Attachment 5 DL1818.pdf

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Attached to
SP3300-22-Q-0089 Sewage Sludge Removal - DLA Distribution Susquehanna PA
Solicitation number
SP3300-22-Q-0089
Issued by

About this file

This document is a visit notification form for Defense Logistics Agency Distribution. The form provides details of a site visit on August 11th, 2022 to building 430 for a construction project involving light replacement. The visitor is Mogen Gilson who will meet with the point of contact David Fetzner at 10:00 AM. The security representative signature block is blank. Additionally, the related federal contract opportunity is solicitation number SP3300-22-Q-0089 for sewage sludge removal services at the DLA Distribution facility in Susquehanna, Pennsylvania. The solicitation and attachments provide additional requirement details.

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VISIT NOTIFICATION

1. ACTIVITY TO BE VISITED

AUTHORITY:

PRINCIPAL PURPOSE:

ROUTINE USES:

DISCLOSURE:

DEFENSE LOGISTICS AGENCY

8725 JOHN J. KINGMAN ROAD

FT BELVOIR, VA 22060-6220

PRIVACY ACT STATEMENT

Section 21, 50 U.S.C. 781 et seq.; Executive Order 10450.

To control access to and movement on DoD installations, buildings, or facilities.

Used by General Services Administration Protective Service Personnel for access control and for any of the Blanket Routine Uses published by DLA.

Voluntary. However, failure to provide all the requested information may result in refusal to grant access to the installation, building, or facility.

DLA PRIVACY ACT SYSTEM NOTICE S500.50 DLA-I APPLIES

SECTION I

2. NAME OF REQUESTOR/PREPARER 4. TELEPHONE3. OFFICE CODE

5. DATE(S) OF VISIT 6. POINT OF CONTACT (at facility to be visited) 7. POC TELEPHONE

8. PURPOSE OF VISIT

SECTION II

9.

NAME(S) OF VISITOR(S)

(Last, First, MI)

10.

GRADE/RANk

(IF APP)

11.LAST 4 -

Social Security No.

12.

DATE OF BIRTH

13.

DL State & Number

14. 15.

16. TYPED NAME OF SECURITY REPRESENTATIVE

SECTION III

18. ACTIVITY 19. TELEPHONE NUMBER 20. DATE17. SIGNATURE OF SECURITY REPRESENTATIVE

DLA FORM 1818, JUL 96 (EG)

FROM: TO:

PerFORM (DLA)

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Text1:
0: DLA Distribution
1: Meeting at the front of bldg 430
2: 10:00 AM-11:00 AM
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Text2: Mogen Gilson
Text3: J7
Text4: X-4757
Text5: 8/11/2022
Text6: 8/11/2022
Text7: David Fetzner
Text8: x-6905
Text9:
0: Site visit for construction project - bldg 430 light replacement
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Text17: Please fax to both X5480 & X8146.
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File details come from the government source that posted it. Updated .