AF IMT 103 at a glance
What it is: AF IMT 103 is the Base Civil Engineering Work Clearance Request.
Who signs: In 5, the requesting official signs.
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.
A filled-in AF IMT 103 example: a base engineer requests clearance for pavement work
How to fill out AF IMT 103, box by box
Date prepared and the work to be cleared
Enter the DATE PREPARED at the top of the form.
In 1, enter the work at which clearance is requested to proceed, the Work Order No. and the Contract No., involving excavation or utility disturbance per attached sketch. Mark has or has not for this area staked or clearly marked.
Type of facility or work involved and the dates
In 2, TYPE OF FACILITY/WORK INVOLVED, mark A. PAVEMENTS, B. DRAINAGE SYSTEMS, C. RAILROAD TRACKS, D. FIRE DETECTION & PROTECTION SYSTEMS, OVERHEAD or UNDERGROUND, G. aircraft or vehicular traffic flow, H. SECURITY or OTHER. Enter in 3 the DATE CLEARANCE REQUIRED and in 4 the DATE OF CLEARANCE.
Signature of requesting official, telephone and organization
Sign the signature of the requesting official in 5, enter the telephone no. in 6 and the organization in 7.
Reviewer's name and initials for each organization
In 8, each organization has remarks (Use Reverse for additional comments) and reviewer's name and initials: electrical distribution, steam distribution, water distribution, POL distribution, sewer distribution, environmental, pavements/ grounds, fire protection, zone and other (Specify).
Boxes 9 to 13 are security police, safety, communications, base operations and cable TV.
Commercial utility company and other
In 14, COMMERCIAL UTILITY COMPANY is TELEPHONE, Gas or ELECTRIC.
In 15, OTHER (Specify).
Requested clearance and the approving officer
In 16, the approving officer marks REQUESTED CLEARANCE APPROVED or DISAPPROVED.
In 17, the approving officer enters the TYPED NAME AND SIGNATURE (Chief of Operations Flight or Chief of Engineering Flight) and, in 17a, the DATE SIGNED.
More rules for AF IMT 103
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.
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.
In 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.
Sources
[1] AF IMT 103 (19940801, V3), Base Civil Engineering Work Clearance Request, Kadena Air Base (the Official source link on this page).