------------------------- ------------------ ------------------- ------------------
  The following equipment                                          
  will be used on                                                  
  Subcontract Number                                               

                                                                   

  **EQUIPMENT**             **MANUFACTURER**                       **SERIAL NO.**

                                                                        

                                                                        

                                                                        

                                                                        

                                                                        
  ------------------------- ------------------ ------------------- ------------------

(Use Additional Sheets As Necessary)

All equipment listed above is properly serviced and maintained in
accordance with each Manufacturer\'s recommendations and OSHA/ANSI/SRS
requirements as applicable. All equipment listed above will be operated,
inspected, and maintained by a competent person for the duration of the
Subcontract. Equipment will not be operated in an unsafe manner or
condition. Equipment that cannot be repaired will be removed from the
INEEL Site.

Documentation of all required certifications, inspections, and
maintenance will be maintained by the Subcontractor\'s Representative on
site, and available for review as requested.

Equipment leaking fluids will be immediately removed from service and
the fluids will be contained to prevent absorption into surface areas.

Before loading, unloading, and transporting self-propelled medium and
heavy duty construction equipment at the INEEL Site, read and complete
the "Self-Propelled Equipment Loading, Unloading & Transport Safety
Review Checklist", pages 2 and 3 of this form.

  --------------------------------- -- -----------------------------------
                                            

  Signature of Company                 Company Name
  Representative                       
  --------------------------------- -- -----------------------------------

***Submit one (1) copy to the INEEL Subcontract Administrator and one
(1) copy to the Subcontract Technical Representative (STR) before
placing equipment in service at the INEEL Site.***

  ----------------- ----------------------- ---------- ------------- --------------
  MAJOR EQUIPMENT                                                    
  LISTING                                                            

  Cranes (All       Front End Loaders       Dozers     Scrapers      Light Plants
  Types)                                                             

  Finishing         Compactors/Rollers      Backhoes   Forklifts     Batch Plants
  Machines                                                           

  Generators,       Spreading Machines      Graders    Gradalls      Compressors
  Portable                                                           

  Aerial/Man Lifts  Saws (Cut                          Ditch Witches 
                    Off-Band-Table-Stone)              (Trenching    
                                                       Machines)     

  Wackers (Soil     Tractors (Agricultural             Trucks and    
  Compactors)       and Industrial)                    Trailers      
                                                       (Excluding    
                                                       P/U's)        

  Drilling Rigs     Welding Machines                   Power         
                    (Gasoline or Diesel)               Equipment     

  ***THIS LIST IS                                                    
  NOT ALL                                                            
  INCLUSIVE.                                                         
  CONTACT THE INEEL                                                  
  SUBCONTRACT                                                        
  ADMINISTRATOR OR                                                   
  SUBCONTRACT                                                        
  TECHNICAL                                                          
  REPRESENTATIVE                                                     
  CONCERNING ANY                                                     
  MAJOR EQUIPMENT                                                    
  TO BE USED THAT                                                    
  MAY NOT BE                                                         
  LISTED***                                                          
  ----------------- ----------------------- ---------- ------------- --------------

> **[Self-Propelled Equipment Loading, Unloading &
> Transport]{.underline}**
>
> **[Safety Review Checklist]{.underline}**

***The following items shall be reviewed by the responsible work group
supervisor prior to performing any activity involving the Loading,
Unloading, and Transport of Self-propelled Medium or Heavy Construction
Equipment (i.e. mobilization / demobilization). INEEL Subcontractors or
Vendors shall submit completed checklists to the responsible Subcontract
Technical Representative (STR). The intent of this checklist is to
enhance personnel safety and does not alter the contractual relationship
between INEEL and its subcontractors/vendors.***

> Verify Lessons Learned "Trackhoe Incident Pond B Dam" has been
> reviewed with applicable personnel.
>
> Responsible Work Group Supervisor shall assign the person in charge of
> loading, unloading, or transport activity.
>
> Ensure trailer is positioned and secured properly and on a surface
> sufficient to support the load.
>
> Ensure that all proximity hazards have been identified and proper
> controls are established.
>
> Inspect trailer and associated equipment to ensure they are in safe
> working condition.
>
> Establish controls to restrict non-essential personnel from the
> immediate proximity of loading/off loading activity.
>
> Determine the need for and assign flagman when necessary.
>
> Driver to determine loading alignment and position for transport.
>
> Equipment Declaration submitted to STR. (Subcontractors)

  ------------------------------------------- ------ -----------------------
  **[Subcontractors Name]{.underline}**              **[Subcontract/P.O.
                                                     Number]{.underline}**

                                                          
  ------------------------------------------- ------ -----------------------

To the best of my knowledge, I believe that this information is accurate
and complete.

  ---------------------- -- ------------------------------- -- ------------
                                                                    

  Print Name                Signature                          Date
  ---------------------- -- ------------------------------- -- ------------

> **[Self-Propelled Equipment Loading, Unloading &
> Transport]{.underline}**
>
> **[Safety Review Checklist (continued)]{.underline}**
>
> **[Do:]{.underline}**

-   If any condition changes unexpectedly or equipment malfunctions
    during loading or unloading, **STOP WORK IMMEDIATELY**, place in a
    safe condition and secure the area, and contact supervision.

-   Follow all manufacturer's instructions and equipment operator
    manuals.

-   Contact the appropriate supervisor or PIC if original plans change
    or any questions arise during the work activity.

-   Always review the work area for potential hazards.

-   Follow established safety controls.

-   Maintain line of sight between spotter/escort and operator.

-   Once the equipment is positioned on the transport vehicle, ensure
    the load is properly secured.

-   Contact STR when necessary to notify an offsite vendor of
    malfunctioning equipment

> **[Don't:]{.underline}**

-   Never place any part of your body within "THE LINE OF FIRE". (i.e.
    Crush Points, Pinch Points, Rotating Structures, under suspended
    loads)

-   Never use equipment when it is unsafe

> **General Considerations**

-   While offloading or loading equipment during inclement weather
    conditions, the driver shall take additional precautions to ensure
    control of the load. During icy conditions, no loading or offloading
    shall be performed.

-   Workers must never place any part of their bodies in a pinch or
    crush point.

-   At the INEEL, every worker has the right and duty to stop work if it
    appears unsafe to continue. While all employees are encouraged to
    thoughtfully comply with rules and job plan steps, they should not
    hesitate to stop work if they do not understand a rule or if
    compliance with the rule appears to be the wrong or unsafe thing to
    do.