Attachment 3 - Site Visit DLA Form 1818.pdf

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Steam Boiler Repairs and Maintenance for DDSP - SP3300-26-Q-0114
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SP3300-26-Q-0114
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This is a DLA Form 1818 Visit Notification document used for controlling access to Defense Logistics Agency installations and facilities. The form documents a site visit to DLA Installation Management at Susquehanna, Building 753 scheduled for April 30, 2026. Christopher Chapman, the requestor and point of contact, can be reached at 717-770-4119. The purpose of the visit is to allow potential vendors interested in quoting boiler repair and maintenance requirements for Building 753 to conduct a site inspection. Visitors must pre-register through the website https://dbids-global.dmdc.mil prior to arrival.

The document includes sections for recording visitor information including name, grade/rank, Social Security number, date of birth, country of birth, and security clearance status. The form is based on Privacy Act authority under Section 21, 50 U.S.C. 781 et seq. and Executive Order 10450, with the principal purpose being to control access and movement on DoD installations. Disclosure of information is voluntary, though failure to provide requested information may result in denial of facility access. The form requires signature authorization from a security representative and includes space for activity codes and telephone verification.

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PRIVACY ACT STATEMENT

VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANK

11.

SSN

12.

DATE OF BIRTH

13.

STATE /COUNTRY OF

BIRTH

14.

CLEARANCE/DATE

GRANTED

15.

TYPE OF INVESTIGATION/

DATE

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PDF (DLA)

RequesterName: Christopher Chapman
OfficeCode: DDSP
FacPOC: Christopher Chapman
Phone: 717-770-4119
POCPhone: 717-770-4119
VisitedActivity: DLA Installation Management at Susquehanna,

Building 753 VisitPurpose: Site Visit of Building 753 for potential vendors interested in quoting boiler repair and maintenance requirements.

Visitor has registered utilizing the pre-enrollment website: https://dbids-global.dmdc.mil

DateTo: 4/30/2026
Visitor:
0: Doe, John M.
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