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Safety Precaution Certification for SVEC Site Entry

Visitors to SVEC facilities who do not have an SVEC badge are required to complete the questionnaire. This form must be completed for each visitor each day they visit an SVEC facility.

Emergency Situations

Please confirm that you have read and understand the instructions below for evacuating SVEC’s facility or sheltering during emergencies.

, I have read and understand the instructions below.

Building Evacuation – When notified, visitors inside the building must evacuate through the nearest exit. Visitors in the Administration Building must proceed to the east side of the building on the grass past the parking area. Visitors in the Operations Building must proceed through the gate to the north side of the chain link fence.
Bomb Threat – Visitors must evacuate all buildings immediately.
Storm Preparedness - In the event of a tornado or hurricane, visitors must take cover in the center hallway.
Active Shooter Inside Building (Code Red) – When notified of a “code red,” visitors who are near an open office must immediately go inside, close and lock the door, close blinds, turn off lights and wait for the all clear. Visitors in the Administration Building who are not near an open office must meet in the “code red” room, which is located in the center hallway next to the vault, and follow the same procedures.

COVID-19

The visitor is responsible for notifying their SVEC point of contact if they begin to show symptoms of COVID-19 or are diagnosed with COVID-19 within 14 days following their visit.

Have you or any member of your household visited a country outside the United States, whether for business or personal purposes, within 14 days of arriving at the SVEC facility?
To the best of your knowledge, have you been in contact (physical contact of 6 feet or less) with anyone who has traveled outside the United States, within the past 14 days?
To the best of your knowledge, have you been in contact (physical contact of 6 feet or less) with anyone that has tested positive for COVID-19 or is suspected of having COVID-19, within the past 14 days?
Do you have a fever (100.4 degrees Fahrenheit or higher), cough, or shortness of breath at this time, or have you had these symptoms in the last 14 days?
Please confirm, by reading the list below, you have been instructed in the following hygiene practices designed to inhibit the spread of the COVID-19:

Wash hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60%

Avoid touching your eyes, nose, and mouth with unwashed

Avoid close contact with people who are

Cover a cough or sneeze with a tissue, or the inside of your elbow and then throw the tissue in the

Clean and disinfect frequently touched objects and

Avoid hugs, handshakes and close quarters – maintain 6 feet of separation.

Stay at home when sick and seek appropriate medical

CAUTION: Individuals should not enter SVEC facilities if they are experiencing any symptoms of a respiratory illness (fever, cough, shortness of breath, or other flu-like symptoms).

JOB AID

Please get the latest form by going to the Forms & Templates pageon the GRID, under Employee Resources and the template is under Member Misc Forms “Visitor Form”.
This form must be completed by external visitors to SVEC facilities who do not have a SVEC
This form will be available to visitors at all SVEC For facilities without reception desks, SVEC hosts should make sure anyone that meets the above criteria completes the form and meets the access criteria below prior to entering the building.
To grant access to SVEC facilities, the entire form must be completed AND questions 2 through 5 must be answered with a “NO” AND questions 1 and 6 must be answered with a “YES”.
If a visitor declines to complete the form, they are not allowed access to the SVEC.
If a visitor is denied access due to question 4 or question 5, consider rescheduling the meeting with the visitor via video or teleconference at a future date.
If a visitor has been denied access and refuses to leave, efforts should be made to encourage a voluntary resolution. If the issues cannot be resolved, SVEC's Safety Director should be contacted.
These forms should be treated as The SVEC host should e-mail completed forms to HR.
Emergency responders (law enforcement, fire, EMS, etc.) are granted an exception to this process if they are visiting an SVEC facility to respond to an emergency.

Visiting Company

Visiting Company
Visitor First and Last Name
Visitor Title
SVEC Facility
SVEC Host First and Last Name

Allowed Entry (Yes / No) **

SVEC Host First and Last Name

Allowed Entry (Yes / No) **
** To be completed by SVEC host.

Date July 5, 2025

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June 2, 2020 12:08 pm EDT

Safety Precaution Certification for SVEC Site Entry Uploaded by John Robinson - johnr@svec-coop.com IP 40.134.162.98