Attchment 3 Gov Inspection Report.pdf

PWS Paragraph 1.1.2 Work Schedule Provide and Follow Quarterly 95%

PWS Paragraph 1.1.3 Work Plan Provide and Follow As Required 95%

PWS Paragraph 1.1.4 Adjustments to Operating Equipment Only Service Equipment on the

Equipment Summary As Required 100%

PWS Paragraph 1.2.1 Project Management Provide As Required 100%

PWS Paragraph 1.2.3 License Requirements Satisfy Requirement As Required 100%

PWS Paragraph 1.2.7 Visitor Register Satisfy Requirement As Required 100%

PWS Paragraph 1.3.3 Quality Control Plan Provide and Follow As Required 100%

PWS Paragraph 1.6.1 Hours of Operation Satisfy Requirement As Required 95%

PWS Paragraph 1.6.2 On‐Site Pre‐Approval Satisfy Requirement As Required 100%

PWS Paragraph 1.8 Supplemental Environmental and Safety

Requirements Satisfy Requirement As Required 100%

PWS Paragraph 1.8.1 Hazardous Materials Satisfy Requirement As Required 100%

PWS Paragraph 1.8.4 Clean Up/Disposal of Waste Materials Satisfy Requirement As Required 100%

PWS Paragraph 1.8.5 Spill Responsibility Satisfy Requirement As Required 100%

PWS Paragraph 1.8.6 Safety Satisfy Requirement As Required 100%

PWS Paragraph 1.8.7 Mishap Reporting Satisfy Requirement As Required 100%

PWS Paragraph 1.9.3 Correction of Defective Service(s) Satisfy Requirement As Required 100%

PWS Paragraph 4 Contractor Furnished Items & Services Provide All As Required 100%

The COR will observe the selected service(s) at any time they determine a need to inspect a service or notices a deficiency . Results of each inspection will be documented on a “Government

Inspection Report”. A “pass”, “fail” or “N/A” rating will be assigned to each service inspected. A "pass" rating will be assigned when the Contractor performs a rated service at or above the listed

"Acceptable Performance Level (APL) ". A “fail” rating will be assigned when the Contractor performs a rated service below the listed "Acceptable Performance Level (APL) ". A brief description of the inspection and observed defects will be recorded. The COR will ascertain whether documented deficiencies were corrected and processes implemented to ensure re‐occurrence of the deficiency is prevented. A “N/A” rating will be assigned when no work was required to be performed on a specific service.

COR:

Government Inspection Report

Contract Number: Dates of Inspection:

Scotia Equipment 2021 at Scotia Depot, Scotia NY

Contractor:

Rating Remarks

PWS Paragraph 1.1

Standard Required Service Action Minimum

Frequency

APL

Required

PWS Paragraph 5.1

Attachment 3 to PWS

Quality Level

Performed

PWS Paragraph 1.2

PWS Paragraph 1.6

PWS Paragraph 1.8

PWS Paragraph 1.9

PWS Paragraph 4

PWS Paragraph 1.3

PWS Paragraph 5.1 Service Mechanical Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.2 Service Fuel Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.3 Service Hydraulic Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.4 Service Electrical Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.5 Service Lubrication Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.6 Service Body/Chassis Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.7 Service Tires/Wheels Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.8 Service Miscellaneous Systems Satisfy Requirement As Required 100%

PWS Paragraph 5.9 Repair Services Satisfy Requirement As Required 100%

PWS Paragraph 5.10 Quarterly Reports Satisfy Requirement Quarterly 100%

PWS Paragraph 5.11 Work Orders Satisfy Requirement As Required 100%

PWS Paragraph 5.12 Minor Repairs Satisfy Requirement As Required 100%

PWS Paragraph 5.4

COR Remarks

PWS Paragraph 5.2

PWS Paragraph 5.3

PWS Paragraph 5.10

PWS Paragraph 5.11

PWS Paragraph 5.12

PWS Paragraph 5.5

PWS Paragraph 5.6

PWS Paragraph 5.7

PWS Paragraph 5.8

PWS Paragraph 5.9

Contractor Remarks

Contractor Sign/Date: COR Sign/Date: