Attachment_P_ Hazardous Material Inventory Log.pdf
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- LP-21/33/34 Renovate Annex - 705 Compliance
- Solicitation number
- N4008525R0147
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SECTION 01 57 19 – APPENDIX A
CONTRACTOR HAZARDOUS MATERIAL INVENTORY LOG
(EPRCA)
PRIME COMPANY NAME: _____________________________________ CONTRACT NO: __________________________
PROJECT TITLE / LOCATION: _______________________________________________________________________
Material Name Manufacturer MSDS Number
State (i.e. Liquid, Solid, Gas)
Storage Quantity
Average Max Daily Daily
Quality (lbs/gals) used in Calendar Year [ ]
Contractor(s) certifies that the hazardous material(s) removed from installation will be used/reused for its intended purpose.
Company Using Material Listed Above Company Representative’s Signature
Submitted By: ________________________ Phone: ______________ Fax: __________ Date: _________ Printed Name
Contracting Officer _______________________ Phone: ______________ Fax: __________ or ROICC Representative Page ____ of ____
Camjam Note Accepted set by Camjam
SECTION 01 57 19 – APPENDIX A
CONTRACTOR HAZARDOUS MATERIAL INVENTORY LOG
(EPRCA)
Continuation Sheet
PRIME COMPANY NAME: _____________________________________ CONTRACT NO: __________________________
PROJECT TITLE / LOCATION: __________________________________________________________________________
Material Name Manufacturer MSDS Number
State (i.e. Liquid, Solid, Gas)
Storage Quantity
Average Max Daily Daily
Quality (lbs/gals) used in Calendar Year [ ]
Page ____ of ____
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