TC 71-126 Rest Area Inspection Form.pdf
PDF 178 KB Posted
- Attached to
- Janitorial Svcs Bullitt Co Rest Areas
- Solicitation number
- RFB 605 2300000053 1
- Issued by
- Breckinridge County, Kentucky
About this file
This is a Rest Area Maintenance Inspection Report form (TC 71-126) issued by the Kentucky Transportation Cabinet Division of Maintenance used to evaluate the condition and maintenance standards of rest areas. The form provides a standardized scoring system across multiple facility categories including men's restrooms, women's restrooms, utility rooms, vending buildings, staff performance, and grounds areas. Each section contains specific inspection items with assigned point values, with a maximum total possible score of 210 points. The inspection covers critical maintenance elements such as floor and wall conditions, plumbing fixtures, lighting, sanitation supplies, HVAC systems, staffing levels, and exterior grounds maintenance including parking areas, sidewalks, and landscaping.
The form employs a tiered rating scale with corresponding penalty assessments based on total points scored: scores of 210-188 receive no penalty, 187-166 incur a 5% daily rate penalty, 165-145 result in a 10% daily rate penalty, 144-124 impose a 15% daily rate penalty, and scores below 124 trigger a 20% daily rate penalty plus vendor complaint or show cause letter. Certain items marked with an asterisk indicate failure results in immediate penalty per contract terms. The inspection document requires completion of location information, directional designation (NB, SB, EB, WB), inspection date and time, inspector signature, and supervisor verification, establishing an objective performance measurement system for rest area maintenance contractors operating under Kentucky Transportation Cabinet jurisdiction.
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Text version
Kentucky Transportation Cabinet
Division of Maintenance
REST AREA MAINTENANCE INSPECTION REPORT
TC 71-126
3/2017
Location: County: Route: NB: EB:
Date: SB: WB:
A.
Points
Possible D.
Points
Possible Points Scored
1 3 1 Pass/Fail
2 3 2 3
3 3 3 3
4 3 4 3
5 3 5 3
6 3 6 3
7 3 7 3
8 3 8 3
9 3 9 3
10 2 10 2
11 2 11 2
31 12 2
B. Pts. Possible 30 0
1 Pass/Fail E. Pts. Possible Scored
2 5 1 3
3 5 2 3
4 5 3 3
5 3 4 3
6 3 5 2
7 3 14 0
8 3 F. Pts. Possible Scored
9 3 1
10 3
11 3 2 3
12 3 3 3
13 3 4 3
14 2 5 3
15 2 6 3
16 2 7 2
48 8 2
C. Pts. Possible 9 2
1 Pass/Fail 10 2
2 5 11 2
3 5 25 0
4 5 G. Pts. Possible Scored
5 5 1 Pass/Fail
6 3 2 Pass/Fail
7 3 3 5
8 3 4 3
9 3 5 2
10 3 6 2 11 3 12 0
12 3 210 0
13 3
14 2
15 2
16 2
Subtotal 0
Inspector:
Floors
Exhaust Fans / Air Vents
Supervisor
Telephone
PPE
Walls / Ceilings
Stall Partitions
123-0 20% Daily Rate +
* Failure results in immediate PENALTY. Refer to Contract.
144-124 15% Daily Rate +Subtotal 0
Supervisor Log Posted
Subtotal
Trash Containers
Interior Lighting
Soap
VENDING BUILDING
Floors
Lights / Emergency Lights
Signs
UTILITY ROOM
Exhaust Fans / Air Vents
Trash Containers
Doors
Sanitary Napkin Containers
Doors
Mirrors
Dryers
Walls / Ceilings
Sidewalk
Subtotal
Sinks/Countertops/Faucets
Interior Lighting
Sharps Containers
Toilet Paper
Storage Area / Kitchen
Floors
Blood pathogen kit/
First Aid Kit*
Scored
Interior Lights
HVAC Filters
Commodes
Baby Changing Station
Sinks/Countertops/Faucets
Urinals
Baby Changing Station
Subtotal
Stall Partitions
MEN'S RESTROOM Scored
Toilet Paper
Trash Containers
Heat and RA Vents
Sharps Containers
Walls / Ceilings
Commodes
Windows
Walls/Ceilings
Subtotal
Working/Not Loitering
STAFF
Fully Staffed*
Courteous / Respectful
RATING SCALE
210-188
Uniforms*
187-166
Pass/Fail
Doors/Closed
PENALTY
No Penalty
5% Daily Rate
SDS Sheets
Floors
Soap
Dryers
Mirrors
LeavesAsh Trays
Outside Storage Area
Subtotal
Trash Containers
Dog bags
Benches
WOMEN'S RESTROOM
Tables / Grills / Pads
Trash Containers
Heat and RA Vents
Interior Lighting
Parking Area / Curbs
Exterior Lighting
Windows Sidewalks
Doors
Map Dispenser
Water Fountains Snow and Ice Removal*
Walls / Ceilings Flag and Flagpole
Floors / Mats
Time of Inspection:
Points Scored GROUNDS AREA
10% Daily Rate 165-145
Litter Pick up
LOBBY / TOURISM AREA
"+" Vendor will receive VENDOR COMPLAINT or SHOW CAUSE LETTER
TOTAL POINTS
Kentucky Transportation Cabinet
Division of Maintenance
REST AREA MAINTENANCE INSPECTION REPORT
TC 71-126
3/2017
Location: County: Route: NB: EB:
Date: SB: WB:
ITEM REMARKS
Supervisor:
SECTION
Inspector:
Time of Inspection:
File details come from the government source that posted it. Updated .