Attachment_3_-_Manifest_Tracking_Log.pdf

Solicitation No. SP4520-15-R-0003 Attachment 3

MANIFEST

TRACKING LOG

DRMS Form 1683E

I CERTIFY THAT THIS CONTRACT PERFORMANCE SUPPORTING DATA IS ACCURATE, COMPLETE

AND MEETS ALL REQUIREMENTS SET FORTH IN THE CONTRACT.

COMPANY NAME:

DATE PREPARED

CONTRACT NUMBER

SP4520-

Delivery Order/Task Order # NAME (Print) SIGNATURE INVOICE NUMBER AND AMOUNT

1.

LINE #

2.

BOSS DOC. NO.

3.

CLIN #

4.

PICKUP MANIFEST

NUMBER(S)

5.

QUANTITY

PICKED UP

6.

INTIIAL (Temporary)

STORAGE FACILITY BOSS

ID #

7.

INTIIAL

(Temporary)

STORAGE

FACILITY

HANDLING

CODES

8.

EWC CODES

9.

FINAL TSDF DISPOSAL

MANIFEST #

10.

FINAL TSDF FACILITY BOSS

ID #

11.

QTY DISPOSED

12.

FINAL TSDF

DISPOSAL

HANDING CODES

13.

FINAL TSDF

ACCEPTANCE DATE

(dd-mm-yyyy)

DRMS FORM 1683E, July 2006

Solicitation No. SP4520-15-R-0003 Attachment 3

INSTRUCTIONS FOR ATTACHMENT 2

Col 1. List the Delivery Order Line Number for the items being disposed (four (4) digits - i.e., 0001)

Col 2. List the waste stream document number as it appears on the DD Form 1155 (eight (8) digits - 12383976)

Col 3. CLIN Number - (N26000)

Col 4. List all pickup manifiest numbers (last five digits)

Col 5 Total kgs picked up

Col 6. List the Facility ID Number (12 digits) for the Initial Temporary Storage Facility used

Col 7. List the temporary storage facility handling codes

Col 8. List the European Waste Code Number(s)

Col 9. List the final TSDF disposal manifest (last five digits)

Col 10. List the Facility ID Number (12 digits) for the Final TSDF Disposal Facility

Col 11. List the quantity disposed

Col 12. List the final disposal handling codes

Col 13. Provide the date accepted at the Treatment Storage Disposal Facility (TSDF)(mm/dd/yyy)