Airfield Data Entry Form -- HEADER SHEET
Unit:
Airfield ID # :
Airfield Name:
Location:
Airfield Type.:
Size (GSF):
Maintenance Level:
Remoteness Factor:
1
Historic :
Inspector Name:
Inspection Date:
Year Constructed:
Year Surveyed:
Benefitting Function:
(Fill in: If Roaded Remote, 1.15; Wilderness/Primitive Remote, 1.5; Historic,
1.5; Roaded Remote & Historic, 1.65; Wilderness Remote & Historic, 2.00)
(Fill in: E=eligible, I=ineligible, L=listed, U=undetermined)
NFFA
(Fill in: NFFA(facilities), QMQM(quarters), NFRM(recreation),
NFFV(reforestation), NFRV(range), NFHR(heritage), etc.)
NOTE: Information entered on this sheet is automatically transferred to the following spreadsheets.
Data Entry Form -- ANNUAL MAINTENANCE
Unit:
Benefitting function:
Maintenance Level:
Remoteness Factor =
0
NFFA
0
1
Airfield Type: 0
Location: 0
Airfield ID #:
Airfield Name:
Size (GSF):
Historic :
0
0
0
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Quantity
101000 GENERAL AND SITE WORK
Inspector Name: 0
Inspection Date: 01/00/00
Year Constructed:
0
Year Surveyed:
0
0
Units
Cost/unit
General and Site Work Totals:
Annual Maint Cost
H&S
Res
$0
$0
Priority for
Funding
Mis
$0
Division 1 - General
General
Management
Other
Other
Division 2 - Site Work
Taxiways, Parking
Sidewalks, Trails
Signage, Exterior
Site Drainage
Landscaping
Irrigation System
Fences, Guard rails
Utilities
Sod Runway
Other
Misc. Annual Maintenance and Repair (Small Items, Break Downs) aviation - .0005
Costs is per s.f. of airfield area
Direct costs only including specific proj prep, procurement, and, Contract
Administration ( .0002 per s.f. of airfield area )
Seal Coat, Repaving, Restripping, Grading, Rock Replacement, etc ( .04 / s.f. of
taxiway)
PMR&R ( .18 / s.f. of walk or trail)
PMR&R ( actual-site specific )
Culvert, Catch Basin, Ditch Clearing ( actual-site specific )
Tree Removal, Trimming, Plant Replacement ( actual-site specific ) (not lawn mowing
or upkeep of grounds)
PMR&R ( actual-site specific )
PMR&R ( actual-site specific )
PMR&R (Not utility bills) - included in water and wastewater
Grading, etc. (.002/s.f.)
202000 ARCHITECTURAL WORK (Divisions 3 to 14)
DO NOT INCLUDE BUILDINGS. EACH BUILDING WILL BE ENTERED SEPARATELY.
Division 3 - Concrete
Concrete Slabs
Retaining Walls
Precast, etc.
Other
Other
Division 4 - Masonry
Retaining Walls
Veneer, panels, etc.
Other
Other
Division 5 - Metals
Structural, Ornamental (See Painting)
Rails, Posts, etc.
Other
Other
Division 6 - Wood
Miscellaneous
Other
Division 7 - Thermal & Moisture Protection
Not Applicable to Airfields
Division 8 - Doors & Windows
Not Applicable to Airfields
Division 9 - Finishes
Painting-Exterior
Other
0 SF-Airfield Area
$0.0005
$0
7
0 SF-Flr Area
$0.0002
$0
$0
$0
$0
7
7
7
$0.04
$0.18
$0
$0
$0
$0
7
7
7
7
$0
$0
$0
$0
$0
$0
7
7
7
7
7
7
SF
SF
EA
Site
Site
Site
LF
EA
SF
$0.002
Architectural Totals:
PMR&R
PMR&R ( actual-site specific )
PMR&R ( actual-site specific )
SF-Slab Area
SF
SF
PMR&R (CMU - .03 s.f of wall area, BRICK - .20 s.f of wall area, STONE - .33 s.f. of
wall area)
Brick .27 and stone .50 per s.f. of wall area
SF-Flr Area
SF-Wall Area
PMR&R ( actual-site specific )
PMR&R ( actual-site specific )
PMR&R ( actual-site specific )
Repaint every 5-10 years ( .10 s.f.)
$0.02
$0
$0
$0
$0
$0
$0
$0
7
7
7
7
7
$0
$0
$0
7
7
7
EA
EA
$0
$0
$0
$0
7
7
7
7
EA
$0
$0
7
7
$0
7
SF
Page 2
$0
$0.10
$0
7
$0
$0
7
7
9/3/2004
Data Entry Form -- ANNUAL MAINTENANCE
Unit:
Benefitting function:
Maintenance Level:
Remoteness Factor =
0
NFFA
0
1
Airfield Type: 0
Location: 0
Airfield ID #:
Airfield Name:
Size (GSF):
Historic :
0
0
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Quantity
Other
Division 10 - Specialties
Flag Pole
Wind Sock & Pole
Fire Extinguishers
Bulletin Boards
Other
Other
Division 11 - Equipment
Specialty Equipment
Other
Other
Division 12 - Furnishings
Not Applicable to Airfields
Division 13 - Special Construction
Lookout Towers
Other
Other
Division 14 - Conveying Systems
Hoists, Cranes
Other
Other
PMR&R ( $100.00 per year)
PMR&R ( $100.00 per year)
One year & Five year inspections/tests ($15.00 per extinguisher)
PMR&R ($30.00 per year)
Units
Cost/unit
Ea
Ea
Ea
Ea
Annual Maint Cost
H&S
Res
$100.00
$100.00
$15.00
$30.00
PMR&R ( actual-site specific )
PMR&R, Rails, Guys, Anchors, etc. ( $3000.00 L.S. per lookout)
Lookout
$3,000.00
PMR&R, Inspections ( actual-site specific )
315000 MECHANICAL WORK
Mechanical Totals:
Division 15 - Mechanical
Plumbing
Seasonal Start Up & Shut Down
Hose Bibs, Fountains
Backflow Preventer
Gas Piping
Water Meters
Air Compressors
Other
Other
PMR&R
PMR&R ( $600.00 per year )
PMR&R ( $10.00 per year)
PMR&R, Inspections, Tests ( included in water systems)
PMR&R ( $20.00 )
PMR&R
PMR&R
416000 ELECTRICAL WORK
$0
Ea
Ea
$600.00
$10.00
LS
Ea
$20.00
Electrical Totals:
Division 16 - Electrical
Power Distribution, Cables, Transformers
Meters, Switchgear, Breakers, Fuses
$0
PMR&R, Bulbs, Ballasts, Cleaning ( .13 per s.f. of floor area, includes next two items
)
PMR&R ( actual-site specific )
PMR&R, Testing ( actual-site specific )
SF-Flr Area
Priority for
Funding
Mis
$0
7
$0
$0
$0
$0
$0
$0
7
7
7
7
7
7
$0
$0
$0
7
7
7
$0
7
$0
$0
$0
$0
$0
$0
$0
7
7
7
$0
$0
$0.13
7
7
7
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
PMR&R ( actual-site specific )
Lighting-Exterior
Lightening Rod Protection System
Stand By Generator
Other
Other
Location Factor or Multiplier =
Inspector Name: 0
Inspection Date: 01/00/00
Year Constructed:
0
Year Surveyed:
0
0
7
7
7
7
7
7
7
7
7
$0
$0
$0
7
7
$0
$0
$0
$0
$0
7
7
7
7
7
1
TOTAL
Page 3
$0
$0
$0
9/3/2004
Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Remoteness Factor =
Benefitting Function: NFFA
0
Airfield Type:
Location:
Maintenance Level: 0
1
0 Airf'ld ID #: 0
0 Bldg Name:
Size (GSF): 0
Historic :
Inspector Name: 0
Inspection Date: 1/0/1900
0
Year Constructed:
0
Year Surveyed:
0
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
Measurements
CSI Division
Description
Deficiencies
Quantity
Units
Cost/unit
101000 GENERAL AND SITE WORK
General and Site Work Totals:
Deferred Maint Cost
H&S
Res
Mis
$0
$0
Priority for
Funding
$0
Division 1 - General
Other
Other
Division 2 - Site Work
Taxiways, Parking
Sidewalks, Trails
Signage, Exterior
Site Drainage
Landscaping
Irrigation System
Fences, Guard rails
Utilities
0
0
Seal Coat, Repaving,
Restripping, Grading,
Rock Replacement, etc
(.89 s.f. of taxiway)
( 4.38 / s.f. of walk or
trail)
( actual-site specific )
Culvert, Catch Basin,
Ditch Clearing (actualsite specific )
Tree Removal,
Trimming, Plant
Replacement ( actualsite specific ) (not lawn
mowing or upkeep of
grounds)
( actual-site specific )
( actual-site specific )
(Not utility bills) included in water and
wastewater
SF
$0.89
0
SF
EA
$4.38
0
0
Site
0
Site
Site
LF
0
0
0
EA
0
0
0
Other
Other
202000 ARCHITECTURAL WORK (Divisions 3 to 14)
Architectural Totals:
DO NOT INCLUDE BUILDINGS . EACH BUILDING WILL BE ENTERED SEPARATELY.
Division 3 - Concrete
Concrete Slabs
( 2.00 s.f )
( actual-site specific )
Retaining Walls
( actual-site specific )
Precast, etc.
Other
Other
0 SF
SF
SF
Page 4
$0
$2.00
$0
$0
0
0
0
0
0
9/3/2004
Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Remoteness Factor =
Benefitting Function: NFFA
0
Airfield Type:
Location:
Maintenance Level: 0
1
0 Airf'ld ID #: 0
0 Bldg Name:
Size (GSF): 0
Historic :
Inspector Name: 0
Inspection Date: 1/0/1900
Year Constructed:
0
Year Surveyed:
0
0
0
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
Measurements
CSI Division
Description
Deficiencies
Quantity
Units
Cost/unit
Deferred Maint Cost
H&S
Res
Mis
Priority for
Funding
Division 4 - Masonry
Retaining Walls
(CMU - 3.00 s.f of wall
area, STONE - 11.06
s.f. of wall area, BRICK 6.75 s.f. of wall area)
Veneer, panels, etc.
25.00 per s.f. of wall
area
SF-Wall Area
( actual-site specific )
( actual-site specific )
EA
EA
Other
Other
Division 5 - Metals
Structural, Ornamental (See Painting)
Rails, Posts, etc.
Other
Other
Division 6 - Wood
Miscellaneous
Other
Other
Division 7 - Thermal & Moisture Protection
Not Applicable to Airfields
Division 8 - Doors & Windows
Not Applicable to Airfields
Division 9 - Finishes
Painting-Exterior
Other
Other
Division 10 - Specialties
Flag Pole
Wind Sock & Pole
Bulletin Boards
Other
Other
Division 11 - Equipment
Specialty Equipment
Other
Other
Division 12 - Furnishings
Not Applicable to Airfields
Division 13 - Special Construction
0 SF
0
0
0
0
0
(actual-site specific)
$0.00
0
0
0
0
0
0
.77 per s.f of wall area
SF-Wall Area
$1500.00 per pole
$1500.00 per pole
( actual-site specific )
Ea
Ea
Ea
( actual-site specific )
$0.77
0
0
0
$1,500.00
$1,500.00
0
0
0
0
0
0
0
0
0
Page 5
9/3/2004
Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Remoteness Factor =
Benefitting Function: NFFA
0
Airfield Type:
Location:
Maintenance Level: 0
1
0 Airf'ld ID #: 0
0 Bldg Name:
Size (GSF): 0
Historic :
Inspector Name: 0
Inspection Date: 1/0/1900
Year Constructed:
0
Year Surveyed:
0
0
0
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
Measurements
CSI Division
Description
Deficiencies
Quantity
Units
Cost/unit
Deferred Maint Cost
H&S
Res
Mis
Priority for
Funding
Rails, Guys, Anchors,
etc. ( actual-site
specific)
Lookout Towers
0
0
0
Other
Other
Division 14 - Conveying Systems
Inspections ( actualsite specific )
Hoists, Cranes
0
0
0
Other
Other
315000 MECHANICAL WORK
Mechanical Totals:
Division 15 - Mechanical
Plumbing
Hose Bibs, Fountains
Backflow Preventer
Water Meters
Air Compressors
Other
Other
($100.00)
($755.00)
( actual-site specific )
( actual-site specific )
Ea
Ea
Ea
416000 ELECTRICAL WORK
$0
$0
0
0
0
0
0
0
0
$100.00
$755.00
Electrical Totals:
Division 16 - Electrical
Power Distribution, Cables, Transformers
Meters, Switchgear, Breakers, Fuses
Lighting-Exterior
Lightening Rod Protection System
Stand By Generator
Other
Other
Location Factor or Multiplier =
$0
$0
$0
$0
( actual-site specific )
($150.00 ea.)
( actual-site specific )
( actual-site specific )
EA
0
0
0
0
0
0
0
$150.00
1
TOTAL
Page 6
$0
$0
$0
9/3/2004
Data Entry Form -- W.O. Summary
ID #:
Name:
Type:
Benef.Funct.:
Item
Size (GSF):
Inspection Date:
Inspector Name:
0
0
0
NFFA
Description
Quantity
Unit Cost
0
1/0/1900
0
0
0
Maintenance Level:
Year Surveyed:
Cost Data: Means
Annual Maint. Cost
Total
H&S
Res.
Mis.
Total
Year constructed: 0
Historical: 0
Age (years): 0
H&S
9/3/2004
Critical
Deferred Maint. Cost
Res.
Mis.
Project Number
101000 SITE WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
202000 ARCHITECTURAL WORK (Divisons 3 to 14)
$0
$0
$0
$0
$0
$0
$0
$0
$0
315000 MECHANICAL WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
416000 ELECTRICAL WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
Total
Annual Maintenance Grand Total:
$0
$0 = Deferred Maintenance Grand Total
Form adapted from Means Facilities Maintenance Standards, 1988 edition by R.S. Means Company, Inc.
Page 7
9/3/2004