FMD-F-11-02.13.1.

Control No.:_______________

MATERIALS/EQUIPMENT GATE PASS FORM

(DELIVERY)

MARK VINCENT MORA

Bearer:_________________________________ 6750 BUILDING
Building:_______________
AIRTECH
Owner/Tenant/Contractor:_____________________ APRIL 25,26, & 27, 2023
Date:__________________

FOR AS-BUILT
Reason for transfer:______________________________________________________________________
______________________________________________________________________________________

To be filled out by security

QUANTITY DESCRIPTION ACTUAL COUNT REMARKS
1 8 FT LADDER
1 BALOMETER
1 PITOT TUBE

Prepared by: Cleared/Inspected by:

MARK VINCENT MORA

_________________________________ _____________________
Owner/Tenant/Contractor Representative Security Guard

Verified by: Date & Time Released:

____________________ _____________________
Security Officer

Approved by: Location:

___________________________________ _____________________
Property Manager/Building Engineer
Rev.02
APMC is not liable for any damage and loss of properties caused by the transferring in or out of the items.
Copy 1 – Tenant/Owner/ Contractor representative; Copy 2 – Security; Copy 3 – Property Manager