IFB_2200_BYS1050_ATT_2_v1.pdf

This is a Notice of Chemical Delivery form used by Austin Water (AW) in Texas for tracking and verifying the delivery of chemicals, specifically 23% Fluorosilicic Acid used in the treatment of potable water for dental health purposes. The form serves as a critical documentation tool that must be completed at the time of chemical delivery to an Austin Water facility and subsequently submitted with payment materials to the Accounts Payable department. The form requires comprehensive information including the chemical vendor name, trucking company details, delivery date and time, chemical type, destination, and estimated arrival information. Additionally, the form captures truck specifications such as make, model, color, license plate number, and tank security seal number to ensure proper vehicle identification and security compliance during the delivery process.

The form places particular emphasis on driver and Commercial Driver's License (CDL) information, requiring verification of the driver's name, CDL number and expiration date, and appropriate CDL endorsements. The endorsement verification is critical to regulatory compliance, as the form specifies that endorsement code H is required for transporting hazardous materials requiring placards, endorsement code N is required for tanker vehicles, and endorsement code X combines both requirements for tanker vehicles carrying hazardous materials. An Austin Water staff member must verify the submitted information against actual delivery conditions, sign the form, and confirm whether the CDL endorsement code is appropriate for the vehicle. The form must be emailed to the delivery location site supervisor when the driver is dispatched, and any questions or concerns should be directed to the contract manager or designee.