| Borrowing Institution: | |
| Contact Person/Borrower: | |
| Institution Address: | |
| Phone: |
| Borrowed? (check if taken) | Item | Amount Taken |
| Brooms (2) | ||
| Clean newsprint (5 rolls) | ||
| Clipboards (10) | ||
| Cutters for sheeting (3) | ||
| Dehumidifiers (2) | ||
| Extension cords (7) | ||
| Filter masks (10) | ||
| First Aid Kit (1) | ||
| Flashlights (12) | ||
| Spare "D" batteries (4) | ||
| Floor fans (2) | ||
| Freezer paper (1 roll) | ||
| Gasoline can (1) | ||
| Hand trucks (2) | ||
| Hard hats (12) | ||
| Disposable gloves (1 box of 100) | ||
| Hygrometer (1) | ||
| Light bulbs (6) | ||
| Monofilament fishing line (3 reels) | ||
| Mops (2) | ||
| Mop buckets (2) | ||
| Pens (15) | ||
| Pedestal fans (4) | ||
| Plastic clothespins (3 packages) | ||
| Plastic crates (50) | ||
| Plastic garbage cans (6) | ||
| Polyethylene sheeting (3 rolls) | ||
| Portable generator (1) | ||
| Rubber aprons (10) | ||
| Safety goggles (1) | ||
| Scissors (3) | ||
| Sling psychrometer (1) | ||
| Squeegees (2) | ||
| Waterproof markers (15) | ||
| Wet/Dry Vacuums (2) | ||
| Work lights (4) | ||
| Yellow pads (15) |
| Copy for: | Borrowing Institution | Supply Depot | Security Office |