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Get Cg5136c.pdf. Pollution Incident Daily Resource Report - Gov't Equipment

IT FOSC/REP/LEAD TRUSTEE SIGNATURE GOVERNMENT EQUIPMENT ITEM DESCRIPTION RATE BASIS # UNITS RATE/ UNIT RATE CHARGE NON-RATE CHARGES TOTAL OFFICE USE TOTAL EQUIPMENT COSTS FOR THIS DATE REMARKS: Reset POLLUTION INCIDENT DAILY RESOURCE REPORT -- CG-5136C GOVERNMENT EQUIPMENT This form should be completed for government equipment costs incurred for each day of removal activity. How to complete form: 1. 2. 3. 4. FPN/CERCLA Number: The FPN or CERCLA case number assigned to the incident.

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