Attachment 11 -KTR Work Surveillance Checklist - Placement or Removal Empty ROB or Vac Box - Pendleton.pdf
PDF 45 KB Posted
- Attached to
- PENDLETON HAZARDOUS WASTE Federal contract opportunity
- Solicitation number
- SP450025R1002
- Issued by
- Defense Logistics Agency
About this file
The document is a Contractor Work Surveillance Checklist for the placement or removal of an empty Rolloff Box (ROB) or Vacuum Box. The checklist is designed for a government representative to systematically evaluate and document a contractor's performance during container delivery, with specific criteria including:
The checklist requires verification of the contractor's punctuality, equipment readiness, container condition, weight documentation, and overall work quality. Key inspection points include confirming the container's appropriate size, presence of a plastic liner and watertight tarp (for ROB), container appearance and integrity, absence of significant damage, and safe equipment operation. The form provides spaces to note the contract number, task order, work dates, start and stop times, and allows the government representative to document comments and provide a signature, serving as an official record of the container delivery and inspection process.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Pendleton Q and As.docx | DOCX document | |
| 20D0025 12 month Usage Pendleton.xlsx | XLSX spreadsheet | |
| Attachment 1 - PWS.docx | DOCX document | |
| Attachment 2 - Price Schedule.xlsx | XLSX spreadsheet | |
| Attachment 6 Addenda to 52.212‐2 Evaluation Pendleton.docx | DOCX document | |
| Attachment 9 CAC Application Process- Pendleton.pdf | ||
| Attachment 3 -Pickup Locations -Camp Pendleton.xlsx | XLSX spreadsheet | |
| Attachment 5 Addenda to 52.212‐1 Instructions Pendleton.docx | DOCX document | |
| Attachment 7 Provisions Fill-in.docx | DOCX document | |
| Attachment 8 PPI Questionnaire.pdf | ||
| Attachment 4 - Provisions and Clauses.docx | DOCX document | |
| Attachment 10 -KTR Work Surveillance Checklist - ICS Work - Pendleton.pdf |
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Text version
Contractor Work Surveillance Checklist
Placement or Removal of Empty Rented Rolloff Box (ROB) or Vacuum Box
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 Contractor arrive on site at the scheduled time and date?
Did the Contractor 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)?
Does the Contractor have an approved weight ticket showing the empty (tare) weight of the container?
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 safely 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 .