(WNC) Attachment 5 - Daily Headstone-Marker Raise _ Realign Verification Survey.pdf
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This document contains an attachment for a daily verification survey of headstone and marker raises and realignments at the Willamette National Cemetery. The attachment provides instructions for cemetery directors, contracting officers, or their designees to perform a re-verification survey of all completed raise and realignment work each day using the original burial register report and gravesite layout map from the initial verification survey. It requires listing the sections and headstones worked on, any discrepancies found, and whether all issues were resolved or need to be reported to the district office director and contracting officer. The signatory certifies that the daily headstone verification survey was completed by providing the date, time, and their signature.
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Willamette National Cemetery National Shrine Project – FY23 Cemetery Section Renovation - Phase 4 Project No.: 907-Mill-FY23-001
ATTACHMENT 5
DAILY HEADSTONE/MARKER RAISE & REALIGN VERIFICATION SURVEY
Station Number:__________ Date:_____________________
Cemetery: _______________ Cemetery Director: _______________
COR: ___________________
Instructions: Prior to the completion of the workday, the Cemetery Director/COR/Foreman/Work Leader/designee MUST perform a re-verification survey for ALL completed work of headstones/markers included in the scope of work. The Cemetery Director/COR/Foreman/Work Leader/designee will use the original Burial Register Report and Gravesite Layout Map used for the Initial Verification Survey.
List Sections and Headstones/Markers R&R: __________________________________
List discrepancy/issue: ___________________________________________________
All discrepancies/issues resolved: Y/N ______
Cemetery Director/COR/Foreman/ Work Leader/designee informed District Office Director and Contracting Officer of all unresolved discrepancies/issues: Y/N _______
By signing below, I certify the Headstone/Marker re-verification survey was completed.
Daily Headstone Verification:
Date: __________ Time Completed: ______________
COR/Director/Foreman/Work Leader/designee Signature: ________________________
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