Items 1 to 3: item, contract and order
Item number (NSN), contract number and order number.
GSA2178
Quality Control Facility Surveillance
- Agency
- GSA
- Revision
- Rev. 5/1989
- Fillable fields
- 19
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 2178: Quality Control Facility Surveillance
GSA Form 2178, Quality Control Facility Surveillance, is a one-page GSA form. The footer reads GENERAL SERVICES ADMINISTRATION and GSA FORM 2178 (REV. 5-1989). GSA hosts it in its forms library, and its page lists the authority or regulation as FSS P 2901.9 and the current revision date as 05/1989.
The form records an item by item number (NSN), contract number and order number, with its name, specification number, quantity and unit, manufacturer, date of manufacturer or pack, warehouse location, lot or batch number, shelf-life code and date of prior inspection. Item 13, Suitable for Issue, has yes and no boxes, and item 16 is for remarks.
It is signed by a Quality Assurance Specialist, with a region number and date. The form prints no instructions. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 2178
Items 4a to 7: item details
Item name, specification number, quantity and unit, name and address of manufacturer, and date of manufacturer or pack.
Items 8 to 10: storage
Warehouse location (city and state), location of material in warehouse, and lot or batch number.
Items 11 to 13: shelf life and suitability
Shelf-life code (when applicable), date of prior inspection, and Suitable for Issue with yes and no boxes.
Item 16: remarks
A large remarks area fills most of the page. The printed form goes from item 13 to item 16, with no items 14 or 15.
Items 17 to 19: signature
Signature of the Quality Assurance Specialist, region number and date.
How to complete GSA Form 2178
- 1
Identify the item
Enter the item number (NSN), contract number and order number in items 1 to 3.
- 2
Describe the item
Fill in items 4a to 7: item name, specification number, quantity and unit, manufacturer, and date of manufacturer or pack.
- 3
Record where it is stored
Enter the warehouse location, the location of the material in the warehouse and the lot or batch number in items 8 to 10.
- 4
Mark suitability for issue
Give the shelf-life code when applicable and the date of prior inspection, then check yes or no in item 13, Suitable for Issue.
- 5
Add remarks and sign
Write any remarks in item 16. The Quality Assurance Specialist signs item 17 and enters the region number and date.
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Routing and authority
Where it goes
The form prints no instructions, address or routing.
Authority
GSA's page lists the authority or regulation as FSS P 2901.9. The PDF itself prints no directive.
Edition
The footer reads GSA FORM 2178 (REV. 5-1989), matching the current revision date of 05/1989 on GSA's page.
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Who fills out GSA Form 2178?
The form prints no instructions. Its blocks name these.
Official sources and the blank
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Questions about Form GSA2178
Who issues GSA Form 2178?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA FORM 2178 (REV. 5-1989). GSA hosts it in its forms library, and its page lists FSS P 2901.9 as the authority or regulation.
Who signs GSA Form 2178?
Item 17 is the signature of the Quality Assurance Specialist, with the region number in item 18 and the date in item 19.
What does item 13 ask?
Item 13 is Suitable for Issue, with a. Yes and b. No boxes.
Why are there no items 14 and 15?
The printed form goes from item 13 straight to item 16, Remarks. Items 14 and 15 do not appear on this edition.
Does GSA Form 2178 include instructions?
No. The PDF prints only the numbered blocks, a remarks area and the signature line.