Appendix L ECMM Sample Trip Report.docx

DEPARTMENT OF THE AIR FORCE

AIR FORCE MEDICAL AGENCY

Falls Church VA

APPENDIX L

ECMM Sample Trip Report

DATE

MEMORANDUM FOR NAME

ADDRESS

FROM: AFMED/SG4W

601 Davy Crockett Rd Bldg 1534, Suite 100 San Antonio, TX 78226-1885

SUBJECT: Delivery Report Name

1. 1. On DATE, the XXXXX Team (XXXXX, XXXXX and XXXXX) performed maintenance on the following projects:

MC-CBRN:

2. Point of contact for D: NAME, Phone: XXXX , Email. NAME was contacted by the NAME on Date, regarding this Name of Maintenance visit.

3. Name of Maintenance Item assemblages maintained were validated using the latest Medical Resource Letter (MRL) and Allowance Standard (AS).

4. A complete inventory of the above Name of Maintenance Item assets was accomplished.

a. All quality assurance data was validated and changes were updated during the inventory.

b. Research was performed on overages and shortages to include validation of prime substitute relationships and adjusted units of issue.

c. Excess and expired items up to 1 Sep 2017 were removed and processed for final disposition on all Name of Maintenance Item assemblages even those not inventoried during this maintenance visit.

d. Training was provided IAW AFMED guidance to XXXX, XXXXX and XXXXX.

e. No Inventory Adjustment Vouchers (IAV) were processed. The inventory certification package was forwarded to the Medical Logistics Flight Commander: NAME.

5. . Name of Maintenance Item assemblages maintained were validated using the latest AS with locally approved changes.

a. Annual inventories and quality assurance requirements were completed, as described for Name of Maintenance Item assemblages, excluding all Biomedical Equipment maintenance work orders.

b. Excess and expired items up to Date were removed and processed for final disposition except for a few pharmaceuticals that Team Chiefs wanted to hold onto until replacements were received.

c. SG06 low percentage was due to items being expired. The Logistics Team will contact XXXX at AFMED/SG4W to work shortages.

e. No Inventory Adjustment Vouchers (IAV) were processed. The inventory certification packages were forwarded to Team Chiefs for signatures and to be briefed at the next Medical Readiness Committee IAW AFI 41-209, Chapter 8.30.3.2.3.1. OPEN: OPR: NAME.

6. During the Name of Maintenance Item inventory process equipment and maintenance significant items were inspected, calibrated or tested. Equipment data files (EDF) were inspected and work orders were filed or provided to Name for further review and filing IAW AFI 41-201, Para 2.4.3. Equipment data files are located in the BMET shop. Attached is a list of equipment requiring additional action (Name of Maintenance Item Equipment Service Report). OPEN: OPR: NAME.

7. The Travel Team Lead from Base had access to Server Name server.

8. Name (s) were out-briefed on all aspects of the Name of Maintenance Item maintenance visit. Members of the XXXX maintenance team express their sincere appreciation for the professional courtesy and assistance provided by the NAME. Please feel free to contact NAME, Phone or Email should you desire further discussion regarding this visit.

NAME

ECMM Contract Program Manager

I certify that the performance of this maintenance visit meets the requirements set forth in the ECMM Contract.

NAME

ECMM COR

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