PWS_Attch_S009.pdf
PDF 21 KB Posted
- Attached to
- STLI Mechanical Operations & Maintenance Services Federal contract opportunity
- Solicitation number
- 140P4526R0007
About this file
Summary of Attachment No. S009: STLI Utilities Maintenance
This document is a template for the Statue of Liberty Maintenance Equipment Form, a tracking card designed to document maintenance activities on all equipment receiving service. The form serves as a permanent record installed directly on each piece of equipment and captures comprehensive equipment identification information and maintenance activity logs.
The template includes fields for equipment specifications (major system, sub-system, component, symbol, manufacturer, rating in tonnage/BTU/HP, building number, equipment number, and three location fields) along with an 11-row maintenance log. The log records worker name, initials, division/company affiliation, start date/time, work authorization number (shop work authorization, contract number, or delivery order number), completion date/time, work order number, and remarks describing work performed. Instructions mandate that technicians print their last name legibly with the first letter of their given name, sign their initials, identify their company or park division, record precise start and completion times and dates, reference the applicable authorization documentation, and document the specific work performed. The card must be removed, replaced, and returned to maintenance when all lines are completely filled.
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Text version
Attachment No. S009 STLI Utilities Maintenance
The following is a sample of the Statue of Liberty “Maintenance Equipment Form”
MAINTENANCE EQUIPMENT FORM
CARD No.00001 Major System:
Sub System:
Component:
Symbol:
Equipment manufacturer:
Rating(S.)(tonnage\ BTU,HP):
Building number:
Equipment number:
Location 1 Location 2 Location 3 Notes:
Name Initial Division/Co. Date time WO No. Remarks performed 1 S
C 2 S
C 3 S
C 4 S
C 5 S
C 6 S
C 7 S
C 8 S
C 9 S
C 10 S
C 11 S
C
Instructions: This card is to be installed on each and every piece of equipment that is receiving maintenance, (Preventive Maintenance, corrective Maintenance etc.). The card will be completed and filled out as follows:
1. NAME: Print Last name legibly then first letter of given name.
2. INIT. Sign your Initials.
3. DIV/Co. The Company or Park Division your From.
4. START . The time and Date that work has begun.
DATE/TIME
5. AUTH No. Insert the Authorization Number given to the work which is being performed. E.g. (Shop work authorization No., Contract No. and Delivery Order No.,)
6. COMP: The Time and Date that the work is Completed on.
DATE/TIME
7. RMKS-WORK PERFORMED
THIS CARD MUST BE REMOVED, REPLACED AND RETURNED TO
MAINTENANCE WHEN ALL LINES ARE FULL!!!
File details come from the government source that posted it. Updated .