FACILITIES CONTRACTOR HAZARDOUS MATERIAL USAGE LOG
LM Aero Point of Contact:	Phone:
Project Name:	Building(s):
Work Performed:
P.O. No.:
Date	Manufacturer	Product Name	Amount Used	Amount Used

Unit of Measure	MSDS

No. *
* - MSDS number to be completed by ESH after contractor submittal.
Record all usage of hazardous materials on the project during the week (for Palmdale), or

Record all usage of paints and solvents (cleaning, strippers, thinners, etc.) during the month (for Marietta), or

Record all usage of paint during the year (for Fort Worth)
Palmdale Hazardous Material Usage:	(total for week of	,	20 )
Month and Day	Year
Marietta:	20
Fort Worth:	20
Month	Year
Year
Signature:
Print Name	Title	Signature	Date
Contractor Company Name:
SEND FORM TO:	Lockheed Martin Aeronautics ESH

Department REP3, Plant 10

1011 Lockheed Way, Palmdale, CA 93599-REP3
or	Lockheed Martin Aeronautics ESH

Zone 0446

86 South Cobb Dr.

Marietta, GA 30063-0446
or	Lockheed Martin Aeronautics Facilities Engineering

P.O. Box 748 MZ 6489

Fort Worth, TX 76101-6489

Important Notice: A hard copy of this blank form may not be the version currently in effect.

The current version of this form is the version in the LM Intranet. 10977-12102004

FACILITIES CONTRACTOR HAZARDOUS MATERIAL USAGE LOG

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2006-01-04

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Lockheed Martin