绿色施工示范工程实施指南 陕西用表
附录4：
陕西省建筑业绿色施工管理过程检查记录用表
目 录
1、附表H-001绿色施工交底记录表································3 2、附表H-002工地噪声测量记录表································4 3、附表H-003绿色施工培训计划表································5 4、附表H-004培训记录·············································6
5、附表H-005 卫生间清洁检查标准·······························7
施工现场及办公生活区环境保护检查标准·······7 6、附表H-006 卫生间清洁检查记录表·····························8 7、附表H-007施工现场及办公生活区环境保护检查记录表····10 8、附表H-008 施工层扬尘检查记录表····························12 9、附表H-009现场道路扬尘检查记录表························13 10、附表H-010办公及生活区垃圾记录表························14
11、附表H-011生活垃圾清运记录表······························15 12、附表H-012 建筑垃圾清运记录·······························16
13、附表H-013 污水排放检查记录表····························17
14、附表H-014 沉淀池、隔离池、化粪池清理记录表··········18
15、附表C-001 限额领料单·······································19
16、附表C-002对讲机发放回收记录表··········· ··············20
17、附表C-003机械保养记录表····································21 18、附表 C-004塔吊保养记录表···································22 19、附表C-005施工电梯保养记录表······························23
20、附表C-006危险品材料进出场记录台帐······················24
21、附表C-007材料进出场记录台帐······························25
22、附表C-008砂浆管理记录表··································· 26
绿色施工示范工程实施指南 陕西用表
23、附表C-009砖、砌体管理记录表····································27 24、附表C-010 塑料管理记录表···································28 25、附表C-011 包装材料管理记录表······························29
26、附表 C-012 装修材料管理记录表·····························30
27、附表C-013钢材用料处理记录表·······························31
28、附表C-014方木模板回收利用记录表························· 32 29、附表C-015混凝土余料使用记录表····························33
30、附表C-016废料出售记录表····································34
31、附表D-001回填土记录表·······································35
32、附表D-002项目部土地使用变更表····························36
33、附表N-001办公区用电记录表·································37
34、附表N-002生活区用电记录表··································38 35、附表N-003塔吊耗能记录·······································39
36、附表N-004钢筋棚耗能记录····································40
37、附表N-005施工电梯耗能记录··································41 38、附表N-006单体耗电记录·······································42
39、附表N-07用电记录汇总表······································43 40、附表S-001项目部临时用水消耗记录··························44 41、附表S-002雨水回收记录表···································· 45 42、附表S-003雨水使用记录表·····································46 43、附表S-004地下水使用记录表··································47
绿色施工示范工程实施指南 陕西用表
附表：H-001
绿色施工交底记录表
工程名称 交底人 交底对象 ***C标段 方案名称 交底时间 参加人员签名 交底内容： 说明：绿色交底应按工序， 在施工全过程中所有的技术交底和安全交底中，必须有独立的
绿色施工交底条款内容，按时间、要素分类，每道工序开始前必须交底。交底的效果可通过考试的形式进行检查、巩固。
绿色施工示范工程实施指南 陕西用表
附表：H-002
工地噪声测量记录表（昼间）
工地名称 地 点 测量仪器型号 测量地点 测点A 测点B 测点C 测点D 测点E 测点F TDJ-814 测量值（DB） ***C标段 施工阶段 测试时间 天气 平均值 测量人 标准值 70dB 70dB 70dB 70dB 70dB 70dB 组长：
注:1、根据现场实际情况，制定测量时间，浇筑混凝土必须进行测量；
2、夜间测量时间为晚22:00～次日06:00；昼间测量时间为早06:00～晚22:00； 3、测量点布置应在临近居民楼、生活区等噪音敏感区域； 4、每月要对测量数据进行分析对比。
绿色施工示范工程实施指南 陕西用表
附表：H-003
绿色施工培训计划表
序号 培训培训培训培训培训培训授课时间 地点 形式 内容 对象 人数 人 培训效果采用的评价方式 培训编号 说明：培训计划可按工期或是按施工阶段制定，应以覆盖施工全过程、全员、培训形式多样培训效果最佳为原则；计划制定后相关责任人要负责落实执行，在培训过程中认真填写《绿色施工培训记录表》，同时留取培训过程中的影像资料，培训效果资料。