Camp Butler National Cemetery – National Shrine Project 806-NSP25-004

ATTACHMENT 6 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: ________________________ -- 1 of 1 --