Contract Att03- CDRL D001 - AT Decommission Checklist_05.19.2025.xlsx
XLSX spreadsheet 59 KB Posted
- Solicitation number
- 70T04026R7672N005
About this file
This is a Decommission Checklist template (CDRL D001) for Advanced Technology X-Ray screening equipment used in airport security checkpoints. The checklist is designed to systematically document the condition and operational status of AT systems during decommissioning, including both Rapiscan and Smiths equipment variants. The form requires verification of core components including the ATU/AT-2 inventory system, power supply, conveyor systems (high-speed, queuing, and infeed), roller tables, UPS units, AVS (Automated Threat Detection) monitors and computers, operator carts, and all associated keys and manuals. Specific conveyor belt speed requirements are detailed by manufacturer: Rapiscan high-speed conveyor at 44cm/s, Smiths at 54cm/s, with corresponding speeds specified for queuing and infeed conveyors.
The checklist mandates comprehensive physical inspections and photographic documentation including operational unit photos, exterior and interior condition assessments, damage evaluation, and serial number/barcode verification for both the AT equipment and AVS systems. The form requires sign-off from three parties: the subcontractor performing decommissioning work (with company, email, and phone contact information), the System Integrator (verifying damage documentation, missing components, and verification kit returns), and a federal employee witness confirming on-site completion. The evaluation sections use Yes/No responses with space for detailed comments regarding unit quality, quantity, and part condition, ensuring accountability and complete documentation of equipment status prior to removal from airport checkpoint service.
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Text version
Table 1
CDRL D001
Decommission Checklist Advanced Technology X-Ray AT S/N: TSA Bar Code Number:
Airport Code: Terminal/Checkpoint/Lane: Decommission Date: Time:
| The comments/concerns section may be used to provide further detail concerning unit quality, quantity, or general notes on unit/part condition | ||||
| Section | Evaluation Criteria | Yes | No | Comments/Concerns |
| Inventory | AT System (ATU/AT-2) | |||
| Power Supply | ||||
| System Keys | ||||
| Confirm/List Bumpout (Left/Right) and Operator (Left/Right) Configurations | ||||
| Operational Test Kit (remove if directed by TSA) | ||||
| Keys (Keyboard/Computer Door) | ||||
| Operator Cart (Rapiscan only - 2 Monitors/Keyboard) | ||||
| High Speed Conveyor | ||||
| High Speed Conveyor belt moves at correct speed |
(Rapiscan -44cm/s; Smiths - 54cm/s)
| Queing Conveyor (Rapiscan only) |
| Queing Conveyor belt moves at correct speed (Rapiscan only |
Forward- 16cm/s; Reverse- 22cm/s)
| Infeed Conveyor | |
| Infeed Conveyor belt moves at correct speed (Rapiscan - 22cm/s; Smiths - 24cm/s) | |
| Entry Roller Table | |
| Exit Roller Table | |
| Extension Roller Table Quantity | |
| UPS | |
| Operator/Maintenance Manual | |
| AVS Monitors | |
| AVS Computer, Keyboard, Mouse | |
| AVS Keys (Cabinet/Computer) | |
| List any missing parts | |
| List Software Version | |
| List Detection Algorithm Version | |
| Conveyor belt moves forward | |
| Conveyor belt stops | |
| Conveyor belt reverses | |
| Testing | Conveyor belt stops |
| Warning lights illuminate | |
| Unit scans when belt moves forward | |
| E-stop performs as expected | |
| Scanned image transmitted to AVS | |
| Date of last radiation survey (in comments) | |
| Passed image quality test |
Unit Condition Does the unit have any Exterior Damage?
(i.e. broken pieces, dents, paint chipping, locally added stickers) Does the unit have Interior Damage?
(i.e. broken pieces, dust, locally added stickers)
| Panels are flush and fit satisfactorily |
| Conveyor belts are free from tears |
| Roller tables legs attached with all hardware |
| Roller tables in good condition |
| Operator Cart/Work Station raises and lowers |
| Visible hardware tightened and secured |
Visual Verification Take a photo of the unit while OPERATIONAL and document any damage or concerns.
Take a photo of the FRONT of the unit and document any damage or concerns.
Take a photo of the SIDES of the unit and document any damage or concerns.
Take a photo of the BACK of the unit and document any damage or concerns.
Take a photo of the SERIAL NUMBER and BARCODE of the AT and document any damage or concerns.
AVS Photos (Operational, front, sides, back, serial number, barcode) Take a photo of the SERIAL NUMBER and BARCODE of the AVS and document any damage or concerns.
Operator Cart Photos (Rapiscan Only)
Unit Take photo of the unit PACKAGED and document any damage or concerns.
| Is the labeling correct on the packaging |
| Copy of shipping Label Attached |
| Subcontractor Contact Information and Verification |
| Sign and date this Decommission Checklist and leave a copy with the unit. |
Performed By:
| ______________________________ ________________________________ | ___________________________________ | ____________________________ | ||
| Company Name | Email Address | Phone | ||
| ______________________________ ________________________________ ________________________________ | ___________________________________ | ______________________________ | ||
| Printed Name | Signature | Date | ||
| System Integrator Section (This section should be filled in by the System Integrator ONLY) | ||||
| Evaluation Criteria | Yes | No | Comments/Concerns | |
| Has all damage been documented? If NO, please specify in the comments section. | ||||
| comments section. | ||||
| Are there any components missing? If YES, please specify in the comments section. | ||||
| Is a Verification Kit being returned with this unit? If YES, please note it in the COMMENTS Section. | ||||
| Systems Integrator Additional Comments |
| Systems Integrator Contact Information and Verification |
| Sign and date this Decommission Checklist and leave a copy with the unit. |
Performed By:
| ______________________________ ________________________________ | ___________________________________ | ______________________________ |
| Company Name | Email Address | Phone |
| ______________________________ ________________________________ | ___________________________________ | ______________________________ |
| Printed Name | Signature | Date |
| Federal Employee Verification | ||
| As a witness, sign and date this Decommission Checklist to confirm the document was completed on-site. | ||
| Confirmed by: | ||
| ___________________________________ | ___________________________________ | ______________________________ |
| Printed Name | Signature | Date |
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