9. KTR Work Surveillance Checklist- Anniston Renewal- PR 25-BE-017.pdf
PDF 96 KB Posted
- Attached to
- Anniston Hazardous Waste Removal Federal contract opportunity
- Solicitation number
- SP450025R0008
- Issued by
- Defense Logistics Agency
About this file
The document is a Contractor Work Surveillance Checklist for Industrial Cleaning Services (ICS), specifically for Contract Line Item Numbers (CLINs) 1002SV-1004SV and 1007SV-1009SV. The checklist is designed for a government representative to systematically evaluate and document a contractor's performance during industrial cleaning work. Key inspection points include verifying the work crew's arrival time, equipment readiness, and operational compliance, with specific focus on vacuum truck specifications such as tank cleanliness, chemical compatibility, and proper documentation like weight tickets. The checklist requires confirmation of equipment including a 3,500-gallon vacuum truck with 300 feet of hoses, a heated power washing unit, a liquid transfer pump, and appropriate personal protective equipment (PPE). The form allows the government representative to mark "Yes", "No", or "N/A" for each criteria and provides space for additional comments, with a section for the representative's signature and date of assessment.
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Text version
Contractor Work Surveillance Checklist
Industrial Cleaning Services (ICS) – CLINs 1002SV-1004SV & 1007SV-1009SV
Date(s) of Work Surveillance: _________________ Start Time: ___________ Stop Time: ___________
Name of Designated Government Representative: ___________________________________________
Title of Designated Government Representative: ____________________________________________
Phone Number of Designated Government Representative: (______) ________-___________
Yes No N/A Description of Contractor Work Surveillance
Did the work crew arrive on site at the scheduled time and date?
Did the crew arrive on site with all of the requisite equipment, including
- One standard vacuum truck (3,500-gal capacity) w/ 300 feet of hoses,
- One self-contained heated power washing unit,
- One liquid transfer pump w/ 300 feet of hoses, and
- All appropriate PPE and tools?
Did the vacuum truck driver provide a weight ticket showing the empty (tare) weight of the vacuum truck?
Was the vacuum truck inspected by a designated Government representative prior to use?
Did the vacuum truck arrive with a clean tank and hose fittings that were constructed of material that that was chemically compatible with the waste to be removed?
Did the vacuum truck arrive free of visible waste residue unless the truck was being used for multiple removals from the same project involving the same waste stream
(in which case it arrived as meeting definition of RCRA empty per 40 CFR 261.7)?
Did all of the equipment operate properly without causing delay in work?
Was the work performed to the satisfaction of the designated Government representative?
Comments:
Signature of Designated Government Representative Date
File details come from the government source that posted it. Updated .