Attachment 3 - Site Visit DLA Form 1818.pdf
PDF 110 KB Posted
- Attached to
- DDSP Boiler Repairs - SP3300-26-Q-0221
- Solicitation number
- SP3300-26-Q-0221
- Issued by
-
Defense Logistics Agency Distribution
About this file
This is a DLA Form 1818 Visit Notification form for a site visit to the Defense Logistics Agency Installation Management at Susquehanna, Building 753 on August 5, 2026. The visit is being coordinated by Christopher Chapman (DISM office code, phone 717-770-4119) to allow potential vendors to inspect Building 753 for the purpose of quoting boiler repair and maintenance requirements. Visitors must pre-register through the DBIDS-global.dmdc.mil website prior to arrival.
The form captures standard security and access control information required for DoD facility visits, including visitor names, grades/ranks, social security numbers, dates of birth, states/countries of birth, security clearances, and clearance dates. The Privacy Act statement establishes the legal authority for information collection under Section 21, 50 U.S.C. 781 et seq., and Executive Order 10450, with disclosure being voluntary but required for facility access. The form must be completed by a security representative and includes sections for signature authorization, activity code, and contact telephone number.
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Text version
PRIVACY ACT STATEMENT
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
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
11.
SSN
12.
DATE OF BIRTH
13.
STATE /COUNTRY OF
BIRTH
14.
CLEARANCE/DATE
GRANTED
15.
TYPE OF INVESTIGATION/
DATE
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:
PDF (DLA)
| RequesterName: Christopher Chapman |
| OfficeCode: DDSP |
| FacPOC: Christopher Chapman |
| Phone: 717-770-4119 |
| POCPhone: 717-770-4119 |
| VisitedActivity: DLA Installation Management at Susquehanna, |
Building 753 VisitPurpose: Site Visit of Building 753 for potential vendors interested in quoting boiler repair and maintenance requirements.
Visitor has registered utilizing the pre-enrollment website: https://dbids-global.dmdc.mil
| DateTo: 8/5/2026 |
| Visitor: |
| 0: Doe, John M. |
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