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Pollution Incident Daily Resource Report
(CG-5136 Form)


 

The CG-5136 Form is used to both summarize and detail all personnel, equipment, and other resources used during the removal activities of an incident. The form consists of several parts.

Details on using and completing all parts of the form are included in Chapters 1 and 6 of the Technical Operating Procedures (TOPs) for Resource Documentation.

Part... Is Used By... When... To..
E1-E4 Contractors Daily To list contractor personnel, equipment, and other resources incurred each day of removal activity

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Download Entire Form & Instructions

If you want to print Parts E to complete the form manually, you can download the forms through CG Form Management Website.

Most of the form can also be completed electronically (see below to download the sections you need individually).

Which file should I download?

CG-5136 E Workbooks

You must use the Microsoft Excel Workbook (e5136) as the primary means of documenting all costs associated with an FPN, CPN, or DPN.. These files are embedded with the Coast Guard standard rates (1 MB PDF) for the times indicated to quickly calculate the daily costs related to oil spill removal. The first worksheet in each file provides additional instructions.

If costs occurred. . . And spill lasted. . . Use. . . File Size

On or after November 18, 2013

7 days or less Current Small Spill Form 171 KB
More than 7 days Current Large Spill Form 656 KB

On or after March 28, 2012

7 days or less Current Small Spill Form 348 KB
More than 7 days Current Large Spill Form 1.37 MB

On or after February 28, 2011

7 days or less Previous Small Spill Form 344 KB
More than 7 days Previous Large Spill Form 1.33
MB
On or after April 9, 2008 7 days or less Previous Small Spill Form 300 KB
More than 7 days Previous Large Spill Form 1 MB

On or after April 5, 2007

7 days or less Previous Small Spill Form 300 KB
More than 7 days Previous Large Spill Form 1 MB
On or after March 15, 2006 7 days or less Previous Small Spill Form 300 KB
More than 7 days Previous Large Spill Form 1 MB
Between February 22, 2005, and March 14, 2006 7 days or less Previous Small Spill Form 300 KB
More than 7 days Previous Large Spill Form 1 MB
Between October 4, 2002, and February 21, 2005 7 days or less Previous Small Spill Form 300 KB
More than 7 days Previous Large Spill Form 1 MB
Before October 4, 2002 N/A Email NPFC for appropriate standard rates

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CG-5136E-1 through CG-5136E-4: Contractor Costs (Dailies)

Oil spill response contractors may use the Parts E1 to E4 of the CG-5136 form to track and submit daily costs. These forms are located on the Coast Guard Form Management System.

CG-5136E-1 Pollution Incident Daily Resource Report - Contractor Personnel
CG-5136E-2 Pollution Incident Daily Resource Report - Contractor Equipment
CG-5136E-3 Pollution Incident Daily Resource Report - Contractor / Subcontractor Materials / Other Expenses
CG-5136E-4 Pollution Incident Daily Resource Report - Contractor / Short Form

If you have questions concerning the CG-5136E contractor forms, please contact the Shore Infrastructure Logistics Center (SILC).

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Last Modified 11/25/2014