Attach 4 - KTR Work Surveillance Checklist.pdf
PDF 102 KB Posted
- Attached to
- South Florida Hazardous Waste Removal
- Solicitation number
- SP450025R1001
- Issued by
-
Defense Logistics Agency
About this file
The document is a Contractor Work Surveillance Checklist for the initial placement or removal of empty rented Rolloff Box (ROB) or Vacuum Box under Contract Line Item Number (CLIN) 1200RE. The checklist is designed for a Designated Government Representative to assess and document the contractor's performance during container delivery, with specific evaluation criteria including:
Key inspection points cover the truck driver's punctuality, equipment readiness, container condition, and overall service quality. The checklist requires verification of container size, presence of plastic liner and tarp cover (for ROB), empty weight documentation, visual inspection for damage or corrosion, proper equipment operation, and ultimate satisfaction of the government representative. The form provides space for comments and requires the government representative's signature to validate the container's acceptance or rejection based on the detailed inspection criteria.
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Text version
Contractor Work Surveillance Checklist
Initial Placement or Removal of Empty Rented Rolloff Box (ROB) or Vacuum Box - CLIN 1200RE
Date(s) of Work Surveillance: _________________ Start Time: ___________ Stop Time: ___________
Contract Number: SP4500-______-D-___________ TO #: ________________ CLIN: ______________
Name of Designated Government Representative: ___________________________________________
Title of Designated Government Representative: ____________________________________________
Phone Number of Designated Government Representative: (______) _______-___________ Ext.______
Yes No N/A Description of Contractor Work Surveillance: [ROB] or [Vac Box] (Circle one)
Did the truck driver arrive on site at the scheduled time and date?
Did the driver arrive on site with all of the requisite equipment, including
- One ROB or Vacuum Box container of the appropriately ordered size, with
- One plastic liner of sufficient size and thickness to adequately contain the waste for which it was intended (ROB only), and
- One watertight tarp cover that was generally free of rips and tears (ROB only)?
Did the driver provide a weight ticket showing the empty (tare) weight of the container prior to placement?
Was the container inspected by a Designated Government Representative upon arrival at the designated location?
Was the container of acceptable appearance and integrity, with minimal evidence of corrosion, visibly void of waste residue and legible/offensive graffiti upon delivery?
Was the ROB, bows and cover free of any defects or damage, other than those attributable to normal wear and tear, and determined acceptable for Government use? Please document below any noteworthy defects or damage and have driver initial for acknowledgment. Note: Failure of the driver to acknowledge any existing noteworthy defects or damage will be cause for rejection of the ROB and liner.
Did the equipment operate properly without causing a delay in work?
Was the work performed and did the equipment meet the satisfaction of the
Designated Government Representative?
Comments:
Signature of Designated Government Representative Date
File details come from the government source that posted it. Updated .