5810.944 Helicopter Hangar at Anderson AFB New Worker Registration
Date
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Month
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Day
Year
Date
Company Name
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Company Designate Email (individual uploading documents)
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example@example.com
Employee Name
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First Name
Last Name
Employee Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Employee Job Title/Occupation
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Have you reviewed the ECC Safety Orientation, Natural and Cultural Resources videos?
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No
Yes
The DOD 3Rs Safety Training is required for all workers. Have you completed this training?
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No
Yes
You must review the Activity Hazard Analysis (AHA) before starting work. Do you agree to review the AHA before starting work?
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No
Yes
Is the employee an H2B Worker?
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Yes, the employee is an H-2B worker and has completed the EM385 16-hr training.
Yes, the employee is an H-2B worker and has NOT completed the EM385 16-hr training.
Employee is not an H-2B worker.
Do you agree to comply with all safety and environmental requirements while working on this project?
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No
Yes
I have received a summary of the information on the contents of the ACCIDENT PREVENTION PLAN for the project including operations to be performed i.e., assembly areas, evacuation routes, emergency signals, drills, and actions to take in the event of a site emergency. Copies of this plan are available for my review. I have been briefed on the contents of the plan, understand its requirements, and agree to comply with all its provisions. I understand that failure to comply with these requirements could result in disciplinary action.
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No
Yes
Have you been briefed on base and site security procedures?
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No
Yes
Emergency procedures have been reviewed, and locations of the Emergency Assemble Area, First Aid Kit, and AED have been provided?
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No
Yes
Hazard Communication (HAZCOM) standard has been reviewed, and the location of the Safety Data Sheet (SOS) have been provided?
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No
Yes
Procedures for using a Fire Extinguisher have been reviewed?
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No
Yes
Hard Hat Sticker Number (entered by ECC H&S)
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