2-RFP 3829 Attachment B - EMWD Reporting Sample Form.pdf

PDF 5 MB Posted

Attached to
RFP-WM-3829 SEISMIC VALVE ANNUAL INSPECTION, CALIBRATION AND AS-NEEDED REPAIRS
Solicitation number
RFP-WM-3829
Issued by
Riverside County, California

About this file

Written by GovTribe AI ·

This document is an Attachment B Reporting Sample Form from the Eastern Municipal Water District (EMWD), designed for annual testing and reporting of water system components. The form provides a standardized template for documenting inspections of various site equipment, including actuators, Koso switches, air bottles, and regulators. The form allows for recording site-specific details such as site code, name, address, and city, along with technical inspection data like pressure settings (PSI), leak detection, and required repairs. Each row represents a potential site or inspection point, with columns for noting equipment status, leak detection, and any necessary repairs or comments.

The form is structured to capture comprehensive technical data during annual equipment testing, with placeholders for the testing company's information, including company name, address, contact details, and the technician's specifics. The default entries are set to "N/A" for most fields, indicating that the form is a blank template to be filled out during actual site inspections. The form appears to be part of EMWD's quality assurance and maintenance tracking process, enabling systematic documentation of infrastructure condition and potential maintenance needs across multiple sites or facilities.

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Other files

File Type Posted
1-RFP 3829 Required Submittals.pdf PDF
3-RFP 3829 - Attachment A - Non-Disclosure Agreement .pdf PDF
6-RFP 3829 Attachment C - EMWD Service Area.pdf PDF
5-RFP 3829 Seismic Valves Annual Inspection, Calibration and As-Needed Repairs.pdf PDF
4-RFP 3829 Exhibit A Price Form.pdf PDF

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ATTACHEMENT B - EMWD REPORTING SAMPLE FORM

SITE

CODE

SITE NAME

ADDRESS

CITY

Actuator

Koso Swtich

Air Bottle Regulator

Set Leaks

Detected Repairs Required Comments

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

______ PSI ______ PSI

Annual Testing conducted by Address:

Technicain Name:

Email Address:

Phone number:

Company Name:

Sheet2

Company Name:
Address:
Phone number:
Email Address:
Technicain Name:
PSI:
PSI_2:
CommentsPSI:
PSI_3:
PSI_4:
Repairs RequiredPSI_2:
CommentsPSI_2:
PSI_5:
PSI_6:
Repairs RequiredPSI_3:
CommentsPSI_3:
PSI_7:
PSI_8:
Repairs RequiredPSI_4:
CommentsPSI_4:
PSI_9:
PSI_10:
Repairs RequiredPSI_5:
CommentsPSI_5:
PSI_11:
PSI_12:
Repairs RequiredPSI_6:
CommentsPSI_6:
PSI_13:
PSI_14:
Repairs RequiredPSI_7:
CommentsPSI_7:
PSI_15:
PSI_16:
Repairs RequiredPSI_8:
CommentsPSI_8:
PSI_17:
PSI_18:
Repairs RequiredPSI_9:
CommentsPSI_9:
PSI_19:
PSI_20:
Repairs RequiredPSI_10:
CommentsPSI_10:
PSI_21:
PSI_22:
Repairs RequiredPSI_11:
CommentsPSI_11:
PSI_23:
PSI_24:
Repairs RequiredPSI_12:
CommentsPSI_12:
Repairs RequiredPSI:
Dropdown8:
0: [N/A]
1: [N/A]
2: [N/A]
3: [N/A]
4: [N/A]
5: [N/A]
6: [N/A]
7: [N/A]
8: [N/A]
9: [N/A]
10: [N/A]
11: [N/A]
Dropdown7:
0:
0: [N/A]
1: [N/A]
1:
0: [N/A]
1: [N/A]
2:
0: [N/A]
1: [N/A]
3:
0: [N/A]
1: [N/A]
4:
0: [N/A]
1: [N/A]
5:
0: [N/A]
1: [N/A]
6:
0: [N/A]
1: [N/A]
7:
0: [N/A]
1: [N/A]
8:
0: [N/A]
1: [N/A]
9:
0: [N/A]
1: [N/A]
10:
0: [N/A]
1: [N/A]
11:
0: [N/A]
1: [N/A]

File details come from the government source that posted it. Updated .