SM
HARLEYSVILLE RISK SERVICES Your Partner in Preventing Losses
Snow and Ice Removal/Treatment Log
Name of Facility:
Type(s) of Work Performed:
______________________________________________________
S/P = Shoveled or Plowed T = Treated
Place  in S/P column if shoveled or plowed, and/or
Place  in T column if treated, alongside “I” for ice melt,“S” for sand, or “C” for cinder to indicate material.
Date
Building
Name/Number
Time
Streets Near
Building
Sidewalks
S/P
S/P
T
AM
PM
S/P
PM
S/P
PM
S/P
S/P
PM
S/P
PM
S/P
T
S/P
T
S/P
I
S
S
S
S
S
S
S
C
C
C
C
C
C
C
S/P
T
S/P
T
S/P
T
S/P
T
S/P
T
S/P
I
I
I
I
I
I
S
S
S
S
S
S
S
C
C
C
C
C
C
C
T
S/P
T
S/P
T
S/P
T
S/P
T
S/P
T
I
I
I
I
I
I
I
S
S
S
S
S
S
S
C
C
C
C
C
C
C
S/P
T
S/P
T
I
S/P
T
I
S/P
T
I
S/P
T
I
S/P
T
I
I
S
S
S
S
S
S
S
C
C
C
C
C
C
C
S/P
T
S/P
T
S/P
T
S/P
T
S/P
T
S/P
T
I
I
I
I
I
I
I
S
S
S
S
S
S
S
C
C
C
C
C
C
C
S/P
T
S/P
T
S/P
T
S/P
T
S/P
T
(Includes dates/times of communications with removal contractors.)
T
I
S/P
Comments
T
I
T
AM
T
I
T
AM
S/P
I
I
PM
T
Initials of
Technician
Roof
I
T
AM
S/P
Parking
Areas
Driveways
I
T
AM
T
Stairways
or Steps
I
T
AM
Other
Walkways
S/P
T
I
I
I
I
I
I
I
S
S
S
S
S
S
S
C
C
C
C
C
C
C
Risk Services Department Tel: 800.523.6344, ext. 8100
Harleysville Insurance
Fax: 215.513.5345
355 Maple Avenue
Email: [email protected]
Harleysville, PA 19438-2297
www.harleysvillegroup.com
Z-1622 07/12