Attachment 3 - A D Form.pdf

Attachment 3

Abandoned/Destruction (A/D) Form DLA Disposition Services Pearl Harbor

Tire Recycling

Activity POC:

Address:

City: Zip Code:

Phone:

Base Location:

DTID(S):

NOUN NOMENCLATURE: Scrap Tires/Rubber

Quantity:

FINDINGS: Property listed has no R/T/D or sales potential nor any value for basic material content, and/or charitable donation is not feasible, and/or sale of property is uneconomical pursuant to the economy formula (property to be buried in commercial landfill).

Public notice is not given because property value is so little that the retention/advertising for sale is not practical.

Abandonment action is approved. __________________________________________ DLA Disposition Services Chief/Designee Date

“I certify these items were abandoned in the manner authorized by DoD 4160.21-M and other applicable regulations” Abandoned/Destruction Officer Date

I have witnessed the release of this property to a hauler/operator as an item for ultimate disposal action or for later destruction in accordance with the applicable directives/contracts.

Witnessing Party Date

DoD Government Employee Date

Citations:

DoD 4160.21-M: Chapter 8, A/D DRMS-I 4160.14: General Processing, Chapter 2, Property Accounting,, A/D, C2-113; Sec 3, Special Processing, S3- 376 – 379;

Sec 4, Supplement 2, S4S2-235