Attachment 5 - KTR Work Surveillance Checklist - Placement or Removal Empty of ROB or Vac Box.pdf
PDF 102 KB Posted
- Attached to
- Hazardous Waste Removal Alaska Federal contract opportunity
- Solicitation number
- SP4500
- Issued by
- Defense Logistics Agency
About this file
This is a Contractor Work Surveillance Checklist for monitoring the initial placement or removal of empty rented rolloff boxes (ROB) or vacuum boxes under CLIN 1200RE of contract SP4500. The checklist is used by Designated Government Representatives to verify contractor compliance with delivery and equipment requirements.
The checklist evaluates several key aspects of the contractor's performance: timely arrival of the truck driver, delivery of properly sized containers with required accessories (plastic liners and watertight tarp covers for ROBs), provision of empty container weight tickets, container inspection upon arrival, acceptable container condition (free from corrosion, waste residue, and graffiti), equipment functionality, and overall work satisfaction. The form requires documentation of any container defects or damage, which must be acknowledged by the driver, and includes fields for the representative's contact information, surveillance dates/times, and signature.
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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 .