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Office Status Questionnaire

PLEASE FILL OUT THE FOLLOWING FORM IF THERE IS A WEATHER OR MECHANICAL SITUATION AT YOUR WORKPLACE, AND SUBMIT IT TO THE DEPARTMENT OF TRANSPORTATION & PUBLIC FACILITIES

QUESTIONS? rob.daly@alaska.gov, 907-269-0300

Do you have access to running water?:  *    

 
Is the plumbing working?:  *    

 
Is the electricity on?:  *    

 
Is the heat working in your building (if necessary)?:  *    

 
Is weather preventing you from getting to your workplace?:  *    

 
Do you feel that there is work you are able to do without electricity (i.e. phone calls, filing, cleanup, meetings, etc.)?: *

Are there any other hazards we should be aware of?: *

Are you asking to: *