009 - Hazardous Material Daily Usage and Removal Report.pdf

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Attached to
Removal and Disposal of Marine Attachments to Raw Water Intake
Solicitation number
N4008524R2666
Issued by

About this file

This document is a Hazardous Material Daily Usage and Removal Report template for a federal contract. The template requires the prime contractor to list the hazardous materials used on the project, including the material name, manufacturer, Safety Data Sheet (SDS) number, physical state, storage quantity, and daily/annual usage. The contractor must certify that the hazardous materials will be properly used and removed from the installation. The report must be submitted to the Contracting Officer or ROICC representative.

The related federal contract opportunity is for the Removal and Disposal of Marine Attachments to Raw Water Intake. The Department of the Navy Naval Facilities Engineering Command is soliciting a contractor to remove and properly dispose of Zebra Mussels and marine deposits from the active Raw Water Intake and associated timber crib structure to ensure unrestricted water flow to the Great Lakes Water Treatment Plant. The solicitation number is N4008524R2666.

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Hazardous Material Daily Usage & Removal Report

PRIME COMPANY NAME: _______________________________

CONTRACT NO: ______________________

PROJECT TITLE / LOCATION:

Material Name Manufacturer

SDS

Number

State (Liquid, Solid, Gas)

Storage Quantity Quantity (lbs/gals) used in

Calendar Year [ ]

Average Daily

Maximum Daily

Contractor(s) certifies that the hazardous material(s) removed from installation will be used/reused for its intended purpose.

Company Using Material Listed Above Company Representative’s Signature

Submitted By: ________________________ Phone: ______________ Fax: __________ Date: _________ Printed Name

Contracting Officer _____________________Phone: ______________ Fax: __________ or ROICC Representative

Page ____ of ____

SECTION 01 57 19.00 20 – APPENDIX A

File details come from the government source that posted it. Updated .