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16-001014-02A (Ultimate SCMMP)

Attached to the e-mail Operational Works Application OPW16/0203 - 4 of 4.

of 192

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HumeGard® unit maintenance record


                                                            Customer details
Company                                                               Phone
Contact name                                                          Email
Address                                                               Date
State                                                                 Operator name
                                                         HumeGard® unit details
Model                                                                 Type (circle one)                Small (weir) | Standard (boom)
Cleaning method (circle one)       Vacuum | Eduction                  Lid type
                                                          Plan view (circle one)
                     Small HumeGard® (weir)                                               Standard HumeGard® (boom)




                                                        Pollutant removal results
Estimated volume of water removed (L)                                 Litter (%)
Estimated volume of pollutants (m3)                                   Vegetation (%)
Percentage of pollutant content (%)                                   Sediments (%)
Percentage of pollutant capacity (%)                                  Total volume (%)
Any evidence of hydrocarbons (grease/oil) contamination?                                                                  YES     NO
Any evidence of sewage contamination?                                                                                     YES     NO
Any evidence of any other unexpected contamination?                                                                       YES     NO
Describe unexpected contamination (if any):




Any problems cleaning the HumeGard® unit (describe briefly):




If problems were experienced were they thenresolved satisfactorily (describe briefly):
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