A01.12 Eng_Form_6048 Munitions Response .pdf

Please wait...

If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.

ENG FORM 6048, JUN 2013

PREVIOUS EDITIONS ARE OBSOLETE.

Page of

ENG FORM 6048, JUN 2013

Page of

US ARMY CORPS OF ENGINEERS (USACE)

MUNITIONS RESPONSE

QUALITY ASSURANCE REPORT (QAR) FORM

The proponent agency is CESO. See instructions on page 2.

10. DISTRIBUTED TO (check boxes and insert individual’s name)

11. RESPONSE DUE DATE (Based on type of nonconformance, IF REQUIRED)

14. DEFICIENCY TYPE (select one)

20. The Contractor will provide the following information to the Contract Specialist by the “Response Due” date above.

Please contact the Contracting Officer’s Representative (COR) or Project Manager if you have any questions.

b. Contractor Representative’s Authentication (form must be signed before returning)

e. Close Out Name Title Date

(YYYY-MM-DD)

Signature

(1) Contractor Notified

(3) Contracting Officer or COR

(2) USACE PDT Representative

INSTRUCTIONS FOR ENG FORM 6048

Block 1. Report number.

Block 2. Name of USACE representative conducting the quality assurance (QA) activity.

Block 3. Date QA Activity completed.

Block 4. Project Name, i.e., “Camp Swampy (MRS-02).

Block 5. Project Location, i.e., “Smithville, Alaska”.

Block 6. Weather conditions, if applicable.

Block 7. Contractor and/or subcontractor executing the work.

Block 8. Contract number.

Block 9. Task Order number.

Block 10. List by name all official recipients of the QAR. At a minimum, the District Program/Project Manager must be selected.

Block 11. Enter the date that the contractor is to respond, if applicable.

Block 12. List all QA-related activities, inspections, audits conducted, operations observed, etc. Include specific references to applicable government quality requirements, i.e., Quality Assurance Surveillance Plans, Department of Defense, Army, and/or USACE requirements, policy, guidance, etc., requiring the inspection/audit being conducted. For example: “Spot-checked inventory of demolition explosives as required by the project QASP and approved Explosives Safety Submission (ESS).”

Block 13. Describe results and observations of each QA activity conducted. Attach discipline-specific checklists/documentation used. All deficiencies noted must include reference to the specific regulation or requirement that was violated. For example: “Demolition explosives stored on site were not inventoried weekly in accordance with ESS paragraph 4.2 and Work Plan paragraph 5.4. Last inventory was conducted 3 weeks ago on xx Feb 2013.”

Block 14. Select the type of deficiency, if any, observed. Use contract-specific definitions if available, or use the following general definitions:

a. Check the appropriate box.

b. Critical: A deficiency that is likely to result in hazardous or unsafe conditions for individuals using, maintaining, or depending upon the supplies or services; or is likely to prevent performance of a vital agency mission.

c. Major: A deficiency, other than critical, that is likely to result in failure of the supplies or services, or to materially reduce the usability of the supplies or services for their intended purpose.

d. Minor: A deficiency that is not likely to materially reduce the usability of the supplies or services for their intended purpose or is a departure from established standards having little bearing on the effective use or operation of the supplies or services.

Block 15. Date the USACE Representative signs.

Block 16. QA representative’s signature.

Block 17. Contractor Representative’s printed name.

Block 18. Date Contractor Representative signs.

Block 19. Contractor representative signature. Signature does not indicate concurrence with stated findings, only that contractor has received the report.

Block 20a. Contractor indicates action(s) taken to determine cause of the deficiency, action taken to correct immediate deficiency, and action taken to prevent a recurrence of the deficiency. Include dates of actions taken and a schedule for completion of planned actions.

Block 20b. Contractor representative’s printed name, title, date signed, and signature.

Block 20c. Indicate government acceptance of contractor’s actions to correct identified deficiencies.

Block 20d. Indicate negative government actions taken as a result of the deficiency.

Block 20e. Signature of contractor, PDT representative and contracting officer or COR indicating close out for all deficiencies indicated.

2.0

18 JAN 2013

Cyndie Coppenbarger 2013-05-22 ACE-IT Forms Team

MUNITIONS RESPONSE QUALITY ASSURANCE REPORT (QAR) FORM