Attachment C - Basic Inspections Form.pdf

PDF 170 KB Posted

Attached to
Regional Vault and Septic Pumping Blanket Purchase Agreement
Solicitation number
127EAT22Q0038
Issued by

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Other files

File Type Posted
Attachment H - Offer Submission Package - May 2023.pdf PDF
Amendment A0001 Regional Vault and Septic Pumping BPA 127EAT22Q0038.pdf PDF
Attachment H - Offer Submission Package.pdf PDF
Regional Vault and Septic Pumping BPA_Solicitation 127EAT22Q0038.pdf PDF
Attachment B.1 - Representative List of Vault Toilet Building Locations.pdf PDF
Attachment A.2 - R5 Central Sierra Zone Map.pdf PDF
Attachment B.2 - Representative List of Septic Tank Locations.pdf PDF
Attachment G - Geographic Capability Form.pdf PDF
Attachment D - Quality Assurance Surveillance Plan.pdf PDF
Attachment A - Pacific Southwest Region Geographic Zones Map.pdf PDF
Attachment A.1 - R5 North Zone Map.pdf PDF
Attachment F - Past Performance Experience Questionnaire.pdf PDF
Attachment A.3 - R5 Southern Sierra Zone Map.pdf PDF
Attachment E - Performance Work Statement.pdf PDF
Attachment A.4 - R5 Southern California Zone Map.pdf PDF
Attachment H - Offer Submission Package.pdf PDF
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BASIC INSPECTIONS FORM

Use space below to document observed needs for repairs and maintenance Note any cracks, missing or broken components, graffiti, and other vandalism.

TOILET BUILDING EXTERIOR

Roof

Ventilation Stack

Walls, including vent cover

Foundation/Slab/Apron

Door and door handle

Signage (present or missing)

TOILET BUILDING INTERIOR

Floor

Walls, including vent cover

Foundation/Slab/Apron

Door and door handle

Toilet Seat and riser condition

Toilet Paper Dispenser (if present)

Signage (present or missing)

SUBSURFACE COMPONENT (Vault or septic system etc.)

Perform a basic inspection of the vault or subsurface structure. Enter N/A if not applicable.

1st Compartment

2nd Compartment

Inlet baffle condition OR access port to vault

Outlet Baffle condition

Effluent baffle screen condition

Total Tank Capacity

Total Gallons pumped

Depth of Scum

Depth of Sludge

Vault tank material type

Access to tank port

General Comments:

Inspection Certification

I verify that the information listed herein is true and accurate to the best of my knowledge, belief, and observation.

Inspection Performed by:

Contractor Name:______________________________ Date:_____________________________

Address:______________________________________ Phone:____________________________

Email:____________________________________________________________________________

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