Daily Work Record

Contractor: Contractor Number: Installer: Installer Number: Apprentice: Apprentice Number: Truck Number:

Project Information

Customer Name: Construction: New Occupied Work Order Number: Ventilated 0.3 ACH: No Yes Project Name: Spray Area Isolated: No Yes Project Address: Building Permit: Project Description: Not Posted:

Material Information

Trade Name: Type: CCMC #:

Mfg Date for "A": Quantity Used (Strokes): EXP Date for "B": Quantity Used (KG): Lot # "A": Quantity Used (lbs.): Lot # "B":

Equipment

Manufacturer: Model: Tip Size: Hose Length (m):

Pressure "A" (psi):

Machine Temp (°F): Hose Temp (°F):

Pressure "B" (psi):

Environmental Conditions

Date and Time:

Ambient Temp (°C): Relative Humidity %: Wind Velocity (km/hr): Substrate Temp (°C):

Substrate Conditions

Type: Preparation Required: No Yes

Structurally Sound: No Yes Comments: Free of Grease or Oil: No Yes

Test Results

Mass (g): Volume (ml):

Density (kg/m³): Density (lb/ft³):

Mfgs' Minimum Required Density: Site Density Equal or Greater? Adhesion / Cohesion Test: Fail Pass Number of Passes: Required Thickness: Actual Thickness: Visual Inspection: Fail Pass

Primers / Coatings

Primer Required: No Yes Interior Thermal Barrier: No Yes Exterior Coatings: No Yes Details:

Date Submitted: I verify that the above information is submitted correctly:

Daily Work Record

Daily Work Record

Document Distribution