IFB_2200_BYS1051_ATT_2_v1.pdf

This is a Notice of Chemical Delivery form used by Austin Water (AW), a municipality within Texas, to track and verify the delivery of chemicals to its waste treatment facilities. The form serves as a standardized document for recording critical information about chemical shipments, including the vendor name, trucking company details, chemical type being delivered, and specific delivery logistics such as destination, departure time, estimated arrival, and truck identification. The form captures essential driver information, including the driver's name, Commercial Driver's License (CDL) number and expiration date, and verification that appropriate CDL endorsements are present—specifically noting that tanker vehicles require an "N" endorsement, hazardous materials require an "H" endorsement, or both combined as an "X" endorsement.

The form is designed to be completed and verified by Austin Water staff upon chemical delivery and must be emailed to the delivery location site supervisor when the driver is dispatched. The document requires staff signature and printed name to confirm that submitted information has been verified against actual conditions at delivery. This form is intended to be retained and submitted with related payment materials to Austin Water's Accounts Payable department, ensuring proper documentation of chemical deliveries for the sodium bisulfate solution (38% sodium bisulfite in 330-gallon intermediate bulk containers) supplied on an as-needed basis to Austin Water Waste Treatment Plants. The form was last revised on December 18, 2025.