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
- 1240LU25R0008
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Project Equipment Cleaning Verification and Inspection Form used for documenting equipment cleaning requirements for U.S. Forest Service contracts. The form is a fillable PDF template that requires contractors to provide detailed information about cleaned equipment including make, model, and ID numbers, cleaning date, cleaning location, cleaning methodology, and the equipment's last operational location (with specific requirements to note if it was used on State/Federal/Private lands or Forest Service lands including forest/grassland name, project name, and road details).
The form requires certification from a contractor representative that all equipment cleaning contract provisions have been met and that equipment has been thoroughly cleaned of soil, seeds, and vegetative material. It includes fields for the contractor representative's name, signature, inspection date, and an optional field for a USFS COR/Inspector name if present during inspection. This form appears to be part of a larger road and bridge construction services MATOC contract (1240LU25R0008) for the USFS Rocky Mountain Region 2.
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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 .