Atch 6-DD_Form_1812.pdf
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- Attached to
- DPM Packing and Containerization Federal contract opportunity
- Solicitation number
- FA558725R0095
About this file
This is DD Form 1812 (February 2024 version), titled "Facility Inspection Report," which is used to document inspections of storage facilities for military household goods and personal property. The form consists of 18 sections covering various inspection areas including pre/post storage services, administration, storage methods and operations, fire prevention/housekeeping, and facility practices.
The form uses a point-based rating system (1-3 points) to assess deficiencies, with higher points indicating more serious findings. Critical items marked with asterisks (*) can result in contract/TOS interruption regardless of overall rating. The overall quality control rating ranges from A (0 points) to D (17+ points). The form requires signatures from both the Service Provider (SP) representative and DOD representative, and includes sections for documenting facility details, fire systems, lot numbers, and corrective actions needed. When completed, the form is retained by the Inspection Agency/DPMO with copies provided to the SP and responsible TO/DPMO.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| DPM Solicitation Questions Rev 1.docx | DOCX document | |
| Combined Synopsis Solicitation - FA558725R0095 Rev 2.docx | DOCX document | |
| Combined Synopsis Solicitation - FA558725R0095 Rev 1.docx | DOCX document | |
| DPM Solicitation Questions.docx | DOCX document | |
| Atch 2- Pricing Schedule Revision 1.xlsx | XLSX spreadsheet | |
| Atch 1_DPM PWS.pdf | ||
| Atch 4-_DD_Form_1811.pdf | ||
| Atch 2- Pricing Schedule.xlsx | XLSX spreadsheet | |
| Atch 7-Historical_Quantity_Variance_DPM_2020-2024.xlsx | XLSX spreadsheet | |
| Atch 5- DTR Part IV Appendix E.pdf | ||
| Atch 8 - Applicable Clauses and Provisions.pdf | ||
| Atch 3 - DTR_Part_IV_Appendix_D.pdf | ||
| Combined Synopsis Solicitation - FA558725R0095.pdf |
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Text version
PREVIOUS EDITION IS OBSOLETE.DD FORM 1812, FEB 2024
FACILITY INSPECTION REPORT
(Read Instructions on back before completing form.)
1.a. TRIP NUMBER:
1.b. (X as applicable)
NTS DPMO
SIT TO
2. DATE OF INSPECTION
(DDMMYYYY)
3. SERVICE PROVIDER (SP)
3.a. NAME:
3.b. ADDRESS:
4.a. ADDRESS OF FACILITIES 4.b. FIRE SYSTEM/CLASS
SS/1 USS/2 D & R/3
4.c. NO. OF
LOTS
d.
WEIGHT
5. CONTRACT/TOS NUMBER 6. STATUS (X as applicable)
ACTIVE INACTIVE NON-USE
7. CURRENT CONTRACT OR
TOS ON FILE (X as applicable)
YES NO
8. PRE AND POST STORAGE SERVICES
8.a. Unauthorized equipment in use (1) 8.b. Unauthorized cartons and packaging used (1) 8.c. Improper packing/sealing/marking of cartons (1) 8.d. Pickup service not accomplished on time (1) 8.e. Improper loading/unloading of van/pallet (1) 8.f. Disassembled parts not packaged/inventoried (1) 8.g. Inventory stickers on finished surfaces (1) 8.h. Improper appliance servicing/labeling (1) 8.i. Smoking observed at residence* (3) 8.j. Employees on duty not efficient/neat (1) 8.k. Origin premises not left in good order (1) 8.l. Destination services improperly performed (1) 8.m. Deviations to service order (1) 8.n. Delivery service not accomplished on time (1)
9. ADMINISTRATION
9.a. Incorrect inventory preparation (1) 9.b. No separate weight ticket and certificate/PBP&E/WT (1) 9.c. Incorrect facility receipt preparation (1) 9.d. Ineffective locator system* (3) 9.e. Contract supporting paperwork needed (1)
10. STORAGE METHODS AND OPERATION
10.a. Consigned lots not stored within 3 days* (2) 10.b. Improper storage, stacks/pallets (2) 10.c. Finished surfaces not protected by pads/wrap (2) 10.d. Lots and separated pieces not elevated 2 inches (2) 10.e. Lots stored against exterior walls (1) 10.f. Lawnmowers not stored at base level of lot (1) 10.g. Improper firearms control* (3) 10.h. Loose stack storage over 10 feet* (2) 10.i. Improper storage of upholstered pieces* (2) 10.j. Improper storage of rugs/pads* (2) 10.k. Improper piano/organ storage (1)
10. STORAGE METHODS AND OPERATION (Continued) 10.l. Improper storage of mattresses (1) 10.m. Segregated pieces not properly identified (2) 10.n. Improper packing of mirrors/glass table tops (1) 10.o. Inadequate protection against mold/mildew (2) 10.p. Aisles being used to process goods in/out (1) 10.q. Previous discrepancies not corrected* (3)
11. FIRE PREVENTION AND HOUSEKEEPING
11.a. Electric/heat/water systems require repair (1) 11.b. Evidence of smoking in facility or within 50 feet* (3) 11.c. Unauthorized items stored* (3) 11.d. Improper aisle and/or stacking clearance (1) 11.e. No fire system inspection* (3) (DDMMYYYY) 11.f. No fire extinguisher inspection (3) (DDMMYYYY) 11.g. No extinguishers on facility equipment (2) 11.h. Trash/debris in storage area (2) 11.i. Fire doors inoperable/in need of repair (3) 11.j. No fire plan posted (1) 11.k. Space heaters/extension cords being used (1) 11.l. Gas and oil not drained from motorized items (2) 11.m. Hazards noted within 20 feet of facility* (2) 11.n. Flammables/combustibles found in facility* (3)
12. FACILITY PRACTICES
12.a. Inadequate security/alarm* (3) (DDMMYYYY) 12.b. Inadequate loading/unloading area (1) 12.c. Structural deficiencies (doors/floors/roof/walls/windows)* (3) 12.d. Inadequate protection from sun/dust/heat/cold/moisture (2) 12.e. Lack of insect/rodent control (2) (DDMMYYYY) 12.f. Vehicles parked in storage area* (3) 12.g. Commingled storage with undesirable commodities (2) 12.h. Multiple occupancy* (3) 12.i. Weight stored in excess of authorized limit* (2)
13. REMARKS
14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE FROM BLOCKS 8-12 ABOVE 14.a. No deficiencies observed. A: 0 B: 1 - 8 C: 9 - 16 D: 17 & OVER 14.b. Corrective action without report is required as soon as possible.
14.c. Corrective action, confirmed in writing/Email, is required by: (DDMMYYYY)
Send notice of corrective action to: Email: ATTN: Phone:
14.d. In non-use from further business as of: (DDMMYYYY) 14.e. Continued non-use from further initial service orders.
15. DOCUMENT FILES CHECKED 16. LOT NUMBERS CHECKED
17. SP OPERATING REPRESENTATIVE
17.a. NAME (Last, First, Middle)
17.b. SIGNATURE
17.c. TITLE
17.d. DATE (DDMMYYYY)
18. DOD REPRESENTATIVE
18.a. NAME (Last, First, Middle)
18.b. SIGNATURE 18.c. DATE (DDMMYYYY)
DD FORM 1812 (BACK), FEB 2024
INSTRUCTIONS
This form will be retained by the Inspection Agency/DPMO. A copy will be furnished to the SP for their records and to the responsible TO/DPMO for information purposes.
BLOCKS 8 - 12: When a discrepancy exists, it will be rated by using the numbers of 1, 2, and 3, reflecting the ascending seriousness of the findings, which are defined following each discrepancy in blocks 8-12 above. The rating will be indicated in the block preceding the violation. If needed, include additional remarks to clarify the deficiencies in Blocks 13 and 19 (if needed). Items marked by an asterisk (*) are applicable by the judgment of the inspector to interrupt the Contract or TOS with or without the quality control rating of total assessed points.
BLOCK 13: Utilized when content will not fit within another block/fleld or additional remarks are warranted or required.
BLOCK 14: An assigned rating of A - D for administrative action corresponds to the total number of points given during the inspection.
If Block 14c. is checked, inspector must complete the required fields ensuring the SP understands the suspense date for corrective action and contact information for reply.
BLOCK 19: This block is utilized when a continuation of Block 13 is needed or required for additional remarks to facilitate completing this form.
19. REMARKS (BLOCK 13 CONTINUATION)
DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
DD FORM 1812, FEB 2024
DD FORM 1812 (BACK), FEB 2024
FACILITY INSPECTION REPORT
(Read Instructions on back before completing form.)
1.b. (X as applicable)
3. SERVICE PROVIDER (SP)
4.a. ADDRESS OF FACILITIES 4.b. FIRE SYSTEM/CLASS
SS/1
USS/2
D & R/3 4.c. NO. OF LOTS d.
WEIGHT
6. STATUS (X as applicable)
7. CURRENT CONTRACT OR TOS ON FILE (X as applicable)
8. PRE AND POST STORAGE SERVICES
8.a. Unauthorized equipment in use (1) 8.b. Unauthorized cartons and packaging used (1) 8.c. Improper packing/sealing/marking of cartons (1) 8.d. Pickup service not accomplished on time (1) 8.e. Improper loading/unloading of van/pallet (1) 8.f. Disassembled parts not packaged/inventoried (1) 8.g. Inventory stickers on finished surfaces (1) 8.h. Improper appliance servicing/labeling (1) 8.i. Smoking observed at residence* (3) 8.j. Employees on duty not efficient/neat (1) 8.k. Origin premises not left in good order (1) 8.l. Destination services improperly performed (1) 8.m. Deviations to service order (1) 8.n. Delivery service not accomplished on time (1)
9. ADMINISTRATION
9.a. Incorrect inventory preparation (1) 9.b. No separate weight ticket and certificate/PBP&E/WT (1) 9.c. Incorrect facility receipt preparation (1) 9.d. Ineffective locator system* (3) 9.e. Contract supporting paperwork needed (1)
10. STORAGE METHODS AND OPERATION
10.a. Consigned lots not stored within 3 days* (2) 10.b. Improper storage, stacks/pallets (2) 10.c. Finished surfaces not protected by pads/wrap (2) 10.d. Lots and separated pieces not elevated 2 inches (2) 10.e. Lots stored against exterior walls (1) 10.f. Lawnmowers not stored at base level of lot (1) 10.g. Improper firearms control* (3) 10.h. Loose stack storage over 10 feet* (2) 10.i. Improper storage of upholstered pieces* (2) 10.j. Improper storage of rugs/pads* (2) 10.k. Improper piano/organ storage (1)
10. STORAGE METHODS AND OPERATION (Continued) 10.l. Improper storage of mattresses (1) 10.m. Segregated pieces not properly identified (2) 10.n. Improper packing of mirrors/glass table tops (1) 10.o. Inadequate protection against mold/mildew (2) 10.p. Aisles being used to process goods in/out (1) 10.q. Previous discrepancies not corrected* (3)
11. FIRE PREVENTION AND HOUSEKEEPING
11.a. Electric/heat/water systems require repair (1) 11.b. Evidence of smoking in facility or within 50 feet* (3) 11.c. Unauthorized items stored* (3) 11.d. Improper aisle and/or stacking clearance (1) 11.e. No fire system inspection* (3)
(DDMMYYYY)
11.f. No fire extinguisher inspection (3)
(DDMMYYYY)
11.g. No extinguishers on facility equipment (2) 11.h. Trash/debris in storage area (2) 11.i. Fire doors inoperable/in need of repair (3) 11.j. No fire plan posted (1) 11.k. Space heaters/extension cords being used (1) 11.l. Gas and oil not drained from motorized items (2) 11.m. Hazards noted within 20 feet of facility* (2) 11.n. Flammables/combustibles found in facility* (3)
12. FACILITY PRACTICES
12.a. Inadequate security/alarm* (3)
(DDMMYYYY)
12.b. Inadequate loading/unloading area (1) 12.c. Structural deficiencies (doors/floors/roof/walls/windows)* (3) 12.d. Inadequate protection from sun/dust/heat/cold/moisture (2) 12.e. Lack of insect/rodent control (2)
(DDMMYYYY)
12.f. Vehicles parked in storage area* (3) 12.g. Commingled storage with undesirable commodities (2) 12.h. Multiple occupancy* (3) 12.i. Weight stored in excess of authorized limit* (2)
14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE FROM BLOCKS 8-12 ABOVE 14.a. No deficiencies observed.
14.b. Corrective action without report is required as soon as possible.
14.c. Corrective action, confirmed in writing/Email, is required by: (DDMMYYYY) Send notice of corrective action to:
Email:
ATTN:
Phone:
14.d. In non-use from further business as of: (DDMMYYYY) 14.e. Continued non-use from further initial service orders.
17. SP OPERATING REPRESENTATIVE
18. DOD REPRESENTATIVE
INSTRUCTIONS
This form will be retained by the Inspection Agency/DPMO. A copy will be furnished to the SP for their records and to the responsible TO/DPMO for information purposes.
BLOCKS 8 - 12: When a discrepancy exists, it will be rated by using the numbers of 1, 2, and 3, reflecting the ascending seriousness of the findings, which are defined following each discrepancy in blocks 8-12 above. The rating will be indicated in the block preceding the violation. If needed, include additional remarks to clarify the deficiencies in Blocks 13 and 19 (if needed). Items marked by an asterisk (*) are applicable by the judgment of the inspector to interrupt the Contract or TOS with or without the quality control rating of total assessed points.
BLOCK 13: Utilized when content will not fit within another block/fleld or additional remarks are warranted or required.
BLOCK 14: An assigned rating of A - D for administrative action corresponds to the total number of points given during the inspection. If Block 14c. is checked, inspector must complete the required fields ensuring the SP understands the suspense date for corrective action and contact information for reply.
BLOCK 19: This block is utilized when a continuation of Block 13 is needed or required for additional remarks to facilitate completing this form.
9.0.0.2.20120627.2.874785 DD Form 1812, "Facility Inspection Report"
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| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
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| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
| 4.b. FIRE SYSTEM/CLASS - D & R/3: 0 |
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| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "A: 0": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "A: 0": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "A: 0": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "B: 1 - 8": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "B: 1 - 8": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "B: 1 - 8": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "C: 9 - 16": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "C: 9 - 16": 0 |
| 12. FACILITY PRACTICES - i. Weight stored in excess of authorized limit* (2): |
| 11. FIRE PREVENTION AND HOUSEKEEPING - e. No fire system inspection* (3) (enter date in format DDMMYYYY): |
| 11. FIRE PREVENTION AND HOUSEKEEPING - f. No fire extinguisher inspection (3) (enter date in format DDMMYYYY): |
| 11. FIRE PREVENTION AND HOUSEKEEPING - a. Inadequate security/alarm* (3) (enter date in format DDMMYYYY): |
| 11. FIRE PREVENTION AND HOUSEKEEPING - e. Lack of insect/rodent control (2) (enter date in format DDMMYYYY): |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - Select for "14.a. No deficiencies observed": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - 14.a. No deficiencies observed - Select for "D: 17 & OVER": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - Select for "14.b. Corrective action without report is required as soon as possible": 0 |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - Select for "14.c. Corrective action, confirmed in writing/Email, is required by (entered date)": 0 |
| 14.c. Corrective action, confirmed in writing/Email, is required by: enter date in DDMMYYYY: |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - Select for "14.d. In non-use from further business as of (entered date)": 0 |
| 14.d. In non-use from further business as of: enter Date (DDMMYYYY): |
| 14. DEFICIENCIES OBSERVED/ACTIONS TAKEN BASED ON QUALITY CONTROL RATING RAW SCORE - Select for "14.e. Continued non-use from further initial service orders.": 0 |
| 17. SP OPERATING REPRESENTATIVE - 17.b. SIGNATURE: |
| 18. DOD REPRESENTATIVE - 18.c. DATE (DDMMYYYY): |
| 18. DOD REPRESENTATIVE - 18.b. SIGNATURE: |
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