Grade Equipment Usage Form

Grade+ Semiannual Equipment Usage Report FormPlease use the following form to report semiannual (6 month) usage for GRADE+ funded equipment. For on-road equipment, you should report miles of operation. For non-road equipment, report hours of operation. Enter the necessary information and then click "Submit Form".

Grade+ Semiannual Equipment Usage Report Form

Following is my GRADE+ funded equipment semiannual usage report.

Reporting Period Start Date (Jan. 1, 20XX or July 1, 20XX) Reporting Period End Date (June 30, 20XX or Dec. 31, 20XX) Grant Recipient Name: Grant Contract #:

Equipment Information:

Equipment Description:Engine Serial Number: Engine Model Number:

Equipment Operation:

Total hours of operation for this period: (Non-Road Vehicles Only) Total miles driven for this period: (On-Road Vehicles Only)

Location of Operation: Indicate the number of hours or miles that the equipment was used in each of the following counties.

Anson, NCCabarrus, NCCleveland, NCGaston, NCIredell, NCLincoln, NCMecklenburg, NCRowan, NCStanly, NCUnion, NCChester, SCLancaster, SCYork, SCOther

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