"Contractor's Daily Report Form - Dex-O-tex"

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Contractor's Daily Report
Project Name________________________
Report Number ______________
Project Location______________________
Phase or Mobilization _________
Room/Space Name/Number or other workspace ID _______________________________
________________________________________________________________________
Contractor ________________________
Day and Date________________________
Owners Name____________________________________________________________
Address_________________________________________________________________
City _______________________
State _________
Zip ______________
Contact Name____________________
E-mail Address_______________________
Telephone________________________
Alt Phone __________________________
Crew
Name
Hours Worked
Task or Activity Code
Worker
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
See Attached for Additional Crew
Job Site Conditions
General Weather Conditions_______________-__________________________________
Exposure _______________________________________________________________
Wind _______________________
UV Exposure ________________________
Traffic ______________________
Chemical/ Water _____________________
Substrate Condition Preparation ______________________________________________
_________________________________________________________________________
Relative References or Specification___________________________________________
_________________________________________________________________________
Contractor's Daily Report
Project Name________________________
Report Number ______________
Project Location______________________
Phase or Mobilization _________
Room/Space Name/Number or other workspace ID _______________________________
________________________________________________________________________
Contractor ________________________
Day and Date________________________
Owners Name____________________________________________________________
Address_________________________________________________________________
City _______________________
State _________
Zip ______________
Contact Name____________________
E-mail Address_______________________
Telephone________________________
Alt Phone __________________________
Crew
Name
Hours Worked
Task or Activity Code
Worker
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
__________________
_________
___________________________
See Attached for Additional Crew
Job Site Conditions
General Weather Conditions_______________-__________________________________
Exposure _______________________________________________________________
Wind _______________________
UV Exposure ________________________
Traffic ______________________
Chemical/ Water _____________________
Substrate Condition Preparation ______________________________________________
_________________________________________________________________________
Relative References or Specification___________________________________________
_________________________________________________________________________
Environmental Conditions
Start of Day
11:00 Mid Day
End of Day
Ambient
Temperature
________
________
________
Relative Humidity
________
________
________
Dew Point
________
________
________
Substrate
Temperature
________
________
________
Surface Temp
________
________
________
MVER or MVT
________
________
________
Material Temperatures
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
Product____________________ Temp__________
Batch No_________ Prod Date _________
PO #_______________________________
Order Date ___________________________
Product Additive/Modifications, Mix Design _______________________________________
________________________________________________________________
________________________________________________________________
Visitors
Company Name
Visitor Name
Reason for Visit
_________________________
________________
___________________________
_________________________
________________
___________________________
_________________________
________________
___________________________
Work Progress and Problems Encountered (include Areas and Quantities)
Contractor ________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Reported By _________________________________
Report Reviewed By __________________________
RV Date ___________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
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