STORMWATER FLOODPLAIN SIMULATOR LOAN REQUEST
1. In borrowing items from Austell Public Works, participants are responsible picking up items
up from the this office or previous user of items and for the set up and tear down of items.
Participants will also work with those who have requested the items before and after our use.
Items not being picked up by others borrowing items must be returned back to Austell Public
Works within five business days after end of use.
2. Coordination will take place through Austell Public.
3. Participants in this loaner program must understand that all efforts will be made to coordinate
items borrowed geographically. In all cases this may not be possible.
4. There are very specific set up instructions for use of many of the items. Participants agree to
read and follow set up instructions. Items broken or lost by participants while on loan will be
asked to replace items. There will be a check off sheet to be sure all items are repacked
before going on to next location. Those receiving items must check items as they receive
them.
5. A follow-up survey of the items used will be completed within ten days after item is used.
6. By signing below, we have read the above information and will abide by the responsibilities
listed above.
PLEASE PRINT
GROUP REQUESTING ITEM(S)
CONTACT NAME
DATE(S) REQUESTED
ADDRESS
CITY
ZIP CODE
TELEPHONE NUMBER
E-MAIL ADDRESS
SIGNATURE
THIS FORM MUST BE RECEIVED BY OUR OFFICE THIRTY DAYS PRIOR TO EVENT
Austell Public Works
Stormwater Management and Floodplain Management Division
5000 Austell-Powder Springs Road, Suite 105
Austell, Georgia 30106-2427
Office: (770) 944-4325 Fax: (770) 944-4335 E-Mail: info@apwsm.org