Contract Att05 - CDRL D001 - BLS - Smiths Responder Decomm Checklist_05.21.2025.xlsx
XLSX spreadsheet 45 KB Posted
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- 70T04026R7672N005
About this file
This is a decommissioning checklist template for the Smiths Responder Bottled Liquid Scanner (BLS), a checkpoint screening device used by the Transportation Security Administration. The checklist is designated as Contract Data Requirements List (CDRL) D001 and is utilized during the decommissioning process for BLS units that are being removed from service.
The checklist is organized into multiple verification sections completed by field personnel and system integrators. The inventory section confirms the presence of required components including the BLS system, power supply, verification kit, safety enclosure, clear sticker dispenser, and test samples. The testing section documents the timeframe of last use and verifies operational functionality including power-on capability, user login, calibration, and system detection verification. The unit condition section assesses exterior and interior damage, followed by cleaning requirements for lens and viewing window areas using specified methods. The visual verification section requires photographic documentation of the unit while operational, front, sides, back, serial number, barcode, and make/model, with all images to include damage or concern notations. The packaging section documents the unit's shipping preparation and labeling accuracy. The checklist requires sign-off from three parties: the subcontractor performing the decommissioning, the system integrator conducting review, and a federal employee serving as witness to confirm on-site completion.
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Text version
Table 1
CDRL D001
Decommission Checklist For the Smiths RespondeR Bottled Liquid Scanner (BLS)
BLS S/N: TSA Bar Code Number:
Airport Code: Terminal/Checkpoint/Lane: Date of Test: 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 | RespondeR BLS System? | |||
| Power Supply with AC Adapter? | ||||
| Verification Kit? | ||||
| Safety Enclosure? |
(Should be attached to the RespondeR BLS) Clear Sticker Dispenser?
(Should be attached to the Safety Enclosure) "Abnormal Object" Test Sample with Red Label?
(NO PASS)
| Testing | What was the time frame when the system was last used? | |||
| Please mark one (1) box. | Please check one | |||
| (1) box: | Past/Current | |||
| Day | Past 3 Days | Past Week | Past Month | More than a |
| month | Unknown | |||
| Does the system turn on? | ||||
| Does the system allow users to Log On? | ||||
| Does the system calibrate correctly? | ||||
| Did the system pass the System Detection Verification Check Successfully? |
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)
Cleaning Using a cotton tip applicator, gently clean the lens area to remove any dust or debris.
Using no chemicals, wipe off any dust or debris from the viewing windows.
Visual Verification Take a photo of the unit while OPERATIONAL and document any damage or concerns. (screen included) 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 on the unit and document any damage or concerns.
Take a photo of the MAKE/MODEL of the unit and document any damage or concerns.
Unit Packaging Take photo of the unit PACKAGED for shipping and document any damage or concerns.
| Is there packaging for the BLS responder? Please indicate what type of packaging in the comments (pelican case, cardboard box, etc.). |
| Is the labeling correct on the packaging? |
| Subcontractor Contact Information and Verification | ||||
| Sign and date this Decommission Checklist and leave a copy with the unit. | ||||
| Performed By: | ||||
| Printed Name | Email Address | Phone Number | ||
| Company 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. | ||||||
| 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. | ||||||
| Reviewed By: | ||||||
| Printed Name | Email Address | Phone Number | ||||
| Company Name | Signature | Date |
Federal Employee Comments/Concerns
| 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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