SOW Attachment 2_951 Tank Farm_Contractor Production Report Form.pdf

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CONTRACTOR PRODUCTION REPORT

(ATTACH ADDITIONAL SHEETS IF NECESSARY)

DATE

CONTRACT NO TITLE AND LOCATION

REPORT NO

Tank Farm 951 – Permanent Closure

CONTRACTOR SUPERINTENDENT

AM WEATHER PM WEATHER MAX TEMP (F) MIN TEMP (F)

WORK PERFORMED TODAY

Schedule Activity No.

WORK LOCATION AND DESCRIPTION EMPLOYER NUMBER TRADE HRS

JOB

SAFETY

WAS A JOB SAFETY MEETING HELD THIS DATE?

YES NO

TOTAL WORK HOURS ON JOB

SITE,

THIS DATE, INCL CON'T SHEETS

WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?

(If YES attach copy of completed OSHA report) YES NO

CUMULATIVE TOTAL OF WORK

HOURS FROM PREVIOUS

REPORT

WAS CRANE/MANLIFT/TRENCHING/SCAFFOLD/HV ELEC/HIGH WORK/ HAZMAT WORK DONE?

(If YES attach statement or checklist showing inspection performed.) YES NO

TOTAL WORK HOURS FROM

START OF CONSTRUCTION

0 WAS HAZARDOUS MATERIAL/WASTE RELEASED INTO THE ENVIRONMENT?

(If YES attach description of incident and proposed action.) YES NO

Schedule Activity No.

LIST SAFETY ACTIONS TAKEN TODAY/SAFETY INSPECTIONS CONDUCTED SAFETY REQUIREMENTS HAVE BEEN MET.

EQUIPMENT/MATERIAL RECEIVED TODAY TO BE INCORPORATED IN JOB (INDICATE SCHEDULE ACTIVITY NUMBER)

Schedule Activity No.

Submittal # Description of Equipment/Material Received

CONSTRUCTION AND PLANT EQUIPMENT ON JOB SITE TODAY. INDICATE HOURS USED AND SCHEDULE ACTIVITY NUMBER.

Schedule Activity No.

Owner Description of Construction Equipment Used Today (incl Make and Model) Hours Used

Schedule Activity No.

REMARKS

CONTRACTOR/SUPERINTENDENT DATE

Attachment 2