AppR_Dredge Reporting Forms.pdf

APPENDIX R

DREDGE REPORTING FORMS

IR Site 7 Sediment Remediation, (HD-S2319)

ACOE PERMIT SPL-2007-00708-TS

CLAMSHELL/HOPPER DREDGING

DATE: DREDGE SITE: PIER T WEST BASIN

LOAD NUMBER: DISPOSAL SITE: NORTH SLIP FILL PIER G

DREDGING START TIME: DREDGING STOP TIME:

DISPOSAL START TIME: * DISPOSAL STOP TIME: *

FLOWBACK START TIME: FLOWBACK STOP TIME:

PORT STARBOARD

BARGE DRAFT AT START OF DISPOSAL TRIP: BOW

STERN

BARGE DRAFT ON ARRIVAL AT DISPOSAL SITE: BOW *

STERN *

COMMENTS:

DREDGING AND DISPOSAL OPERATIONS

Requirements Yes If No, Corrective Action Taken

Captain's License Present, *

ACOE Permit Present

Monitoring VHF Channels 13 & 16, *

Electronic Positioning System Functioning, *

Captain of the Port & Pilots Notified, *

Load Capacity Not Exceeded

No Solid Material in Flowback

* Information that is entered by the Contractor’s representative

To the best of my knowledge the information herein is true, accurate, and complete

Contractor’s Representative - Signature Contracting Officer Inspector - Signature

Contractor’s Representative - Printed Name Contracting Officer Inspector - Printed Name

EMERGENCY NOTIFICATIONS: POLB Security (562) 590-4185, USCG (310) 521-3815

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HYDRAULIC DREDGING

PIPELINE INTACT?, * DISPOSAL SITE:*

COMMENTS:

DREDGING AND DISPOSAL MONITORING

Direction and Speed of Current, *

General Weather Conditions and Wind Velocity

Appearance of Trash, Floatable Material, Grease, Oil or Oily Slick, or Other Objects

Tide Stage

Discoloration/Turbidity - Size of Plume &

Distance From Dredge or Barge

Odors

Depth of Dredge Operations

Amount of Material Dredged This Day (cy), *

Cumulative Amount Dredged, *

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RWQCB FILE 08-133

CLAMSHELL/HOPPER DREDGING

LOAD NUMBER: DISPOSAL SITE: * NORTH SLIP FILL PIER G

DISPOSAL START TIME: * DISPOSAL STOP TIME: *

DREDGING AND DISPOSAL MONITORING

Direction and Speed of Current, *

General Weather Conditions and Wind Velocity

Appearance of Trash, Floatable Material, Grease, Oil or Oily Slick, or Other Objects

Tide Stage

Discoloration/Turbidity - Size of Plume &

Distance From Dredge or Barge

Odors

Depth of Dredge Operations

Amount of Material Dredged This Day (cy), *

Cumulative Amount Dredged, *

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REPORT OF POSSIBLE VIOLATION OF

At approximately _______________________ on __________________, 2009, the following incident occurred in connection with the above dredging project:

The Government is investigating the circumstances surrounding this incident. In the event this incident is found to be a violation of the permit, the Government has taken the following steps to ensure compliance with the notification requirements of Special Conditions of the permit:

Reported incident to Army Corps of Engineers, Regulatory Branch at (805) 585-2146 at approximately _______________ on _______________, 2009, and

Spoke to ________________________________________

Left message

Sent fax to (805) 585-2154

AND

Reported incident to USEPA Region IX at (415) 972-3475 at approximately __________ on ______________, 2009, and

Spoke to ________________________________________

Left message

Sent fax to (415) 947-3537

DATE: ___________________________ INSPECTOR: _________________________________

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