SOW - Doc A11 - Monthly Waste Report - 2010-10.pdf

CONTRACTOR'S MONTHLY PROJECT WASTE SUMMARY REPORT (CMPWSR)

Ref: NAVSHIPYDPUGETINST P5090.11

CONTRACT NUMBER:

CONTRACT TITLE/DELIVERY ORDER:

CONTRACTOR:

GOVERNMENT POINT OF CONTACT’S NAME: PHONE:

REPORTING DATES: From / / To / /

¾ CHECK HERE IF NO WASTE ORIGINATED FROM YOUR PROJECT THIS MONTH

Discarded items were: (Refer to the SWTS, Section II. Check the applicable disposition box and enter the discarded items as described.)

SWTS

SERIAL #

LOAD

NUMBERS

POUNDS

See * footnotes below

Example: ROI2002-

Asphalt Reused Recycled Disposed 234567 4-7 10,457

1. Reused Recycled Disposed

2. Reused Recycled Disposed

3. Reused Recycled Disposed

4. Reused Recycled Disposed

5. Reused Recycled Disposed

6. Reused Recycled Disposed

7. Reused Recycled Disposed

8. Reused Recycled Disposed

9. Reused Recycled Disposed

10. Reused Recycled Disposed

11. Reused Recycled Disposed

12. Reused Recycled Disposed

13. Reused Recycled Disposed

14. Reused Recycled Disposed

15. Reused Recycled Disposed

* For waste soil where no scales are available at place of delivery, calculate 2600 pounds per cubic yard removed.

** For common trash which has been collected by a disposal transporter and combined with others' trash in the truck, estimate 250 pounds per cubic yard. Base your estimate on how many cubic yards were removed, NOT the size of the box.

FINAL REPORT:

¾ CHECK HERE IF YOUR PROJECT/DELIVERY ORDER IS COMPLETE AND THIS IS THE LAST REPORT

NOTE: The SOLID WASTE TRACKING SHEET (SWTS), PSNS 5090/114, describes each load removed from the Bremerton Naval Complex by the Contractor or subsequent Sub-Contractors, and is used as a custody sheet to track all discarded items which have been designated by the Government as not Hazardous and do not contain PCBs or Asbestos. This report is a monthly summary of the SWTSs for this project.

(SEE REVERSE SIDE FOR INSTRUCTIONS)

PSNS 5090/113 (Rev. 07-02) (Front)

X kyle.bringedahl Typewritten Text SOW - Document A7

CONTRACTOR’S MONTHLY PROJECT WASTE SUMMARY REPORT (CMPWSR)

INSTRUCTIONS

DO NOT USE THIS FORM AS A SUMMARY FOR

HAZARDOUS WASTE OR WASTE CONTAINING PCBs OR ASBESTOS

CONTRACTOR:

a. Complete and accumulate all Solid Waste Tracking Sheets (SWTSs) each month for the duration of the project. At the end of each calendar month, compile requested data from the SWTS and complete the Contractor’s Monthly Project Waste Summary Report in the manner shown in the shaded example. Note that the reporting unit is “POUNDS.” If no waste originated from the project this month, or if this is the last report for the project, check the applicable boxes.

b. Submit the report no later than the fifth calendar day of the following month, along with all SWTS originals referenced in the report, to the Contracting Officer. If no waste transport activity has occurred during the month, check the applicable box and submit the report reflecting negative activity for that time period.

c. When a project ends in mid-month, submit the Contractor’s Monthly Project Waste Summary Report reflecting only the work activity which occurred from the first calendar day of that month to the project’s completion. Check the applicable box reflecting last report. Submit the final report, along with all SWTS originals referenced in the report, to the Contracting Officer prior to project close-out.

GOVERNMENT CONTRACT POINT OF CONTACT:

a. Forward a copy of the Contractor’s Monthly Project Waste Summary Report to Code 106.33, Solid Waste Program Manager, on a monthly basis.

b. Maintain all SWTSs in the permanent project file or, at the agency’s discretion, submit the SWTSs along with the Contractor’s Monthly Project Waste Summary Report to Code 106.33, Solid Waste Program Manager, each month.

CODE 106.33:

a. Record all data submitted on the Contractor’s Monthly Project Waste Summary Report.

b. Include this information in the Solid Waste Annual Report.

PSNS 5090/113 (Rev. 07-02) (Back) kyle.bringedahl Typewritten Text SOW - Document A7