10,000 pounds).
Property (nonhazardous)
Hazardous substances, as defined in 49 CFR 171.8,transported in cargo tanks, portable tanks, or hopper-type vehicles with capacities in excess of 3,500water gallons; or in bulk Division 1.1., 1.2, and 1.3materials. Division 2.3, Hazard Zone A, or Division 6.1, Packing Group I, Hazard Zone A material; in bulk Division 2.1 or 2.2; or highway route controlled quantities of a Class 7 material, as defined in 49 CFR 173.403.
Oil listed in 49 CFR 172.101; hazardous waste, hazardous materials, and hazardous substances defined in 49 CFR 171.8 and listed in 49 CFR 172.101, but not mentioned in (2) above or (4) below. Any quantity of Division 1.1, 1.2, or 1.3 material; anyquantity of a Division 2.3, Hazard Zone A, or Division6.1, Packing Group 1, Hazard Zone A material; or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403.
$ 750,000
$5,000,000
$1,000,000
$5,000,000
COMMERCIAL AUTO CA 99 48 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CA 99 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
POLLUTION LIABILITY – BROADENED COVERAGE FOR COVERED AUTOS – BUSINESS AUTO AND
MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as
follows: 1. Paragraph a. of the Pollution Exclusion
applies only to liability assumed under a contract or agreement.
2. With respect to the coverage afforded by Paragraph A.1. above, Exclusion B.6. Care, Custody Or Control does not apply.
B. Changes In Definitions For the purposes of this endorsement, Paragraph D. of the Definitions Section is replaced by the following:
D. "Covered pollution cost or expense" means any cost or expense arising out of:
1. Any request, demand, order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or
2. Any claim or "suit" by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of "pollutants".
"Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants":
a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or
b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured".
Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if:
(1) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and
(2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage.
IWT Transport Inc.
306 Ramapo Valley Road
Oakland, NJ 07432
Policy #SISIPCA08323316
Policy Term 3/16/16 to 3/16/17
Strategic Insurance Partner Inc.
492 Franklin Ave
Nutley, NJ 07110
CERTIFICATE HOLDER
© 1988-2010 ACORD CORPORATION. All rights reserved.ACORD 25 (2010/05)
AUTHORIZED REPRESENTATIVE
CANCELLATION
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
LOCJECTPRO-POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
OCCURCLAIMS-MADE
COMMERCIAL GENERAL LIABILITY
GENERAL LIABILITY
PREMISES (Ea occurrence) $DAMAGE TO RENTEDEACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
$RETENTIONDED
CLAIMS-MADE
OCCUR
$
AGGREGATE $
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
INSRLTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF(MM/DD/YYYY)
POLICY EXP(MM/DD/YYYY) LIMITS
WC STATU-TORY LIMITS
OTH-ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe underDESCRIPTION OF OPERATIONS below
(Mandatory in NH)OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTOALL OWNED SCHEDULED
HIRED AUTOSNON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)PROPERTY DAMAGE $
$
$$
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSRADDL
WVDSUBR
N / A
$
$
(Ea accident)
(Per accident)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s).
The ACORD name and logo are registered marks of ACORD
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE(A/C, No, Ext):
PRODUCER
ADDRESS:E-MAIL
FAX(A/C, No):
CONTACTNAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.
6/30/2016
BB&T - The Addis Group2500 Renaissance Blvd Suite100King Of Prussia PA 19406-2639
Clean Earth Inc.334 South Warminster RoadHatboro PA 19040
Ironshore Specialty Insurance CompaZurich American Insurance Company oXL Specialty Insurance CompanySteadfast Insurance Company
25445
3788526387
27855
Christopher Bean610-279-8550 610-279-8543
150CLEANEAR
892666368
A 001087005 6/30/2016 6/30/2017 1,000,000
500,000
25,000
1,000,000
2,000,000
2,000,000
X
X
X
C
X
X X
AEC0047797 6/30/2016 6/30/2017 1,000,000
A X X 001087004 6/30/2016 6/30/2017 20,000,000
20,000,000
B
N
WC819647605 3/1/2016 3/1/2017 X
1,000,000
1,000,000
1,000,000AAD
Contractors PollutionPoll Legal/ProfesMotor Truck Cargo
001087005001087005CPP013465802
6/30/20166/30/20166/30/2016
6/30/20176/30/20176/30/2017
LimitLimitLimit
1,000,0001,000,000500,000
Named Insureds:Clean Earth, Inc.Advanced Remediation & Disposal Technologies, of DE, Inc.Allied Environmental Group, Inc.Carteret Asphalt Corp.Clean Earth of Carteret, Inc.See Attached...
IWT Transport, Inc. & Industrial Waste Technologies,Inc.; 306 Ramapo Valley Road, Ste 2Oakland NJ 07436
ACORD 101 (2008/01)The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
Clean Earth of Maryland, Inc.Clean Earth of New Castle, Inc.Clean Earth of North Jersey, Inc.Clean Earth of Philadelphia, Inc.Clean Rock Properties, LtdClean Earth Dredging Technologies, Inc.Advanced Remediation & Disposal Technologies of Delaware, LLCAllied Environmental Group, LLCClean Earth of Carteret, LLCClean Earth of New Castle, LLCClean Earth of Philadelphia, LLCClean Earth of Southeast Pennsylvania LLCClean Earth Dredging Technologies, LLCClean Earth of Maryland, LLCClean Earth of Southeast Pennsylvania, Inc.Clean Earth of Williamsport, LLCClean Earth of Southern Florida, LLCClean Earth of West Virginia, Inc.Clean Earth Environmental Services, Inc.Clean Earth of Georgia, LLCClean Earth of Greater Washington, LLCCEHI Acquisition CorporationAES Asset Acquisition CorporationAES Asset Acquisition Corporation dba AES Environmental, LLCAmerican Environmental Services, Inc.American Environmental, LLCAmerican Transportation Solutions, LLCClean Earth of Carteret, LLCdba Clean Earth of Connecticutdba Phoenix Soil - A Clean Earth Company Clean Earth of Alabama, Inc**AES Asset Acquisition Corporation/ AES/Clean Earth of Alabama Inc., Workers Compensation Policy is with AIG Insurance Company,Policy Number WC 012851831, Policy Period 7-8-16 through 7-8-17
IWT Transport, Inc., Industrial Waste Technologies, Inc and New Jersey Turnpike Authority, PO Box 5042-581Main St, Woodbridge, NJ 07095, its commissioners, officers, employees, & agents are named Additional Insured with regard to workperformed by the Named Insured under contract or agreement. A waiver of subrogation applies in favor of Additional Insured's. CertificateHolder Note: Coverage is primary and non-contributory.
11
Clean Earth Inc.334 South Warminster RoadHatboro PA 19040
150CLEANEAR
BB&T - The Addis Group
25 CERTIFICATE OF LIABILITY INSURANCE
' ® ACCORD CERTIFICATE OF LIABILITY INSURANCE ■■•■•-----
DATE (MWDDNYTY)
09/01/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
PHOENIX RISK MANAGEMENT, LLC PO BOX 8144, JERSEY CITY, NJ 07306
CONTACT NAME ANA PEGUERO PHO (Nc,
NE No, Bo): 201-668-5669 Wm, No): 201-624-7670
E-MAIL ADDRESS: PHOEN IXRM.PEGUEROaGMAIL.COM
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: US LIABILITY INSURANCE COMPANY INSURED
DOING IT RIGHT TECHNOLOGY, LLC EAB TRANSPORT, LLC. 182 HOWELL ST., JERSEY CITY, NJ 07306
INSURER E:
INSURER B: NATIONAL CONTINENTAL INSURANCE COMPANY INSURER C: NEW JERSEY CASUALTY INSURANCE CO. INSURER a LLOYDS OF LONDON
INSURER F:
IFICATE NUMBER:
103636
REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTA N, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LTR TYPE OF INSURANCE
ADDL INSR
SUBR WVD POLICY NUMBER
POLICY EFF (MWDDNYTY)
POLICY EXP (MWDDNYTY) UNITS
A GENERAL LIABILITY X CL1737342 02/05/2016 05/05/2017 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES RENTED PREMISES (Ea occurrence) $ 100,000
CLAIMS-MADE X OCCUR MED EXP (Any one person) 5 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ INCLUDED
—1 POLICY PRO- JECT LOC $
B AUTOMOBILE LIABILITY CNJ0005476573-6 02/05/2016 02/05/2017 CND (E
OMa acBIcidEent)SINGLE LIMIT $ 1,000,000
X
X
ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS
HIRED AUTOS X
SCHEDULED AUTOS rAIRJorINED
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $
$ UMBRELLA LIAB
EXCESS LIAB OCCUR
CLAIMS-MADE
EACH OCCURRENCE $
AGGREGATE
DED RETENTION $ $ C `-'
WORKERS COMPENSATION AND EMPLOYERS' LIABILITY M76564-4-15 07/13/2016 07/31/2017
WC STATU- TORY IM LIMITS I
I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH)
Y / N
N N / A E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
D PHYSICAL DAMAGE Z158324-006APD 08/04/2016 02/18/2017 $185,000 ACV WITH $1,000 DED. COMP & COLL.
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER
CANCELLATION
IWT TRANSPORT, INC. 306 RANAPO VALLEY ROAD OAKLANDM, NJ 07436
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
© 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD
B9 Negative Exposure Assessment
Negative Exposure Monitoring
A negative exposure assessment is not being submitted as part of the Work Plan. It is anticipated that due to the nature of the lead operation noted in the lead Work Plan, operations on the bridge exposures will likely exceed the OSHA action level of 30 µg/m3. Since this is the case, EnviroMed will perform sampling on contractor employees performing lead abatement activities that will be monitored for personal exposure in accordance with the OSHA Lead Standard 29 CFR 1926.62. In addition to worker personal lead and air sampling, wipe sampling of hands and equipment is also performed. A requirement in addition to OSHA sampling is that all workers within the restricted zone are required to wear protective clothing and respirators to minimize any contact with lead in accordance with the OSHA standard.