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SCR Safety Form


Recognized Hazards of the Job
Specific Parking Restrictions? *
Yes No
Actual Day Time Hours & Air Quality (WSDOT iPhone weather Application):

Sunrise: Sunset:
Industrial Fire Precaution Level: IFPL Map and Levels
Check Level That Applies to the Area You are Working in: * 1 2 3 4

Are your personnel properly equipped with all PPE’s and safely prepared for today’s task? *
Yes No
Personal Protective Eqipment Required on Site:
Please visit this link: COVID Data Tracker

I have reviewed the COVID Data Tracking map and will take the necessary precautions during travel



Survey Team (Check Box if Attending):



Safety Team:
EMERGENCY 911
Amilo Morales (SCR) 509-577-1610 509-759-5434
Brandon Carter (NWR) 206-440-4073 n/a
Sue Tellesbo (NWR) 206-799-4973 n/a
Chris Rios (NWR) 206-464-1296 n/a
Eric Summers (NWR) 206-768-5917 n/a
TMC (SCR) 509-577-1910 n/a
TMC (NWR) 206-440-4490 n/a

General:
Kevin Carlascio, PLS, RP (SCR) 509-571-7583 n/a
Kenny King, PD PE (SCR) 509-577-1729 360-560-2264
Brent Schilperoort, PD APE (SCR) 509-577-1746 509-945-7965
Brian White (SCR) 509-577-1700 509-945-3680
Julie Heilman (HQ) 509-577-1703 509-969-3223
Gabe Ng (Jacobs-NW) n/a 509-206-5252
Heather Pittman (HQ - OL) 360-705-7495 n/a
KR Leica Support 425-953-2825 n/a
CAE Help Desk 360-709-8013 n/a

SCR building 4 2809 RUDKIN RD, UNION GAP, 98903
P.O. BOX 12560 YAKIMA 98909-2560 * 509-577-1600