SOW Attachments.doc

ATTACHMENT 1

Contractor Hazardous Material Identification Form

Part I Date: _______________

This part is to be completed by Contractor prior to the construction start date, and shall be maintained on the job site.

Contractor Company:

Proposed work term:

____________ to ______________

Contractor Point of Contact:

(full name or names, phone/pager numbers, emergency 24 hour contact number, etc.)

HM to be used:

M.S.D.S.

Quantity Disposal Procedures Used/Unused material removed

MFG./Product Attached used from ANG installation

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Note: This form is good for a one-month period and is to be submitted to the Hazardous Material Pharmacy. All Hazardous Material used thereafter will be identified to the Contracting Officer's Representative for approval by the Hazardous Material Pharmacy. See Part II for Contractor close-out procedures. The Hazardous Material Pharmacy phone number is (860) 292-2823

Approval Signatures:

COR (Contracting Officer Representative)

BEER (Bio-Environmental Engineering Representative)

EM (Environmental Manager)

SO (Safety Officer)

ATTACHMENT 2

Contractor Hazardous Material Identification Form

Close-Out Procedures

Part II Date: _______________

Attach this form to Part I

The Contractor shall accompany the Contracting Officer Representative and Environmental Manager on the close-out inspection to ensure all used/unused HM was removed from the installation.

Close out Approval Signatures:

COR (Contracting Officer Representative)

BEER (Bio-Environmental Engineering Representative)

EM (Environmental Manager)

Contractor