FOI_2011-00646_Enclosure - Hanford Site

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Acrobat 9.0 WCH SURVEILLANCE REPORT 1. Surveillance No.: 2. ProjectlFunction/SubcontractorOHC: 3. Date(s): FR-2010-SO72 4. Topic: Remedial Action/i 181/Dance Design Inc (DDI) ODI PROCUREMENT DOCUMENT CONTROL/CONTROL OF PURCHASED ITEMS AND SERVICES 5. Location: 6. Surveillance Personnel: 7. Personnel Contacted: 8. Applicable Requirements: DDI Q.A. Manual rev 0, Sections 4 and 7 9. Results: (Record numbers of any IFs, NCRs, SDRs or OHCDRs) 10. Description of Surveillance: (e.g., what methods were used in the surveillance, what observations were noted, what deficiencies were noted.) Requested, and obtained a copy of DDI Subcontract No.: WCH09199-S01, issued to WATTS Construction. Selected Attachment B - General Conditions parts GC 7.30 Quality Assurance Program, GC 8.1 Authorized Representative to assist in verification of DDI's QAM Sections 4 and 7 Implementation. This verification is intended to provide objective evidence of DDI's conformance to NQA-1 requirements for PROCUREMENT DOCUMENT CONTROL/CONTROL OF PURCHASED ITEMS AND SERVICES. 11. Describe Any Immediate Action Taken: WCH-QA-047a (02/05/2009) Page 1 of 2
Acrobat 9.0 WCH SURVEILLANCE REPORT 1. Surveillance No.: 2. ProjectlFunctionlSubcontractorOHC: 3. Date(s): FR-2010-S072 Remedial Action/i 18K1/Dance Design Inc (DOI) 12. Surveillance Performed By: ADAMSON EVERETT L ___________ Name Signature Date 13. Reviewed by STRJWork Order Originator, if applicable: BEACH CHRISTOPHER L___ _________ Name Signature Date 14. Approved by Initiating Manager: PARNELL SCOTT E X3-16 ____________ Name Signature Date 15. Continuation Sheets or Attachments: Yes No No. of Pages: 5 If yes, list: 16. Distribution: Initiator: ADAMSON EVERETT L X3-40 STIR for subcontractor surveillances: BEACH CHRISTOPHER L X3-16 Work Order Originator for OHC surveillances: N/A Affected Management: (including subcontractor or OHC through the responsible STIR or Work Order Originator, if applicable): FERGUSON RAYMOND J X3-17 Initiating Manager: PARNELL SCOTT E X3-16 QA&S Manager: HAS SELL HAROLD (MIKE) M H-4-25 Environmental Manager: JOHNSON WAYNE F H4-22 CAMS Coordinator: WOODFORD TERRY L H-4-25 PAAA Coordinator: CHRISTENSEN KEVIN C H4-25 Document Control (original of Report and copies of any Deficiency Reports): H4-11I HUXOLL ROBIN L N3-30 CANTWELL ROBERT D N3-30 CARTER ROBERT A N3-23 WCH-QA-047a (02/05/2009) Page 2 of 2
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