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EQUIPMENT SIGNOUT
NAME
*
Department
*
Choose One
Field
Pump watch
Trucking
Office
Position
*
Choose One
Manager
Crew Lead
Heavy Equipment Operator
Pipe Layer
General Laborer
Flagger
Pumpwatcher
Condition
*
A
NEW - Working
B
USED - Damaged
C
LIKE NEW - Working
D
NEW - Damaged
E
USED - Working
Equipment Make and Model
*
Serial Number
*
PHOTO OF EQUIPMENT 1
PHOTO OF EQUIPMENT
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PHOTO OF EQUIPMENT 2
PHOTO OF EQUIPMENT
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PHOTO OF EQUIPMENT 3
PHOTO OF EQUIPMENT
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Addition Description
*
I understand that this equipment is company-owned, and I am using it for work related purposes. I understand that I am responsible for the care and will maintenance of the equipment. In case that the equipment is, in any case, damaged, lost, stolen, while outside the shop premises, I can be held responsible for its cost for its replacement. In case the equipment gets broken due to wear and tear, I shall have it inspected with the company's shop department as soon as possible.
*
A
I Agree
Signature
*
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Approved by
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dcarter@cceatlanta.com
Jerryjean@cceatlanta.com
fcummings@cceatlanta.com
bvalle@cceatlanta.com
Approved Date
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Signature
*
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Type
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