Attachment 11 JBER HAZMAT Usage Tracking Form 25 October 2020.pdf
PDF 506 KB Posted
- Solicitation number
- FA500021R0078
About this file
This document contains a standard operating procedure and hazardous materials usage tracking form for contractors working at Joint Base Elmendorf-Richardson. The form requires contractors to provide information such as the shop code, base, contractor name, reporting dates, contract details, location and description of work, hazardous materials used including product name, part number, manufacturer, container type and size, total quantity, and a description of how each material is used. Contractors must submit this form monthly, updating only the total quantity used for each material, and adding any new products. The form will be used to track hazardous material usage by embedded and short-term contractors performing work such as repairing the Arctic Warrior Chapel Building 3 to renovate the multi-purpose room and conduct associated electrical, abatement, and renovation work.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1 STATEMENT OF WORK rev1.pdf | ||
| Attachment 14 Af 3065.xlsx | XLSX spreadsheet | |
| Attachment 12 AF FORM 3000.pdf | ||
| Attachment 13 AF FORM 3064.xls | XLS spreadsheet | |
| Solicitation Amendment FA500021R00780001 SF 30.pdf | ||
| Attachment 10 AF FORM 66.xlsx | XLSX spreadsheet | |
| FY21 REPAIR ARCTIC WARRIOR CHAPEL RENOVATION B3.zip | ZIP file |
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Text version
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JOINT BASE ELMENDORF-RICHARDSON STANDARD OPERATING PROCEDURE
- CONTRACTOR HAZARDOUS MATERIALS
Appendix A: Contractor Hazardous Materials Usage Tracking Form Instructions
Block Description Information Required
1 Shop Code Shop Code provided by the HAZMAT Manager
2 Base Identify the Installation the Contractor is residing (JBER)
3 Contractor Name Name of contractor and/or sub-contractor
4 Date of Report Date the report is prepared
5 Reporting Period The dates the reporting period covers (Example: 1 Jun 2012 -30 Jul 2012)
6 Project/Contract Manager Contract or Project Manager assigned to the contract/project
7 Contractor POC for obtaining Hazardous Materials information
Point of contact of contractor responsible to provide SDS and usage data
8 Contract # Contract number assigned by contracting
9 Project # Project number assigned by Project Manager
10 Location of Work + Contract Title Description
Enter building number(s) where work is to take place & brief description of the work being performed by the contractor.
11 Project/Contract Start Date & End Date Date work begins and ends (estimate)
12 Product Identifier Name of product as listed on SDS
13 Part Number Part number as listed on SDS
14 Manufacturer Name of the Manufacturer (not the distributor)
15 Type of Container The type of container that the product comes in. Example: can, barrel, bottle, container, cylinder, drum, etc…
16 Size of Container Size as listed on container. Example: oz, lbs, Liter, Quart, Gallon, etc…
17 Total Quantity This will be the amount that you anticipate using for the first submission.
For subsequent submissions this is the amount consumed during the reporting month
18 EESOH-MIS MSN
(Completed by: Hazmat Manager)
This is the Material Stock Number assigned for EESOH-MIS tracking.
(The Hazardous Materials Manager will provide this number)
19 Process (How is material used)
***Critical*** Brief description of the work performed with each material.
(Identify how the material is utilized for the duration of theproject.)
**Note** It is crucial each contractor POC input the data on the form and follow the guidelines when generating the Contractor’s HAZMAT Usage Tracking Form.
This form can be utilized for embedded and short term contractors. Once all the hazmat is listed on the form, the only changes that will occur each month are the “Total Quantity Used”. Unless there are new products that need to be added to this form. Please DO NOT REMOVE any materials that are currently listed. If the reporting month did not consume any usage, the contractor still needs to report and place a quantity of “0” for each item(s) usage and submit it to COR or Project Manager.
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JBER Contractor Hazardous Materials Usage Tracking Form Return this form to Contracting/Project Manager with manufacturers original SDS
Shop Code Base Contractor Name Date of Report
Reporting Period to
Project/Contract Manager
Contractor POC for obtaining Hazardous Materials information Name: Phone: Email:
Contract# Project #
Location of Work & Description Project/Contract Start Date & End Date to
Safety Data Sheet (SDS) Product Identifier
Part # Manufacturer
Type of Container
Size of
Container
Total Quantity
Used
EESOH MSN (to be added by Hazmat Manager)
Example: PROMAR 400 Interior Latex Semi- Gloss Enamel, Extra White
Process (How is material used): Used to paint H-62 office interior walls.
B31W4451
SHERWIN WILLIAMS
Can
1 Gal
8010PHM00002556
1.
Process (How is material used):
2.
3.
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Safety Data Sheet (SDS) Product Identifier
Part # Manufacturer Type of Container
Size of Container
Total Quantity
Used
EESOH MSN (to be added by Hazmat Manager)
4.
5.
6.
7.
8.
9.
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