PWS Attachments.pdf

ATTACHMENT A

DATE: ______________

MEASURE DESCRIPTION OK

NEEDS

ATTENTION NOT APPLICABLE COMMENTS

Number

Identified

Completed and/or TURF / NON-TURF (Circle One)

GM-2.3b/2.9b Visually Prominent Areas are free of trash.

GM-2.4b/2.9d Sunken graves are identified and measures taken to re-establish ground level and cover within 30 calendar days of the date identified.

GM-2.8

Turf damage due to grounds maintenance tasks is identified and corrective action initiaited by close of business the same day

GM-2.9h Grave reopeners are raked and groomed to return the grave to its original state within the same workday (non-turf areas only).

GENERAL MAINTENANCE

GM-6.2a Debris, equipment, tools and supplies are removed from turf areas at the conclusion or each task or at the end of the workday.

GM-6.2b All roads, walkways, shelters, etc are free of grounds maintenance debris at the end of the workday.

SAFETY

OS-3.1a Necessary personal protective equipment and safety measures are adhered to at all times during Grounds Maintenance operations.

OS-3.2a Safety hazards (holes, sunken graves, pest, etc.) identified and corrective action initiated to ensure safety with the same workday.

OS-3.3a

Roads, sidewalks, paths and parking lots open to the public or for cemetery operations during adverse conditions are safe and accessible (e.g. clear of ice and snow or storm debris).

GROUNDS MAINTENANCE CHECKLIST - DAILY

Area/Section Inspected:

Completed by: Title

DATE:

NEEDS

ATTENTION

NOT

APPLICABLE COMMENTS

TURF / NON-TURF (Circle One)

GM-2.1c Turf in Visually Prominent Areas is maintained within one inch of the recommended height.

GM-2.3a/2.9a Turf areas are cleared of leaves and other natural debris as needed or weekly.

GM-2.5/2.9e Visually Prominent Areas have no standing water.

GM-2.6a Turf surrounding headstones is trimmed to its recommended mowing height.

GM-2.6b Turf is edged vertically even with marker and marker is free of trimming debris.

GM-2.6c Other features on cemetery grounds are trimmed or edged within appropriate limits.

GM-2.9f Headstones and markers with sand or gravel surrounding them are generally weed free (non-turf areas only).

GM-2.9g Burial areas appear raked and groomed (non-turf areas only).

PLANTING BEDS

GM-4.1b Planting beds are weed free.

GM-4.1c Plants in planting beds are healthy, vigourous, and free of pests and disease and are maintained in accordance with the CGMP.

GROUNDS MAINTENANCE CHECKLIST - WEEKLY

Completed by: Title

NEEDS

ATTENTION NOT APPLICABLE COMMENTS

Number Identified

Number Completed

TURF / NON-TURF (Circle One)

GM-2.1a Visually prominent area is generally weed free.

GM-2.1b Visually prominent area is generally free of bare areas.

GM-2.7a Grave reopeners during the growing season show healthy turf re-established within 60 days of the interment.

GM-2.7b Winter grave reopeners show healthy turf re-established within 60 days of the start of the growing season.

TREES AND SHRUBS

GM-3.2

Trees and shrubs are healthy, vigorous, free of pests and disease and/or are maintained in accordance with the Cemetery Grounds Management Plan.

GENERAL MAINTENANCE

GM-6.4a Containers for floral vases are well marked, clean, neat and in good repair.

GM-6.4b Floral vases are clean and in good repair

Completed by: Title

GROUNDS MAINTENANCE CHECKLIST - MONTHLY

MEASURE DESCRIPTION OK NEEDS

ATTENTION NOT APPLICABLE COMMENTS Number

Identified Number Completed

TURF / NON-TURF (Circle One)

GM-1.1a Grounds Management Plan is current and includes a cemetery site plan and all maintenance activities and schedules.

GM-1.1b Grounds Management Plan has been reviewed and updated.

GM-1.1c Activities in the Grounds Management Plan are being accomplished

GM-2.2 Turf is compatible with the geographic region.

TREES AND SHRUBS

GM-3.1 Trees and shrubs are compatible with the geographic region.

PLANTING BEDS

GM-4.1a Planting beds contain only material that is compatible with the geographic region.

WASTE MANAGEMENT

GM-5.2a Cemetery has a centralized trash collection point established in a location that is screened from the public.

GM-5.3

Cemetery spoils areas are located, concealed or maintained to minimize public visibility.

GENERAL MAINTENANCE

GM-6.3 Floral regulations are posted in visually prominents areas.

Title

GROUNDS MAINTENANCE CHECKLIST - ANNUAL

Completed by:

A T T A C H M E N T B

P E S T I C I D E A P P L I C A T I O N D A T A S H E E T

Date: Applicator:

APPLICATION SITE

Location:

Size of Treatment Area: Plant Age and Condition:

Description (Turf, Bed etc.): Soil Conditions:

Surrounding Sensitive Areas:

Previous Pesticides Used:

PEST PROBLEM Primary Pest: Damage Observed:

Other Pests Present: Location of Damage:

Beneficials Present:

Severity of Pest Problem:

PESTICIDE(S) USED Pesticide(s): Formulation:

(1)

Rate: Total Amount Used:

(2) (3) Adjuvants Type: Amount: Total Gallons of Diluted Spray

Used:

Surfactant Type: Amount:

APPLICATION Date(s) of Application: Weather Conditions

Temperature:

Equipment used: Cloud Cover:

Wind Speed:

Equipment Calibrated By: Wind Direction:

Rain:

Travel Speed:

Total Hours for Application:

Persons Notified or Spoken to Regarding Application:

(1) (2) (3)

FOLLOW UP Effectiveness of Application:

Beneficials Present: Pest Resurgence Noted:

Injury to Non-Target Plants or Surfaces:

COMMENTS

Signature & Date

ATTACHMENT C

VERTEBRATE PEST INSPECTION SHEET

Gophers, Voles, Moles, Ground Squirrels, Raccoons, Skunks, Geese, Turkeys, Pigs, Snakes, Etc.

Location of Service: __________________ National Cemetery

Date of Service: ______________________

NO. CEMETERY

SECTION

ID# OF NEAREST

HEADSTONE

ANIMAL

PEST TYPE

OLD OR NEW

DAMAGE?

DATE OF

DISCOVERY

CHEMICAL OR

TRAP

TREATMENT

DATE OF

TREATMENT

DATE OF

TURF

REPAIR

CONTRACTOR

SIGNATURE COMMENTS

ATTACHMENT D

CONTRACTOR’S EMPLOYEE STATEMENT OF COMPLIANCE

EMPLOYEE NAME: ______________________________

POSITION/TITLE: ______________________________

DATE: ______________________________

Please check the appropriate blank.

____ New Employee, New Contractor

____ Annual Confirmation for current Employees or Contractor(s) (Due on Nov. 1 of each Contract year or immediately after NTP.)

FOR ALL EMPLOYEES

I have been briefed and understand the following guidance:

INITIALS

_________ The National Cemetery Administration honors veterans with a final resting place and lasting memorial that commemorate their service to our Nation. National Cemeteries are National Shrines. Therefore, the standards for management, maintenance, appearance and operational procedures have been established by the National Cemetery Administration to reflect this Nations’ concern and respect for those interred there. For this reason, my strict adherence to the Performance Work Statement, Performance Work Requirements Summary and Guidance Specifications must be required and must be essential.

_________ I will remain aware of the remains buried in the grounds where work is being performed.

The utmost care must be given to these remains and the headstones and flat grave markers that mark those gravesites and memorialize the service of individuals.

_________ I will not walk, stand, lean, sit or jump on headstones, markers, or monuments. Nor will I drive over them.

_________ I will not place or lean tools, equipment, or other items on headstones, markers, or monuments at any time.

_________ I have been briefed on the approved methods and tools to remove headstones and markers from their sockets in accordance with the Contract Specifications. I will use the tools and methods approved by the Contracting Officer Representative (COR) to lift headstones and markers out of the ground in order to avoid damage; pick axes are not an acceptable tool.

_________ I will not place headstones or markers on dirt piles or mud once they are removed from their sockets; in order to show appropriate respect towards the families visiting the gravesites and the remains that are buried, I will ensure headstones and markers are carefully stored on each associated gravesite and protected from damage or soiling, in accordance with Contract Specifications.

_________ I understand that the Contractor must be responsible for replacing damaged headstones and markers and for restoring turf damaged during performance of this work.

_________ Should any on-site activity, incident, emergency, or disaster result in exposure and/or damage to any remains, container for remains (i.e., casket or urn), or outer burial container, I will IMMEDIATELY notify the Cemetery Director, the COR and/or the Contracting Officer; I will take immediate steps to protect and render safe any exposed remains; and stop any further work until the Cemetery Director provides the Contractor ‘s Supervisor guidance regarding disposition of the remains and permission to proceed.

SIGNATURE BLOCK

Signature

Printed Name

Date

IF THIS STATEMENT IS THE EMPLOYEE’S ANNUAL COMPLIANCE STATEMENT, THIS COMPLIANCE

STATEMENT MUST BE RETURNED TO THE COR BY NOVEMBER 1 OR AFTER NTP.

AS TO STATEMENTS OR COMMITMENTS OF FUTURE ACTIONS, THIS COMPLIANCE STATEMENT COVERS THE PERIOD FROM OCTOBER 1 OF THE CALENDAR YEAR DURING WHICH THIS COMPIANCE STATEMENT

IS DUE THROUGH SEPTEMBER 30 OF THE NEXT CALENDAR YEAR.

Attachment E

Monday Wednesday FridayTuesday Thursday

Flower Pick-up / Mow Schedule

GMC

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Attachment F

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