Attachment 11 - Invoice DLA Form 2505 -PR 24-BE-131xlsx.xlsx

XLSX spreadsheet 20 KB Posted

Attached to
Puerto Rico Hazardous Waste Disposal Contract
Solicitation number
SP450025R0003
Issued by

About this file

The file is a DLA Form 2505 Invoice template for documenting hazardous waste disposal contract performance details. This specific form is associated with the Puerto Rico Hazardous Waste Disposal Contract (Solicitation Number SP450025R0003) issued by the Defense Logistics Agency. The invoice template provides a comprehensive tracking mechanism for documenting waste disposal activities, requiring contractors to record line item numbers, document numbers, hazardous item numbers, pickup quantities, manifest details, disposal quantities, interim/disposal facility information, EPA identification numbers, disposal method codes, and acceptance/disposal dates.

The contract scope involves removing, transporting, and disposing of various waste types including RCRA hazardous wastes, non-RCRA wastes, state-regulated wastes, universal wastes, compressed gases, PCBs, and PFAS within military installations or within a 50-mile radius of specified pickup locations in Puerto Rico. Specifically excluded from the contract are infectious medical waste, ammunition, explosives, radioactive wastes, and mixed waste types. The form allows for detailed tracking of waste disposal processes, ensuring comprehensive documentation of each stage of waste management, with specific instructions for completing different columns based on contract requirements and waste disposal scenarios.

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InvoicePrescribe by: FAR 32.9/DLAM 4140.15 Sponsor: Disposition Services
COMPANY NAME:CONTRACT #:TO #:INVOICE AMOUNT ($):DATE:
"I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THIS CONTRACT PERFORMANCE SUPPORTING DATA IS ACCURATE, COMPLETE AND MEETS ALL REQUIREMENTS SET FORTH IN THE CONTRACT."
NAME:Signature:
1.2.3.4.5.6.7.8.9.10.11.
Line Item #Document #HIN #P/U QtyP/U Mnfst #Mnfst Pg/LiQty Disposed or ReceivedInterim/Disp Manifest #Interim/ Disposal Facility EPA ID #Interim/ Disposal MMCTSDF Accept Dates/ PCB Dates (DD/MMM/YY)

DLA Form 2505, FEB 2022 Page 1 of 2 PDF (DLA)

2505 04/2021 (Draft Revision) &P

INSTRUCTIONS

NOTE 1: For special service and supply items, complete only blocks 1, 2, 3 and 7.
NOTE 2: For foreign contract disposal lines, complete all columns.
NOTE 3: For US contracts, complete all columns only when the task order contains line(s) requiring a Certification of Destruction (CD) or Certification of Recycling (CR) or contains HIN 650300. Complete only columns 1 thru 4, 6, 7 and 11 when the task order DOES NOT contain line(s) requiring a certificate of destruction (CD) or a certificate of recycling (CR) or HIN 650300.

Column 1: Line Item # - DD Form 1155 or SF30 line-item number for the supply or service ordered. (Four digits - e.g.: 0001)

Column 2: Document # - Document number as it appears on DD Form 1155 or SF30 (Six characters -e.g.: NR04C7)

Column 3: Hazardous Item Number (HIN) # - HIN Number as it appears on DD Form 1155 or SF30 (Six characters -e.g.: NR04C7)

Column 4: Picked Up (P/U) QTY - Actual quantity picked up.

Column 5: P/U Mnfstr # - Manifest document number assigned to each manifest or shipping paper used to ship the waste to the initial TSDF (5 or 12 characters - e.g.: 02034; 123456789GBF)

Column 6: Manifest Page/Line- Identify the page and manifest line number that the document number has been placed on from manifest block 9a, 27a, etc…. (Does not apply for foreign contracts.)

Column 7: Final QTY Disposed or Received – Actual quantity of item disposed or service/supply performed/delivered.

Column 8: Interim/ Disposal Manifest # - Manifest document number assigned to each manifest or shipping paper used to ship all, or parts of the waste to other TSDFs, including all interims and finals, after receipt at initial TSDF. EXCEPTION: If final treatment/ disposal is accomplished by the initial TSDF, insert "Same as # 4 or SAC4" and do not need to fill out columns 6 thru 11. (EXCEPTION #2 Lines requiring a CD/CR will require block 11 CD date entry DD/MMM/YY)

Column 9: Interim/Disposal Facility EPA# - EPA Identification number (or DLA Disposition Services "dummy" number) assigned to each facility involved in the treatment, storage, and final disposal. (As defined in section 5.0 of the contract) of the item. Use additional lines as necessary. (Twelve digits - e.g.: PAD456123912) NOTE: If final disposal did not occur at the initial facility, then the initial facility is considered an interim facility for tracking purposes. In those instances, the initial facility's EPA ID number should be included in Column 9 when information is submitted.

Column 10: Final Disposal MMC Codes - List the appropriate Management method code(s) listed in the Hazardous Waste Report Instructions and Forms online (https://www.epa.gov/sites/production/files/2015-06/documents/codes.pdf). (40 CFR 264, Appendix 1, Table 2 no longer applies), performed by any final disposal facilities. Note: Include any treatment and/or handling performed at initial TSDF, which was NOT identified in initial facility.

Column 11: Interim/Disposal TSDF Accept Date and Disposal Date (CD/CR required lines Only) - Actual date listed on the shipping paper next to the signature of the representative of each and every interim and final TSDF's accepting, treating, and/or disposing of the waste (dd/mmm/yy). NOTE - Date of actual final disposal of CD/CR required lines item (dd/mmm/yy).

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