Per-event salt and de-icing application log for liability documentation. Tracks material type, quantity, temperature, and property conditions.
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SALT / DE-ICING APPLICATION LOG
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Company: __________________________________
Season: 20_____ / 20_____
Property: _________________________________
Property Address: __________________________
Account #: _____________
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INSTRUCTIONS
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Complete one entry per service event. This log serves as
a liability record documenting de-icing applications.
Retain for a minimum of 3 years.
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EVENT LOG
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--- EVENT #1 ---
Date: ___/___/______
Storm Type: [ ] Snow [ ] Ice [ ] Freezing Rain [ ] Frost
Accumulation: ________ inches
Temperature (arrival): ________ °F
Temperature (departure): ________ °F
Wind Speed: ________ mph
Service Times:
Arrival: ________ Departure: ________
Plowing Performed: [ ] Yes [ ] No
Passes: ________
De-Icing Application:
Material: [ ] Rock Salt [ ] Calcium Chloride
[ ] Mag Chloride [ ] Sand [ ] Brine
Quantity Applied: ________ lbs / gal
Application Rate: ________ lbs per 1,000 sq ft
Areas Treated:
[ ] Full parking lot
[ ] Driving lanes only
[ ] Sidewalks / walkways
[ ] Loading docks
[ ] Entrance / exits
[ ] ADA routes
[ ] Other: ________________________
Condition at Departure:
Lot: [ ] Bare/Wet [ ] Thin Cover [ ] Slushy
Walks: [ ] Clear [ ] Treated [ ] Partial
Visibility of Pavement Markings: [ ] Yes [ ] No
Photos Taken: [ ] Yes (________ count) [ ] No
Operator: _________________________________
Signature: ________________
--- EVENT #2 ---
Date: ___/___/______
Storm Type: [ ] Snow [ ] Ice [ ] Freezing Rain [ ] Frost
Accumulation: ________ inches
Temperature (arrival): ________ °F
Temperature (departure): ________ °F
Wind Speed: ________ mph
Service Times:
Arrival: ________ Departure: ________
Plowing Performed: [ ] Yes [ ] No
Passes: ________
De-Icing Application:
Material: [ ] Rock Salt [ ] Calcium Chloride
[ ] Mag Chloride [ ] Sand [ ] Brine
Quantity Applied: ________ lbs / gal
Application Rate: ________ lbs per 1,000 sq ft
Areas Treated:
[ ] Full parking lot
[ ] Driving lanes only
[ ] Sidewalks / walkways
[ ] Loading docks
[ ] Entrance / exits
[ ] ADA routes
[ ] Other: ________________________
Condition at Departure:
Lot: [ ] Bare/Wet [ ] Thin Cover [ ] Slushy
Walks: [ ] Clear [ ] Treated [ ] Partial
Visibility of Pavement Markings: [ ] Yes [ ] No
Photos Taken: [ ] Yes (________ count) [ ] No
Operator: _________________________________
Signature: ________________
--- EVENT #3 ---
(Repeat format for additional events)
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SEASON SUMMARY
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Total Events Serviced: ________
Total Salt Applied: ________ tons
Total Calcium Chloride Applied: ________ lbs
Total Brine Applied: ________ gallons
Total Sand Applied: ________ tons
Average Application Rate: ________ lbs per 1,000 sq ft
Highest Single-Event Usage: ________ lbs (date: _________)
Lowest Temperature Serviced: ________ °F (date: _________)
Reviewed By: _____________________________
Date: ___/___/______
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