Pit/Vault Toilet Data Entry Form -- HEADER SHEET
Unit:
Bldg ID # :
Bldg Name:
Location:
Bldg. Cat.:
Size (GSF):
Maintenance Level:
Vault/Pit Toilet
0
Remoteness Factor:
1
Historic :
Inspector Name:
Inspection Date:
Year Constructed:
Year Surveyed:
Benefiting Function:
(Fill in: If Roaded Remote, 1.15; Wilderness/Primitive Remote, 1.5; Historic,
1.5; Roaded Remote & Historic, 1.65; Wilderness Remote & Historic, 2.00)
(Fill in: E=eligible, I=ineligible, L=listed, U=undetermined)
NFRM
(Fill in: NFFA(facilities), QMQM(quarters), NFRM(recreation),
NFFV(reforestation), NFRV(range), NFHR(heritage), etc.)
Pit/Vault Toilet Data Entry Form -- ANNUAL MAINTENANCE
Unit:
Bldg Cat.: Vault/Pit Toilet
Location:
Bldg ID #:
Bldg Name:
Size (GSF): 0
Historic :
Maintenance Level:
Remoteness Factor: 1
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Quantity
Units
Description
101000 GENERAL AND SITE WORK
Inspector Name:
Inspection Date:
Year Constructed:
Year Surveyed:
Cost/unit
General and Site Work Totals:
Annual Maint Cost
H&S
Res
$0
$0
0
Mis
Priority for
Funding
$0
Division 1 - General
General
Management
Other
Division 2 - Site Work
Driveways, Parking (if not incl. In site)
Sidewalks, Trails (if not incl. In site)
Signage, Exterior
Site Drainage (if not incl. In site)
Landscaping
Other
Misc. Annual Maintenance and Repair (Small Items, Break Downs)
All costs are per s.f. of floor area
Direct costs only including specific proj prep, procurement, and,
Contract Administration ( .50 s.f. of floor area )
Seal Coat, Repaving, Restripping, Grading, Rock Replacement, etc
( .04 / s.f. of driveway)
PMR&R ( .18 / s.f. of walk or trail)
PMR&R ( actual-site specific ) As attached for toilets
Culvert, Catch Basin, Ditch Clearing ( actual-site specific )
( actual-site specific ) (not lawn mowing or upkeep of grounds)
202000 ARCHITECTURAL WORK (Divisions 3 to 14)
Division 3 - Concrete
Precast Building, etc.
Precast Vault
Other
Division 4 - Masonry
Other
Division 5 - Metals
Rails, Posts, etc.
Other
Division 6 - Wood
Exterior Siding and Trim (See Painting)
Interior Trim (See Painting)
Wood Framing/Trusses (See Painting)
Other
Division 7 - Thermal & Moisture Protection
Roofing
Flashings, Grilles, Louvers
Caulking
Other
Division 8 - Doors & Windows
Doors & Frames - Exterior
Windows & Frames
Hardware-Locks, Keys, Closers - Ext
Weatherstripping
Other
Division 9 - Finishes
Plywood/Fiberglass Walls/Ceiling
Painting-Exterior
0 SF-Flr Area
$1.50
$0
7
0 SF-Flr Area
$0.50
$0.00
$0
$0
7
7
$0.04
$0.18
$0.50
$0
$0
$0
$0
$0
$0
7
7
7
7
7
7
SF
SF
SF
Site
Site
Architectural Totals:
PMR&R ( $95.00 per s.f. of floor area/50 yr = 1.90 )
PMR&R ( $4.00 per gallon capacity /50 yr = 0.08)
SF
Gallon
PMR&R ( actual-site specific )
EA
PMR&R, Rot/Mildew Control ( .10 s.f. of wall area )
PMR&R ( .05 s.f. of floor area )
PMR&R (.02s.f. of floor area)
SF
SF-Flr Area
SF-Flr Area
PMR&R ( wood shingle and shake - .23, standard metal - .10,
composition shingles - .10, fiberglass - .07. All costs per s.f. of roof
area ) See division 3 for a concrete precast roof
PMR&R (Included in roof costs)
PMR&R ( .02 cents per floor area)
SF-Roof Area
0 SF-Flr Area
PMR&R ( $40.00 per year per door )
Glazing, Glass Replacement, Entire Unit Replacement ( $30.00 per window)
PMR&R (exterior doors - $50.00 per year per door )
PMR&R ( $5.00 per opening, exterior doors and windows)
EA
EA
EA
EA
PMR&R (.04 cents per s.f. of floor area)
Repaint every 5-10 years ( .10 s.f. of floor area )
SF-Flr Area
SF-Flr Area
Page 2
$0
$1.90
$0.08
$0
$0
$0
$0
$0
7
7
7
$0
7
$0
7
$0
$0
$0
$0
7
7
7
7
$0
$0
$0
$0
7
7
7
7
$40.00
$30.00
$50.00
$5.00
$0
$0
$0
$0
$0
7
7
7
7
7
$0.04
$0.10
$0
$0
7
7
$0.10
$0.05
$0.02
9/3/2004
Pit/Vault Toilet Data Entry Form -- ANNUAL MAINTENANCE
Unit:
Bldg Cat.: Vault/Pit Toilet
Location:
Bldg ID #:
Bldg Name:
Size (GSF): 0
Historic :
Maintenance Level:
Remoteness Factor: 1
Inspector Name:
Inspection Date:
Year Constructed:
Year Surveyed:
PRIORTITY for FUNDING: 1 High Safety Hazard
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Quantity
Units
Repaint every 5-10 years ( .15 s.f. of floor area )
0 SF-Flr Area
Painting-Interior
Other
Division 10 - Specialties
Signage-Interior
Toilet & Bath Accessories
Other
Division 11 - Equipment
Other
Division 12 - Furnishings
Other
Division 13 - Special Construction
Fiberglass/Steel Vault
Other
Division 14 - Conveying Systems
Other
PMR&R - included in genral
PMR&R ($25.00 per year per bathroom)
Cost/unit
$0.15
Bathroom
PMR&R ($1.0 per buried gallon capacity/10 yr life = 0.10)
315000 MECHANICAL WORK
$25.00
Gallon
$0.10
Mechanical Totals:
Division 15 - Mechanical
Plumbing
Vault Pumping
PMR&R
PMR&R Times Pumped per Year
Fixtures - Toilet Risers
Ea
PMR&R ( $50 per toilet riser)
PMR&R, Inspections, Clear - (covered under general) (include odor
control vents)
Plumbing Vents
Other
416000 ELECTRICAL WORK
Annual Maint Cost
H&S
Res
Riser
$0
$0
$0
$0
$0
7
7
7
$0
7
$0
7
$0
7
$0
7
$0
$0
$0
7
7
$50.00
$0
7
$0
$0
7
7
$0
$0
Division 16 - Electrical
Other, including Solar power
Location Factor or Multiplier =
Priority for
Funding
$0
7
$0
7
Mis
$200.00
LS
Electrical Totals:
0
$0
$0
7
1
TOTAL
Page 3
$0
$0
$0
9/3/2004
Pit/Vault Toilet Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Bldg Cat.: Vault/Pit Toilet
Location:
Maintenance Level:
Bldg ID #:
Bldg Name:
Size (GSF):
Historic :
Remoteness Factor: 1
Inspector Name:
Inspection Date:
Year Constructed: 0
Year Surveyed:
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Deficiencies
Quantity
Units
Cost/unit
101000 GENERAL AND SITE WORK
Division 1 - General
Other
Division 2 - Site Work
Signage, Exterior
General and Site Work Totals:
Priority for
Funding
Deferred Maint Cost
H&S
Res
Mis
$0
$0
$0
0
( actual-site specific )
EA
Toilet Removal (includes backfilling vault)
(500 per toilet building)
EA
Landscaping
Tree Removal, Heavy Brushing or
Trimming, Plant Replacement
(actual-site specific ) (not lawn
mowing or upkeep of grounds)
Site
0
$500.00
0
0
0
Other
202000 ARCHITECTURAL WORK (Divisions 3 to 14)
Division 3 - Concrete
Precast Buildings, etc.
Precast Vault
Replace Toilet (Aspen Style)
Other
Division 4 - Masonry
Other
Division 5 - Metals
Structural, Ornamental (See Painting)
Rails, Posts, etc.
Other
Division 6 - Wood
Exterior Siding and Trim
Interior Trim
Wood Framing/Trusses
Other
Division 7 - Thermal & Moisture Protection
Roofing
Flashings, Grilles, Louvers
Caulking
Other
Division 8 - Doors & Windows
Doors & Frames - Exterior
Windows & Frames
Hardware-Locks, Keys, Closers - Ext
Architectural Totals:
( actual-site specific )
( actual-site specific )
(9,000 per unit)
$0
SF
EA
EA
$0
$0
0
0
$9,000.00
0
0
( actual-site specific )
( actual-site specific )
EA
EA
0
Cedar siding (3.50 s.f. of wall area)
( actual-site specific )
( actual-site specific )
SF-Wall Area
SF-Flr Area
SF-Flr Area
( wood shingle/shake - 4.50, metal 2.00, composition -1.50, fiberglass 1.00. Per s.f. of roof area)
(actual)
( $1.47 per linear foot)
SF-Roof Area
$3.50
0
0
0
0
0
0
0
0
0
LF
$1.47
$750.00
g, per Door p
,
Entire Unit Replacement ($500.00
avg.)
EA
$750.00
EA
$500.00
0
(exterior doors - $150.00 per door )
EA
$150.00
0
Page 4
0
9/3/2004
Pit/Vault Toilet Data Entry Form -- DEFERRED MAINTENANCE
Unit:
Bldg Cat.: Vault/Pit Toilet
Location:
Maintenance Level:
Bldg ID #:
Bldg Name:
Size (GSF):
Historic :
Remoteness Factor: 1
Inspector Name:
Inspection Date:
Year Constructed: 0
Year Surveyed:
0
2 Safety Hazard
3 Structural Hazard
4 Not According to Code
PRIORTITY for FUNDING: 1 High Safety Hazard
5 Critical Maintenance 6 Energy Conservation 7 Routine Maintenance 8 Outdated/Nice to Have
CSI Division
Measurements
Description
Deficiencies
Quantity
Units
Cost/unit
Weatherstripping
Other
Division 9 - Finishes
Plywood/Fiberglass Walls/Ceiling
Painting-Exterior
Painting-Interior
Other
Division 10 - Specialties
Signage-Interior
Toilet & Bath Accessories
Other
Division 11 - Equipment
Other
Division 12 - Furnishings
Other
Division 13 - Special Construction
Fiberglass/Steel Vault
Other
Division 14 - Conveying Systems
Other
( $100.00 per opening, exterior
doors and windows)
EA
($
p
walls, $1.19 per s.f. of ceiling for
ceilings)
.77 per s.f of wall area
.45 per s.f of wall area
SF
SF-Wall Area
SF-Wall Area
( actual-site specific )
( actual-site specific )
Ea
Ea
Priority for
Funding
Deferred Maint Cost
H&S
Res
Mis
$100.00
0
0
0
0
0
0
$0.77
$0.45
0
0
0
0
0
( actual-site specific )
0
0
0
315000 MECHANICAL WORK
Mechanical Totals:
Division 15 - Mechanical
Plumbing
Toilet Riser Replacement
Venting Retrofits
Other
$0
$0
$0
0
( $250.00 per riser)
($600/vent riser, incl. related work)
Ea
Ea
416000 ELECTRICAL WORK
$250.00
$600.00
Electrical Totals:
0
0
$0
$0
$0
Division 16 - Electrical
Other - including Solar Power
Location Factor or Multiplier =
0
1
TOTAL
(If Roaded Remote, 1.15
$0
$0
$0
If Wilderness/Primitive Remote, 1.5
If Historic, 1.5
If Roaded Remote & Historic, 1.65
If Wilderness Remote & Historic, 2.00)
Page 5
9/3/2004
Pit/Vault Toilet Data Entry Form -- W.O. Summary
Size (GSF):
Inspection Date:
Inspector Name:
Bldg ID #:
Bldg Name:
Bldg Cat.: Vault/Pit Toilet
Item
Description
Quantity
Unit Cost
0
Maintenance Level:
Year Surveyed:
Cost Data: Means
Annual Maint. Cost
Total
H&S
Res.
Mis.
Year constructed: 0
Historical: 0
Age (years): 0
0
0
Means
Total
H&S
Deferred Maint. Cost
Res.
Mis.
9/3/2004
Critical
Project Number
101000 SITE WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
202000 ARCHITECTURAL WORK (Divisons 3 to 14
$0
$0
$0
$0
$0
$0
$0
$0
$0
315000 MECHANICAL WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
416000 ELECTRICAL WORK
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
$0
Totals:
Annual Maintenance Grand Total =
$0
$0 = Deferred Maintenance Grand Total
Form adapted from Means Facilities Maintenance Standards, 1988 edition by R.S. Means Company, Inc.
Page 6
9/3/2004