Equipment Cleaning Form_Fillable_20241203.pdf
PDF 100 KB Posted
- Attached to
- UNITED STATES FOREST SERVICE, ROCKY MOUNTAIN REGION 2, ROAD AND BRIDGE CONSTRUCTION SERVICES MATOC
- Solicitation number
- 1240LU24R0013
- Issued by
-
Department of Agriculture Forest Service
About this file
This is an Equipment Cleaning Verification and Inspection Form template associated with a US Forest Service (USFS) road and bridge construction services MATOC contract. The form is designed to document and verify the cleaning of equipment used on Forest Service lands to prevent the spread of soil, seeds, and vegetative material.
The form requires detailed documentation including the contract/project number, project title, equipment details (make, model, ID number), cleaning date, cleaning location, cleaning methodology, and the location where the equipment was last operated. It includes fields for contractor representative information, signature, and date, as well as space for a USFS COR/Inspector name if present during inspection. The form requires certification that all equipment cleaning contract provisions have been met and that equipment has been thoroughly cleaned of soil, seeds, and vegetative material, with specific attention to documenting whether the last operation site was State/Federal/Private/Other land, including Forest/Grassland Name, Project Name, and Road information for Forest Service lands.
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Text version
Contract # / Project #:
Project Title:
Equipment Cleaned:
(include make, model, and ID Number)
Date equipment was cleaned :
Location where equipment was cleaned:
Summary of how the equipment was cleaned:
Location of Last Equipment Operation:
(describe where the equipment was last operated, including if site was State/Federal/Private/Other. If on Forest Service Lands, include Forest/Grassland Name, Project Name, Road Number, and Road Name):
Contractor Representative Name:
Date of Cleaning Verification and Inspection:
Contractor Representative Signature:
Date Signed:
(If present at inspection) Name of USFS COR / Inspector:
I certify that all requirements as outlined in the equipment cleaning contract provisions have been met and that all equipment has been thoroughly cleaned of soil, seeds, and vegetative material. I also certify that the above information is true to the best of my knowledge.
Project Equipment Cleaning Verification and Inspection Form
Equipment Cleaning Verification and Inspection by Contractor:
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File details come from the government source that posted it. Updated .