SOUTH DAKOTA DEPARTMENT OF TRANSPORTATION
POLICY LETTER

Approval Date: 03/09/1999

Effective Date: 03/09/1999

Expiration Date:

Last Review Date: 03/09/1999

Next Review Date: 03/01/2002

Superceded by Policy #

Policy Number: OM-1999-03

Title: Monthly Rest Area Appraisals

Purpose: To establish guidelines for appraising Rest Area Caretakers

Key Topic Areas: Administration, & Maintenance

Responsible Program:

Supercedes Policy Numbers or New Policy: OM-08-00

Recommended: Approved:

Norman Humphrey, Program Manager Michael J. Durick, Director


Policy Statement

At the end of each month, assigned personnel from each region will summarize the Weekly Rest Area Inspection report forms and record the summary on a DOT-841 Rest Area Performance Appraisal form (copy attached) and forward a copy of same to the Operations Support office in Pierre. Any additional information regarding caretaker performance or lack of performance should be noted at the bottom of the form

DOT 841
REV 11-98 / SOUTH DAKOTA DEPARTMENT OF TRANSPORTATION
REST AREA PERFORMANCE APPRAISAL
REST AREA:
CONTRACTOR:
MONTH COVERED BY THIS APPRAISAL: / 1 = UNSATISFACTORY
2 = MARGINAL
3 = SATISFACTORY
4 = VERY GOOD
5 = EXCELLENT
1 / 2 / 3 / 4 / 5
BUILDING: doors, windows, walls, partitions, floors, drains, drinking fountains, bulletin boards, trash containers, interior lighting, storage/utility room.
REST ROOMS: counters, sinks, stools, urinals, mirrors, hand dryers, heaters, toilet paper, soaps, paper towel dispensers, soap dispenser.
Walks, Parking Areas, Ramps, Gutters.
PICNIC AREA: tables, benches, shelters, grills, fireplaces, trash containers.
GROUNDS: lawn, shrubs, native areas, tree belts, pet exercise areas.
EXTERIOR BUILDING: exterior lighting, roof overhang, roof, save troughs.
MISC: sewage lagoon, flags, flagpoles, storage sheds, trailer dump stations, historical markers, etc.

ITEMS MARKED LESS THAN SATISFACTORY (1 OR 2), DESCRIBE THE DEFICIENCY BELOW:

INSPECTED BY: DATE: / /

DOT 841A ATTACHMENT A

WEEKLY REST AREA PERFORMANCE APPRAISAL

REST AREA CONTRACTOR

WEEK ENDING ___/___/___

1 / 2 / 3 / 4 / 5 / COMMENTS AND/OR REPAIRS NEEDED

1 - BUILDING INTERIOR:

Doors, windows
Walls, partitions
Floors, drains
Drinking fountain
Bulletin board
Trash Containers
Interior lighting
Storage/utility room
Other

2 - RESTROOMS: (clean and properly maintained)

Counters, sinks
Stools, urinals
Mirrors
Hand dryers, heaters
Paper towels, soap
Other

3 - WALKS:

Walks
Parking area, ramps
Curbs & gutters
Other

4 - PICNIC AREA: (clean and properly maintained)

Tables, benches
Shelters
Grills, fireplaces
Trash containers
Other

5 - GROUNDS: (clean and properly maintained)

Lawn
Shrubs, trees
Native area, tree belt
Pet exercise area
Other

6 - BUILDING EXTERIOR: (clean and in good repair)

Exterior lighting
Roof, overhangs
Entry, building exterior
Other

7 - MISCELLANEOUS:

Sewage lagoon
Flags, flagpoles
Storage sheds
Trailer dump station
Other

OVERALL RATING: 1=UNSATISFACTORY 2=MARGINAL 3=SATISFACTORY 4=VERY GOOD 5=EXCELLENT

CONTRACTORS PERSONNEL (comments)

WORK TO BE COMPLETED BY STATE FORCES

am

INSPECTOR DATE ___/___/___ TIME ____:____pm

DISTRIBUTION:

original: file copies: 1-contractor, 1-region