Hazardous Materials Worksheet.pdf
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- Attached to
- SXHT 09-1000 - Repair Water Lines, Various
- Solicitation number
- FA252125B0008
About this file
The document is a Forecast of Contractor's Hazardous Waste Generation form for a water line repair project at Patrick Space Force Base (Project #SXHT 09-1000). The form is designed to help the installation identify and regulate processes involving hazardous materials and their potential waste generation. Contractors are required to complete this form if they must remove and dispose of materials containing hazardous substances like lead or mercury, or if they submit a Material Safety Data Sheet (MSDS) for a hazardous material. For multi-contractor projects, each contractor must specify the processes requiring hazardous materials and potential waste streams, including details such as the material's name, description of use, method of application, and estimated waste quantity.
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Text version
FORECAST OF CONTRACTOR’S HAZARDOUS WASTE GENERATION
PROJECT #: SXHT 09-1000 PROJECT TITLE: Repair Water Lines, Various
CONTRACTOR:
POINT OF CONTACT:
PHONE: FAX:
HAZARDOUS MATERIAL: DESCRIPTION OF PROCESS(ES) INVOLVING MATERIAL
(INCLUDE METHOD OF APPLICATION)
DESCRIPTION OF
WASTE:
QUANTITY:
CONTRACTOR’S SIGNATURE DATE
Purpose: The Forecast of Contractor’s Hazardous Waste Generation is required to assist the installation to identify processes using hazardous materials and regulate the generation and disposal of hazardous waste.
Instructions: The Forecast of Contractor’s Hazardous Waste Generation form must be completed by any contractor who:
1) Must remove and dispose of paints, building components, or equipment containing hazardous materials (lead, mercury, etc.)
2) Submits an MSDS for approval of use of a material known to be hazardous.
On multi contractor projects, each contractor (sub-contractor) must specify each process requiring the use of hazardous materials and the potential waste to be generated.
1. Project #: Provide installation project number.
2. Project Title: Provide installation project title.
3. Contractor: Enter complete name of contractor performing process.
4. Point of Contact: Provide name of individual knowledgeable on requirements of materials listed.
5. Phone/Fax: Provide phone and fax numbers for point of contact.
6. Hazardous Material: Provide common name of each hazardous material
7. Description of Process(es) Requiring Material: Describe each process in which the material will be used (Thinning paint, cleaning tools, etc.). Describe methods of application where appropriate (applied to rag, sprayed gun, etc.).
8. Description of Waste: Provide description of anticipated waste stream or enter “none” if no waste is anticipated to be generated.
9. Quantity: Estimate quantity of waste to be generated
10. Sign and date each form at bottom
File details come from the government source that posted it. Updated .