MAF-R_MX_PWS_(20180829)_Final.pdf

Attachment 1

FA6800-18-Q-S028

PERFORMANCE WORK STATEMENT (PWS)

MISSILE FACILITY REFUELER (MAF-R) MAINTENANCE

BARKSDALE AFB, LOUISIANA

Date: 28 September 2018

TABLE OF CONTENTS

SCOPE OF WORK

SECTION I

1. DESCRIPTION OF SERVICES

1.1. MAINTENANCE SERVICE

1.2. PREVENTIVE MAINTENANCE AND INSPECTION PROGRAM (PMI)

1.3. MAINTENANCE LOGS/INSPECTION CHECKLIST

1.4. REPAIRS

1.5. COORDINATION

1.6. SERVICE CALLS

1.7. CALL BACKS

1.8. COMMUNICATION AND RESPONSE TIME

1.9. PARTS AND MATERIALS

1.10. ORIGINAL EQUIPMENT MANFACTURER (OEM) REPLACEMENT PARTS

1.11. INITIAL REFUELER ASSESSMENT REPORT

1.12. AUTHORIZED PERSONNEL

SECTION II

2. SERVICES SUMMARY

2.1. OVERVIEW

2.2. PERFORMANCE EVALUATION

SECTION III

3. GOVERNMENT-FURNISHED PROPERTY AND SERVICES

3.1. UTILITIES

3.2. TECHNICAL DATA

3.3 ACCOUNTABILITY

SECTION IV

4. GENERAL INFORMATION

4.1. PERSONNEL

4.2. EMPLOYEES

4.3. IDENTIFICATION

4.4. ATTIRE

4.5. QUALIFICATIONS

4.6. QUALITY CONTROL PLAN

4.7. QUALITY ASSURANCE

4.8. HOURS OF OPERATION/HOLIDAYS

4.9. SAFETY AND HEALTH STANDARDS

4.10. SAFETY DATA SHEET

4.11. ENVIRONMENTAL COMPLIANCE/HAZARDOUS MATERIALS

4.12. CONTRACTOR FURNISHED ITEMS AND SERVICES

4.13 VEHICLES

SECTION V

5. SECURITY REQUIREMENTS

5.1. SECURITY

5.2. PASS AND IDENTIFICATION ITEMS

5.3. RETRIEVING IDENTIFICATION MEDIA

5.4. TRAFFIC REGULATIONS

5.5. RANDOM PERSONNEL AND VEHICLE SEARCHES

5.6. WEAPONS, FIREARMS, AND AMMUNITION

5.7. REPORTING REQUIREMENTS

5.8. PHYSICAL SECURITY

5.9. KEY CONTROL

5.10 WORK AREA

APPENDICES

A. DEFINITIONS

B. ACRONYMS

C. WORK LOCATIONS

D. WORKLOAD ESTIMATES

E. MAF-R INSPECTION CHECKLIST

F. CONTRACTOR PROCURED BENCHSTOCK

SCOPE OF WORK

The Contractor shall provide all personnel, labor, equipment, supplies, tools, materials and other items necessary to perform regular periodic inspection and maintenance, and emergency repair for 16 Missile Field Refuelers (MAF-Rs) at and within the vicinity of Malmstrom Air Force Base (AFB), F.E. Warren AFB, and Minot AFB, and geographically separated locations in Nebraska, and Colorado as listed in Appendix C herein. Work shall comply with commercial standards for maintenance and repair of these units as well as all commercial, federal, state, and local requirements that may apply.

SECTION I

DESCRIPTION OF SERVICES

1.1. MAINTENANCE SERVICE: Contractor will perform full preventive maintenance inspection (FPMI) and repair in accordance with equipment manufacturer’s specifications/recommendations, industry standards, and Air Force Technical Orders. Contractor will perform periodic inspections, and be responsible for repair and replacement of all worn or failed components and parts. Replacement parts and interface shall be fully compatible with existing systems.

1.2. PREVENTIVE MAINTENANCE AND INSPECTION PROGRAM (PMI): The contractor shall establish and perform PMI IAW T.O. 37A-1-101 and local manufacturers guidance to ensure reliable and continuous safe operation. Contractor shall ensure fuel systems meet manufacturer maintenance performance specifications. Contractor shall provide trained mechanics and inspectors for all fuel systems maintenance. A certified inspection report and checklist shall be provided to the Contracting Officer’s Representative (COR) within 10 days of inspection.

1.3. MAINTENANCE LOGS/INSPECTION CHECKLIST: Fuel systems Maintenance Logs - AF Form 4427, Operator’s Inspection Guide and Trouble Report (Fuels Support Equipment) will be updated and maintained by the contractor IAW Air Force Manual 33-363, Management of Records, and disposed of IAW Air Force Records Information Management Systems, Records Disposition Schedule. The maintenance log shall include a complete history of maintenance and repairs, indicating dates and name of technician who performed the work.

1.4. REPAIRS: During any scheduled FPMI, the contractor shall immediately service any system that is not operating properly. If the inoperable systems cannot be repaired during the inspection, the contractor shall notify the COR and Fuels Service Center (FSC) within one (1) hour of determining the irreparable status of the refueler. Additionally, contractor shall provide the COR and FSC with the refueler expected time in commission (ETIC) date.

1.5. COORDINATION: The contractor shall coordinate all inspections with the COR, FSC, and missile facility personnel so inspections are conducted during the hours of operation.

1.6. SERVICE CALLS: The contractor shall be available to respond to all service calls that occur during routine duty hours, and after hour requirements pertaining to situations that hinder normal operational efficiency or serviceability of the fuel systems.

1.6.1. ROUTINE SERVICE CALLS: Routine service require unscheduled repairs, but the unit can still be utilized until the repairs are fixed. Some examples include minor fuel seeps/weeps/drips and hoses that indicate a replacement is warranted. A routine service call requires the Contractor to be on location within 72 hours. In the event the Contractor is unable to correct any deficiencies while on location, the COR shall be notified with current status report which will include required repairs, parts cost estimate and ETIC.

Parts required over $500.00 will be routed through the COR to the Contracting Officer for approval.

1.6.2. URGENT SERVICE CALLS: An Urgent service call is a MAF-R becomes nonoperational, such as Differential Pressures that indicate the Filter Elements need to be replaced. An Urgent service call requires the Contractor to be on location within 24 hours. In the event the Contractor is unable to correct any deficiencies while on location, the COR shall be notified with current status report which will include required repairs, parts cost estimate and ETIC. Parts required over $2,000.00 will be routed through the COR to the Contracting Officer for approval.

1.6.3 EMERGENCY SERVICE CALLS: An Emergency service call is when two or more MAF-R’s become nonoperational at the same Missile Wing. The contractor shall be at one of the locations within 8 hours to initiate repairs to a point of safe utilization. In the event the Contractor is unable to correct any deficiencies while on location, the COR shall be notified with current status report which will include required repairs, parts cost estimate and ETIC. Parts required over $3,000.00 will be routed through the COR to the Contracting Officer for approval.

1.7. CALLBACKS: Defective repairs will be re-accomplished within service call time frames listed above at no additional cost to the government.

1.8. COMMUNICATION AND RESPONSE TIME: The contractor will provide the COR(s) and FSC’s with at least one primary and one alternate emergency contact phone number to initiate service response (business phone/cell phone). Contractors will ensure voicemail systems are utilized when unavailable to receive service calls. The contractor must respond to service call requests within the time frames listed in 1.7.1, 1.7.2 and 1.7.3.

1.9. PARTS AND MATERIALS: The Contractor shall establish a bench stock of parts within 45 days of contract start. The bench stock shall consist of (1) each replaceable item for rapid repair of MAF- R identified in Appendix G. The Contractor shall have a bench stock located in each Wing’s area of responsibility to expedite repairs. Additional items may be placed in bench stock with the approval of the Contracting Officer. The initial bench stock invoice shall be sent to the COR(s) within 15 days of the start of contract performance. The Contractor shall be responsible for costs associated with reoccurring and preventative maintenance parts. All items will be reimbursed by the Government utilizing the invoice process stipulated in awarded contract. The Contractor shall respond to initial service calls with sufficient parts and tools to repair equipment.

1.10. OEM REPLACEMENT PARTS: The contractor shall use OEM, or equal parts and materials when repairs are needed. All parts shall be Underwriters Laboratories approved/listed. Only new standard parts will be used in completed repairs. All parts obtained by the contractor will be invoiced at contractor’s cost. Additional cost/mark-up on materials of work performed by sub-contractor will not be accepted. If applicable, contractors will abide by any existing active mechanical warranties.

1.11. INITIAL REFUELER ASSESSMENT REPORT: The contractor shall prepare and submit a written report, including the Inspection Checklist, to the COR within 10 days of the first FPMI performed.

The report will include identification of each refueler, location, maintenance and repair performed (if applicable), additional repairs needed, date of inspection, inspector, and overall condition of the equipment.

The Contractor shall submit one report, sectioned with tabs according to fuel system location, to the designated COR.

1.12. AUTHORIZED PERSONNEL: The Contracting Officer (CO) will provide the contractor a list of COR and FSC contacts who are authorized to request/accept services for the government. The contractor will only accept work from designated CORs.

SECTION II

SERVICES SUMMARY

2.1 This Services Summary (SS) identifies critical success factors for the contract. It identifies both the performance objectives for those factors and the performance threshold required for each performance objective. The Government reserves the right to survey all services called for in the contract to determine whether or not the performance objectives and goals were met. This Services Summary (SS) lists the performance objectives performance objectives for services the Government shall survey.

2.1.1 The absence of any contract requirement from the SS shall not detract from its enforceability, nor limit the rights or remedies of the Government under any clause of the contract.

2.2. PERFORMANCE EVALUATION: Performance of a service will be evaluated to determine whether or not it meets the performance threshold. Preferred method of correcting unacceptable performance is to recomplete necessary performance to evaluated standards.

Table 2.2.1. Performance Objectives

Performance Objective Para Performance Threshold Perform Preventative Maintenance. Maintenance performed according to submitted timeline.

1.1 95% of preventative maintenance completed

Perform Inspections. Inspections performed and an accurate report is delivered within 10 days of inspections.

1.2 95% of all reports and supporting documents must be received within

Perform Routine Service Call Repairs. Respond to and repair system within 72 hours.

1.7.1 95% of routine service calls are responded to within 72 hour

Perform Urgent Service Call Repairs. Respond to and repair system within 24 hours.

1.7.2 98% of urgent service calls are responded to and repair system within 24 hours.

Perform Emergency Service Call Repairs. Respond to and repair system within 8 hours.

1.7.3 100% of emergency service calls are responded to within 8 hours

Special Maintenance Projects Repairs completed within time frame negotiated between Government and Contractor.

APDX-A 95% of special maintenance projects completed within time frame negotiated between Government and Contractor.

SECTION III

GOVERNMENT-FURNISHED PROPERTY AND SERVICES

3.1. UTILITIES. The government will furnish, where available, water, natural gas, sewage service, and electricity at no cost to the contractor for the sole purpose of accomplishing the requirements of this contract. Any temporary connection of electrical lines that may be required shall be installed, maintained, and removed by the contractor at its own expense.

3.2. TECHNICAL DATA. The Contractor shall contact AFGSC/A4RE if fuel system (and associated equipment) Plans and Specifications are required.

3.3. ACCOUNTABILITY. All parts purchased by the Government will remain the property of the Government. The Contractor shall maintain a listing of all Government furnished property valued at or above $10.00 and shall ensure 100% accountability of the items. The CORs will conduct annual of accountable GFP.

SECTION IV

GENERAL INFORMATION

4.1. PERSONNEL: The contractor shall be responsible for obtaining all necessary identification cards, passes, badges, and decals to perform the requirements of this PWS. The Contractor shall contact the appropriate base Pass & ID offices for access to secured locations.

4.2. EMPLOYEES: The contractor shall not employ any person who has been identified by the contracting officer as a potential threat to the health, safety, security, general well-being, or operational mission of the installation and its population. All employees and potential employees are subject to a local background investigation. Investigation results will be provided to the CO and COR for all employees prior to start of contract. The contractor shall submit an organizational structure and a list of personnel designated to perform work under this contract to the contracting officer within 30 calendar days following notification of contract award. The contractor shall notify the administrative contracting office, in writing, of any additions, deletions, or changes in personnel within one duty day of any change.

4.2.1. The contractor shall provide the Government a contact number that can be accessed 24 hours a day, 7 days a week. The contractors shall be able to read, write, speak, and understand the English language.

4.3. IDENTIFICATION: The contractor shall obtain a Base Identification Card for all contractors.

While in restricted access areas (i.e. Flight-line Area, Missile Alert Facilities) an appropriate government official with access authorization must escort contract employees. The contractor shall turn in all forms of Government issued identification items of employees who are terminated or willfully leave the contracted company within 48 hours. Long-term contractor passes are issued at the Security Forces Squadron’s Pass and Registration office. Identification shall be obtained and remain in the contractor’s possession at all times while on the installation.

4.4. ATTIRE: The Contractor shall provide uniforms that a represent a professional appearance that are clean, free of rips/tears, displays the company logo and provide a professional appearance. The Contractor shall also provide any Personal Protective Equipment required.

4.5. QUALIFICATIONS: Contractor shall have a minimum of three years of experience in performing fuels maintenance on various types of fuel systems to include gas station dispensing systems, bulk fuel facilities, hydrant fuel systems, or mobile refueling vehicle pumping systems.

4.6. QUALITY CONTROL PLAN: The contractor shall develop and maintain a quality control program to ensure inspection, maintenance, and repair services are performed in accordance with applicable standards, manufacturer instructions. The contractor shall develop and implement procedures to identify and prevent defective services from occurring and reoccurring. As a minimum, the contractor shall develop quality control procedures that address the areas identified in Section II, Services Summary. The Quality Control Plan (QCP) shall be provided to the CO as part of their initial proposal. Although a QCP may have been deemed technically acceptable during the evaluation for contract award, minor modifications may be required after contract award. The contractor shall make these modifications, if necessary, within 10 calendar days following notification from the CO.

4.7. QUALITY ASSURANCE: The Government will evaluate the contractor’s performance in accordance with the QASP. The contractor shall submit a schedule to the COR of all inspections, prior to start of work. The COR shall evaluate the contractor’s performance through periodic inspections of service call repairs, periodic inspections of routine FPMIs, and inspection of SMPs.

4.8. HOURS OF OPERATION/HOLIDAYS: Maintenance shall be performed during the duty hours identified below:

4.8.1. SCHEDULED MAINTENANCE/ROUTINE SERVICE CALLS: Monday through Friday between 7:30 a.m. and 4:30 p.m., excluding recognized federal holidays as defined by the Service Contract Act Wage Determination.

4.8.2. URGENT/EMERGENCY SERVICE CALLS: The COR/FSC will coordinate with Facility Managers to ensure an escort is available. Any hour restrictions will be provided to the Contractor prior to the Contractor departing for the service call.

4.9. SAFETY AND HEALTH STANDARDS: Contractor personnel shall comply with all applicable laws and safety regulations. Compliance with Occupational Safety and Health Administration (OSHA) and other applicable laws and regulations for the protection of employees is exclusively the obligation of the contractor, and the Government will assume no liability or responsibility for the contractor’s compliance or non-compliance with such responsibilities.

4.10. SAFETY DATA SHEET (SDS): The contractor will be provide a copy of an SDS for each product(s) used.

4.11. ENVIRONMENTAL COMPLIANCE/HAZARDOUS MATERIALS: Oil cans, oil residue and any oil soaked material (e.g., rags and/or paper towels, granulated materials and sand) shall be disposed IAW base directives. The contractor shall transport and dispose of all waste in accordance with Federal, State and local laws and regulations. The contractor shall adhere to written procedures for hazardous material spill clean-up and prevention according to Environmental Protection Agency regulations.

4.12. CONTRACTOR FURNISHED ITEMS AND SERVICES: Except for those items referred to as government furnished in Section III, the contractor shall furnish everything needed to perform the services identified in this contract.

4.13. VEHICLES: The Contractor shall provide vehicle(s) for transport to locations identified in Appendix C. Vehicle(s) shall be maintained in a clean and serviceable condition. The Contractor is required to travel in all types of weather conditions and is recommended that 4-wheel drive vehicle(s) is/are provided. Government parking space shall not be used for parking privately owned vehicles, trailers, snowmobiles, all-terrain vehicles or other conveyances. All vehicles shall be in operable condition and meet all local, state, and federal safety requirements. Each vehicle shall have the contractor name neatly exhibited on each side of the cab.

SECTION V

SECURITY REQUIREMENTS

5.1. SECURITY: The Contractor shall safeguard all materials and parts removed, as well as replacement parts. The Contractor shall secure fuel areas and fueling systems at the end of each work period.

The contractor shall immediately notify the COR, FSC, and the base SFS when damage to government property, such as accidental abuse or misuse is discovered. The contractor shall annotate the damage on the vehicle’s inspection report.

5.2. PASS AND IDENTIFICATION ITEMS: The contractor shall ensure that pass and identification items required for contract performance are obtained for contactor employees and non- Government owned Vehicles.

5.3. RETRIEVING IDENTIFICATION MEDIA: The Logistics Readiness Squadron’s MAF-R COR shall retrieve all identification media, including vehicle passes from employees who depart for any reason before the contract expires; e.g. terminated for cause, retirement, etc., and turn them in to the issuing office.

5.4. TRAFFIC REGULATIONS: Contractor employees shall comply with all base traffic regulations, and are subject to random vehicle speed control checks. Contractor personnel cited for speeding on the installation may suffer loss of base driving privileges, debarment from the base, or other administrative action. The use of cell phones, except hands-free phones, are prohibited while driving on military bases/property.

5.5. RANDOM PERSONNEL AND VEHICLE SEARCHES: Contractor personnel are subject to random personnel and vehicle searches. If contractor personnel refuse to be searched, they will be denied entry to the base, and may result in loss of base driving privileges, debarment from the base, or other administrative action.

5.6. WEAPONS, FIREARMS, AND AMMUNITION: Contractor employees are prohibited from possessing weapons, firearms, or ammunition, on themselves or within government-owned vehicles or privately owned vehicles while on military bases.

5.7. REPORTING REQUIREMENTS: Contractor personnel shall immediately report any information or circumstances of which they are aware may pose a threat to the security of Department of Defense personnel, contractor personnel, resources, and classified or unclassified defense information to an appropriate Government authority

5.8. PHYSICAL SECURITY: Contractor employees are responsible for safeguarding all Government property and controlled forms provided for the contractor’s use. At the end of each work period, all Government facilities, equipment, and materials shall be secured.

5.9. KEY CONTROL: The contractor shall establish a key control process that ensures Government issued keys are not misplaced or used by unauthorized personnel. The Contractor shall not duplicate any keys issued by the Government.

5.9.1. The contractor shall immediately report any occurrences of lost or duplicated keys to the COR.

5.9.2. In the event keys, other than master keys, are lost or duplicated, the contractor may be required, upon written direction from the CO, to re-key or replace the affected lock or locks. The Government may, however, at its option, replace the affected lock or locks or perform rekeying and replace any affected lock or locks or perform rekeying and deduct the cost of such from the monthly payment due the contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the contractor.

5.9.3. Only authorized contractor personnel will receive cipher lock combinations and approval to use Government issued keys.

5.10. WORK AREA. The contractor shall at all times, keep work areas free from any accumulation of debris, waste material, rubbish, tools, scaffolding, equipment, and materials. Upon completion of the job, or when away from the work site, the contractor shall leave the work area and its premises in a clean, neat, safe and workmanlike condition.

APPENDIX A

DEFINITIONS

Authorized Personnel: Individuals authorized to place "calls" to the contractor for response to a service call or any other maintenance action or service covered in the Performance Work Statement.

Damage to Government Property: Damage or abnormal deterioration caused by physical abuse or negligence.

Defective Service: A service/part that does not fix the initial maintenance work order.

Escort: One or more persons accompanying the contractor in high security areas on a military base.

Inspection: Detailed visual examination of MAF-R and its components.

Proposal: To submit in writing an offer listing discrepancies identified during inspection of barriers.

Quality Assurance Surveillance Plan (QASP): An organized written document used for quality assurance surveillance. The document contains specific methods to perform surveillance of the contractor.

Quality Control (QC): A contractor program of action to effectively and efficiently manage the quality of performance objectives relating to standards of performance and inspections necessary to assure that the service satisfy the requirements from concept through validation.

Service Call: Service calls are defined as additional visits and service requested at any time other than scheduled/reoccurring maintenance.

Services Summary (SS): Identifies the key service outputs of the contract that will be evaluated by the government to assure contract performance.

Special Maintenance Projects (SMP): Work requirements within the general scope of this contract work but not elsewhere defined or priced

APPENDIX B

ACRONYMS

AFB Air Force Base

AFPET Air Force Petroleum Office

EPA Environmental Protection Agency

CDRL Contract Data Requirement List

CLIN Contract Line Item Number

CO Contracting Officer

COR Contracting Officer’s Representative

FAR Federal Acquisition Regulation

FPMI Full Preventative Maintenance Inspection

FSC Fuels Support Center

IAW In Accordance With

SDS Safety Data Sheet

OSHA Occupational Safety and Health Administration

POC Point of Contact

QASP Quality Assurance Surveillance Plan

QC Quality Control

QCP Quality Control Plan

SMP Special Maintenance Projects

SS Service Summary

APPENDIX C

Work Locations

FE Warren Air Force Base Malmstrom Air Force Base 90th LRS/Fuels 341st LRS/Fuels 7310 Post Rd bldg. 1274 6710 Trainer Dr. Bldg 1469 FE Warren AFB, WY 82005 Malmstrom AFB, MT 59402

Delta One Bravo One 5083 State Rd 21 7046 Sourdough Rd Kimball, NE 69145 Geyser, MT 59447

Golf One Charlie One 3025 State Rd 101 24 Mountain View Rd Sidney, NE 69162 Stanford, MT 59479

Lima One Echo One 63159 State Rd 71 4250 Echo Dr Stoneham, CO 80754 Hilger, MT 59451

Golf One Minot Air Force Base 9958 MT HWY 200

5th LRS/LGRF Agusta, MT 59410 781 Bomber Blvd Minot AFB, ND 58705 Hotel One

579 2ND LN NE

Charlie One Fairfield, MT 59436 1 County Road 6 Benedict, ND 58716 Lima One

1940 US HWY 191 N

Gulf One Judith Gap, MT 59453 1 County Road 3 Plaza, ND 58771 November One

102906 US HWY 87

Mike One Lewistown, MT 59457 3 County Road 2 Tolley, ND 58787

APPENDIX D

WORKLOAD ESTIMATES

AFGSC Missile Facility Refueler (MAF-R) Maintenance

Installation Level of Service Available Hours Number of visits

Minot Air Force Base, North Dakota Full Time M-F 7:30 am – 4:30 pm TBD Malmstrom Air Force Base, Montana Full Time M-F 7:30 am – 4:30 pm TBD FE Warren Air Force Base, Wyoming Full Time M-F 7:30 am – 4:30 pm TBD

Minot Air Force Base, North Dakota Non-Routine Overtime 10 per month (Estimate)

Malmstrom Air Force Base, Montana Non-Routine Overtime 23 per month (Estimate)

FE Warren Air Force Base, Wyoming Non-Routine Overtime 10 per month (Estimate)

APPENDIX E

MAF-R INSPECTION CHECKLIST

AF Form 4427, Operator’s Inspection Guide and Trouble Report

AF4427 Operator's Inspection Guide an

APPENDIX F

Contractor Procured Bench stock

F.E. WARREN AFB, WY

Description Manufacturer Part No. Qty Required Aircraft Nozzle OPW 295SAJ 4 each

Deadman Switches “Pistol

Grip”

Western Technology

1003-CR-25 4 each

Static Grounding Reels

Hannay Reels GR 75 4 each

Filter Separator Elements

Parker Velcon I-622MMTB 4 each

Pump Seals Blackmer 701914, 702242, 701947

4 each

MINOT AFB, ND

Aircraft Nozzle OPW 295SAJ 4 each Deadman

Switches “Pistol Grip”

Western Technology

1003-CR-25 4 each

Static Grounding Reels

Hannay Reels GR 75 4 each

Filter Separator Elements

Parker Velcon I-622MMTB 4 each

Pump Seals Blackmer GX2B 701914, 702242, 4 each

MALMSTROM AFB, MT

Aircraft Nozzle OPW 295SAJ 8 each

Deadman Switches “Pistol Grip”

Western Technology 1003-CR-25 8 each

Static Grounding Reels

Hannay Reels GR 75 8 each

Filter Separator Elements

Parker Velcon I-622MMTB 8 each

Pump Seals Blackmer 701914, 702242, 8 each

DATE: (Month / Year)

PHONE NUMBER

DAY NAME DAY NAME DAY NAME

____________ PSI

DATE COMPLETED:

AF FORM 4427, 20160712 (Previous Editions Are Obsolete) Page 1 of 3 Pages

FILTER SEPARATOR / DP GAUGE / METERS / WATER SLUG VALVE

BOTTOM-LOADING SYSTEM / MANUALLY OPERATED VALVES

DRIVE BELTS / MOTORS / PULLEYS / RADIATOR HOSES

GROUNDING / BONDING HARDWARE

HOSES / HOSE REELS / NOZZLES / COUPLERS / STRAINERS

OPERATE LIFTS / PLATFORMS

TIRES (e.g. Condition / Lugnuts / Valve Caps / Valve Stem Spacing)

CORROSION CONTROL

(Optional Use)

DATE COMPLETED:

OTHER:

NAME:MONTHLY INSPECTIONS

COMPLETED

PANTOGRAPH SECURING PINS

FRONT TIRE PRESSURE: REAR TIRE PRESSURE: ____________ PSI

Page 3 of 3 Pages AF FORM 4427, 20160712

BEGINNING ENGINE HOURS or MILES:

ENDING ENGINE HOURS or MILES:

SIGNATURE & DATE:

FUELS MANAGEMENT TEAM REVIEW

31VEHICLE / EQUIPMENT USAGE & REVIEW SECTION

CARGO TANK / CLEAN OUT STUBS / MANHOLE SEAL / VAPOR RECOVERY SYSTEM / VENTS

GAUGES / INSTRUMENTS / SWITCHES

ELECTRICAL / LIGHTS / SOLAR PANEL / WIRING / EPOSD

ACCESSORIES (e.g. Air Conditioner / Defroster / Heater / Windshield Wipers)

MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS

AIR TANKS

BATTERY SYSTEM / EXHAUST

2 12

7 17

ITEMS TO BE CHECKED

(Place "X" in block adjacent to items requiring Operator's Inspection for the vehicle / equipment type only )

DAILY WHEN USED

SAFETY ITEMS (e.g. Fire Extinguisher / Horn / Markings / Reflectors / Warning Devices)

CLEANLINESS / CORROSION / DAMAGE / LEAKS / MISSING ITEMS / UNUSUAL NOISE

TANK SUMPS / FILTER SEPARATOR SUMPS / RECOVERY TANKS / EXPANSION TANKS

EMERGENCY SHUTOFFS

SURGE SUPPRESSORS

PUMPING SYSTEM / FILTER SEPARATOR / METERS / FUEL SENSING LINES

OPERATOR’S INSPECTION GUIDE AND TROUBLE REPORT

(Fuel Servicing Vehicles & Equipment)

VEHICLE CONTROL OFFICER (VCO) OR VEHICLE CONTROL

NONCOMMISSIONED OFFICER (VCNCO) RANK / NAME

REGISTRATION NUMBERVEHICLE / EQUIPMENT TYPE

LOCATION / BASEORGANIZATION

PHONE NUMBER

HOSES / HOSE REELS / NOZZLES / COUPLERS / MOOSEHEADS

(First Initial, Last Name)

OPERATOR’S NAME SIGNIFIES ACCOMPLISHMENT OF CHECKS

TIRES / WHEELS / BRAKES / TOW CONNECTION / STEERING / CASTERS

GROUNDING / BONDING HARDWARE

INTERLOCKS (e.g. Auxiliary Throttle / PTO / Transmission)

FLUID LEVELS (e.g. Coolant / Gear Oil / Hydraulic / Oil / Transmission / Washer Fluid)

DATE DATE HOURS NAME WORK STATUS EMPLOYEE OPEN SYSTEM LAB TECH

DISCOVERED TIME MILES (First Initial, Last Name) ORDER # CODE NUMBER Y / N NAME

C-T by Temp. Fix

C-P by Perm. Fix

Page 2 of 3 Pages

(See AFI 24-302, Chapter #7)

STATUS CODES:

REMARKS:

D-D for DispositionD = DELAYED

D-P for Parts D-M for Maint.

W = Waiver for Repair

N = No Repairs Required

LABORATORY USE ONLY

VEHICLE / EQUIPMENT DISCREPANCY AND MAINTENANCE REPORT

OPERATOR DISCREPANCY REPORTING OPERATOR REPORTED TO MAINTENANCE MAINTENANCE REPORT STATUS

DATE

AF FORM 4427, 20160712

C = CORRECTED:

DISCREPANCY

Pages 1 & 3

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MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS_Row_10:

MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS_Row_11:

MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS_Row_12:

MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS_Row_13:

MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS_Row_14:

MONTHLY ITEMS TO BE CHECKED IN ADDITION TO DAILY INSPECTIONS_Row_15:

OTHER::

VEHICLE / EQUIPMENT TYPE:

REGISTRATION NUMBER:

ORGANIZATION:

LOCATION / BASE:

PHONE NUMBER:

VEHICLE CONTROL OFFICER (VCO) OR VEHICLE CONTROL NONCOMMISSIONED OFFICER (VCNCO) RANK / NAME:

PHONE NUMBER:

BEGINNING ENGINE HOURS or MILES::

ENDING ENGINE HOURS or MILES::

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