Tool Loan Check-out Form - Marion SWCD

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This tool loan program is available only to residents of Marion County, Oregon.

The borrower assumes full responsibility for their proper and safe use.

The District is not liable for any injuries, damages, or losses resulting from the use or misuse of borrowed tools.

Tool Check Out Form

The individual and/or organization using equipment loaned by the Marion Soil and Water Conservation District is responsible for loss or damage of the equipment.

Date of Request(Required)

Month

Day

Year

Name of affiliated group, organization or MSWC Partnership (if any)

Name of Person Requesting Items(Required)

First Last

Name of Person Picking Up Items (if different)

First Last

Phone(Required)

Email(Required)

Date Requested to Pick Up(Required)

Month

Day

Year

Anticipated Date of Return(Required)

Month

Day

Year

Not to exceed 2 weeks without prior approval

Requested Items:(Required)

Garden Gloves

Grass Shears

Hand Pruners

Hand Saws- Foldable

Hand Trowels

Lopping Shears

Metal Rake

Rebar Stake Planters

Shovel – Flat Head

Shovel – Round Point Head

Shovel – Spade

Shovel – Spearhead

Weed Wrench – Small

Weed Wrench – Large

Other

Garden Gloves (pairs)(Required)

Grass Shears(Required)

Hand Pruners(Required)

Hand Saws – Foldable(Required)

Hand Trowels(Required)

Lopping Shears(Required)

Metal Rakes(Required)

Rebar Stake Planters(Required)

Shovels – Flat Head(Required)

Shovels – Round Point Head(Required)

Shovel – Spades(Required)

Shovels – Spearhead(Required)

Weed Wrenches – Small(Required)

Weed Wrenches – Large(Required)

Other, include qty.(Required)

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For Office Use Only

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Date Picked Up

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Date Due

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Staff Signature

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Borrower Signature

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Date Returned

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Please indicate if the tools were:

Returned

Returned Damaged

Not Returned

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Notes/Comments

Δ

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Marion Soil and Water Conservation District

408 N Third Avenue PO Box 537 Stayton, OR 97383

Phone: (503) 391-9927

Email: office@marionswcd.net

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