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179TH AIRLIFT WING/200TH REDHORSE SQUADRON DET-1
CONTRACTOR HAZARDOUS MATERIALS INVENTORY
This form is to be used by Contractors for approval and tracking of all hazardous materials being used during the project. This form will need to be submitted twice. PRIOR to the project, the form will need to be filled out EXCEPT for the ACTUAL USAGE and STOCK NUMBER columns. A Safety Data Sheet (SDS) must accompany this form for every hazardous material listed. This step is to gain access to bring the hazardous materials onto the installation. At the end of the project, this form must be re-submitted with the ACTUAL USAGE column completed. The final submittal of this form can occur with all other closeout documents. The STOCK NUMBER column will be completed by the 179AW.
| CONTRACT NUMBER: |
| WORKPLACE/BUILDING: |
| PRIME CONTRACTOR/ORGANIZATION: |
| EXPECTED START DATE: |
| EXPECTED FINISH DATE: |
PROJECT TITLE/DECRIPTION:
PRODUCT NAME
MANUFACTURER
PHYSICAL FORM (S,L,G)
CONTAINER SIZE1
MAX AMOUNT ONSITE AT ANY TIME2
EXPECTED USAGE AMOUNT
ACTUAL USAGE AMOUNT
PROCESS TYPE3
STOCK NUMBER (to be completed by 179AW)
FOOTNOTES:
1. Specifically list the container size you will be using (i.e., 1 gallon, 5 gallons, 18 oz., 1 quart, etc.) and the vessel the material comes in (i.e., bucket, can, bottle, jar, etc). The 179AW requires the exact container size for correct hazardous materials tracking.
2. Identify maximum amount expected to be present onsite at any one time. This will typically be the amount delivered at the beginning of the project.
3. See Reverse: Table 1 – PROCESS TYPES for appropriate codes.
TABLE 1 – PROCESS TYPES
| CODE |
| PROCESS DESCRIPTION |
| CODE |
| PROCESS DESCRIPTION |
| A |
| Adhering/Bonding/Sealing – Aerosol |
| V |
| Equipment Repair/Prev. Maintenance – Equipment Installation, Cable Pulling |
| B |
| Adhering/Bonding/Sealing – All Usages |
| W |
| Equipment Repair/Prev. Maintenance – Equipment Installation/Removal |
| C |
| Asbestos Work, NOC |
| X |
| Equipment Repair/Prev. Maintenance – NOC |
| D |
| Brazing |
| Y |
| Housekeeping/Janitorial/Maintenance – Facility Maintenance, Multiple Operations |
| E |
| Cutting – Multiple Operations |
| Z |
| Housekeeping/Janitorial/Maintenance – Janitorial/Custodial, Multiple Operations |
| F |
| Soldering – Torch |
| AA |
| HVAC – Air Conditioning/Refrigeration Charging |
| G |
| Soldering – NOC |
| BB |
| HVAC – HVAC Repair and Maintenance |
| H |
| Welding – Multiple Operations |
| CC |
| Lead Paint Abatement – Lead Abatement, All Methodologies |
| I |
| Cleaning, Chemical & Degreasing – Chemical Stripping |
| DD |
| Miscellaneous Operations – Chemical Processing, NOC |
| J |
| Cleaning, Chemical & Degreasing – Multiple Operations |
| EE |
| Miscellaneous Operations – Decontamination |
| K |
| Cleaning, Other – Multiple Operations |
| FF |
| Miscellaneous Operations – Service, NOC |
| L |
| Coating/Painting Operations – Brush/Roller |
| GG |
| Miscellaneous Operations – Testing, NOC |
| M |
| Coating/Painting Operations – Spray/Aerosol |
| HH |
| Pest Control – Aerosol Can Spray |
| N |
| Coating/Painting Operations – NOC |
| II |
| Pest Control – Multiple Operations |
| O |
| Communications – Multiple Operations |
| JJ |
| Plumbing – Multiple Operations |
| P |
| Drywall/Plastering – NOC |
| KK |
| Protective Services, Fire – NOC |
| Q |
| Electrical/Electronics – Multiple Operations |
| LL |
| Protective Services, Security – NOC |
| R |
| Electrical/Electronics – Electronic Repairs, Multiple Operations |
| MM |
| Structure Demolition – Multiple Operations |
| S |
| Electrical/Electronics – Telecommunications |
| NN |
| Structure Fabrication/Renovation – General Construction |
| T |
| Electrical/Electronics – Installation, Repair, Service |
| OO |
| Structure Fabrication/Renovation – Multiple Operations |
| U |
| Equipment Repair/Prev. Maintenance – Charging, Recharging, NOC |
| PP |
| Water Operations – Drinking Water System, Operation & Maintenance |
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