Document RJ7OJKNbKmy7b38L351pvb3wa

Merico Abatement Contractors, Inc. 701 Gum Springs Road, Longview, Texas 75602 (214) 757-2656 Subsidiary of Gregg Industrial Insulators, Inc. \ n\o1=r?'Cft) ASBESTOS DAILY WORK RECORD DATE: Co /# 1 -y------------ -- P W Q U OSCOPE OF WORK: 1 P inn s /M n ZZ LOCATION: 7 v ___ Ca (A ) J~ /^7 o <&^ I TT' 4> /o au /^ AIR SAMPLING: Yes LOCATION: MA 7 No ____ m A/Aj Q> I ^ Or / DURATION: y C <J l T_____________ BY: /ft? , A* ^ U As l /> (Wax, , u >-->) RESULTS RESPIRATORY PROTECTION USED: _____ AIR SUPPLIED TYPE HALF MASK FILTER TYPE TRAINING FORM SIGNED BY EMPLOYEES: ^Yes ____ No ASBESTOS VOLUME ) .57) BAGS DISPOSED AT: Tv I ' m K ^ MANIFEST NO METHOD OF REMOVAL: WET /X DRY ____ SURFACTANT ____ 27r ^ j WATER BARRIERS SET UP: lT Yes No ______ PLASTIC CONTAINMENT USE: __ ^ Yes ___ N NAMES OF EACH PERSON WORKING IN AREA. ( Additional space on back) (1) VT` ` HRS- /3 (5) Ha > i -/// ///?//THRS. K7- (2) hz H'i 'C kjArinas. I i (6) A) ,'ltf' (3) /< Wo vs mA,/HRS. / 3 (7) (4) g 7~ J"0 ^ 9 -O' HRS. I -A (8) ASBESTOS COORDINATOR INFORMED ABOUT THIS WORK: Yea lS No ______ HRS. i-/ HRS. ____ HRS. ' WHEN: EMPLOYEES SHOWERED AT END OF WORK DAY: V <* <T EMPLOYEES LEFT WORK CLOTHES IN WORK AREA: Yes No HAVE EFFORTS BEN TRULY MADE TO REDUCE AIRBORNE FIBERS IN THE WORK AREA? Yes ^ No SUPERVISOR'S SIGNATURE: REVIEWED BY: THIS REPORT MUST BE RETAINED IN A CENTRAL FILE IN THE OFFICE FOR A PERIOD OP NO LESS THAN TWENTY (20) YEARS. SUPERVISORS SHALL FILL OUT THIS FORM FOR ANY ASBESTOS TEAR OFF REGARDLESS OF THE VOLUME. FAILURE TO DOCUMENT THIS WORK SHALL BE CONSIDERED A SERIOUS VIOLATION OF G.I.I. SAFETY POLICY. ^ Merico Abatement Contractors, Inc. 701 Gum Springs Road, Longview, Texas 75602 (214) 757-2656 Subsidiary of Gregg Industrial Insulators, Inc. DATE: C/ -//f 1 ASBESTOS DAILY WORK RECORD LOCATION: 1 V F, SCOPE OF WORK: F P a u (J (A C H\ F ^ *jj> 4-* ______________ _______________________________ F ^ /- /3 ^ ^ ^ - AIR SAMPLING: Yes jy No ____ LOCATION: Q-^ou '~J ft DURATION: 4 00 lT BY: An / K r ^ (An ,-t > / v /*i ^ 1 L, Jc, U RESULTS: (0,0 0 3 RESPIRATORY PROTECTION USED: /AAIR SUPPLIED TYPE ___ HALF MASK FILTER TYPE TRAINING FORM SIGNED BYrEMPLOYEES : - ____ No ASBESTOS VOLUME tfc. - BAGS- DISPOSED-AT fA7yy//cm .-a'/, i-manifest no. METHOD OF 'REMOVAL: L) u ^ ^ 5 r',-*, -S WET DRY ____ SURFACTANT WATER BARRIERS SET UP: ^Yes ____ No ______ PLASTIC CONTAINMENT USE: /^^es ____ No NAMES OF EACH PERSON WORKING IN AREA. ( Additional space on back) (1) h (2) -7 U - A L,.s > Q AT,/Am IS (5) HRS. / S~~ (6) <3 7~i / C> _3_ aV, r/ (L.n cy TdZ. (3) J 7, r U , / /, shrs. / (7) aJ (4) L /j v ^ 4, HRS. I ? (8) HRS. HRS. HRS. HRS. ASBESTOS COORDINATOR INFORMED ABOUT THIS WORK: Yes No WHEN: /ToA? ) EMPLOYEES SHOWERED AT END OF WORK DAY: \ EMPLOYEES LEFT WORK CLOTHES IN WORK AREA: Yes LS' No HAVE EFFORTS BBEEEE.N TRULY MADE TO REDUCE AIRBORNE FIBERS IN THE WORK AREA? Yes No L-) qJlIJ- SUPERVISOR'S SIGNATURE: REVIEWED BY: THIS REPORT MUST BE RETAINED IN A CENTRAL FILE IN THE OFFICE FOR A PERIOD OF NO LESS THAN TWENTY (20) YEARS. SUPERVISORS SHALL FILL OUT THIS FORM FOR ANY ASBESTOS TEAR OFF REGARDLESS OF THE VOLUME. FAILURE TO DOCUMENT THIS WORK SHALL BE CONSIDERED A SERIOUS VIOLATION OF G.I.I. SAFETY POLICY. T-Z6757 job# T.b'fOOO ____________________________ ----------------------------- 3*---------------------------------------------------------- po# oi..s`qn QplO D .t- LASOR, MATERIAL, EQUIPMENT, SUPERVISION, AND INSURANCE REQUIRED TO ff.fmno____a-a/L. efira otf r>/ A C^h~T/f o/*i 3Co / Ak/sJ 1 ft O fr. Piu.K_____ I at *r+r^------__ ~f. |lg-<- ^'taa^ f>AA ^ PCo-S 3 7 ~7_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (S A "T ft * a-J_____''LfuvK , ( tr A