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Energy Storage System Site Access Log
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3
- Select a Role
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ESS FACILITY ACCESS LOG
This form is intended to serve as an electronic log that tracks the entry or request made by individuals or groups to enter a NineDot Energy, ESS (Energy Storage System) facility.
Please select the role that best describes you:
*
Contractor
Con Edison Employee
NineDot Employee
COF (Certificate Of Fitness) Holder
FDNY / Emergency Responder
First Name
*
Last Name
*
Phone
*
Email
*
Company Name
*
Confirm the number of people with you — enter zero if you are alone.
*
Select one
0
1
2
3
4
5
6 to 10
11 to 15
16 to 20
21 to 25
26 to 30
Who is accompanying you?
What site are you trying to access today?
*
2550 Gunther, Site A - (HTV-20869 / 5X66)
2550 Gunther, Site B - (HTV-7203 / 5X62)
PURPOSE/ACTIVITY
What would you like to do?
*
Log Your Entry
Log Your Exit
Give Advance Notice to Perform Work
Request A Site Tour
Emergency Incident — Log In & Log Out
ADVANCE NOTICE / ACCESS REQUEST
When would you like to perform the planned work, or to conduct the requested site visit tour?
Date
*
YYYY dash MM dash DD
Time
*
Hours
:
Minutes
AM
PM
AM/PM
Would you like to upload a detailed description of the planned work scope, or the site visit tour?
*
Yes
No
Please upload the details of your planned work scope or site tour here.
*
Max. file size: 300 MB.
ENTRY LOG
Log the time you entered the facility.
Date
*
YYYY dash MM dash DD
Time
*
Hours
:
Minutes
AM
PM
AM/PM
Would you prefer to upload your work scope?
*
Yes
No
Please upload the details of your planned work scope or site tour here.
*
Max. file size: 300 MB.
EXIT LOG
Log the time you exited the facility.
Please describe what you are doing at the site
*
Date
*
YYYY dash MM dash DD
Time
*
Hours
:
Minutes
AM
PM
AM/PM
Was all work completed?
*
Yes
No
Do you have any incident, safety condition(s) or security concerns to report?
*
Yes
No
Please enter your incident, safety condition(s) or security concerns:
*
If have nothing to add please type N/A
EMERGENCY LOG IN & OUT
What time did you enter the facility?
Date
*
YYYY dash MM dash DD
Time
*
Hours
:
Minutes
AM
PM
AM/PM
What time did you exit the facility?
Date
*
YYYY dash MM dash DD
Time
*
Hours
:
Minutes
AM
PM
AM/PM
Was the emergency fully abated?
*
Yes
No
INCIDENT REPORT
Provide a detailed description of the of the incident that occurred.
*
Do you have any photos you would like to upload?
*
Yes
No
Please upload your photos:
*
Drop files here or
Select files
Max. file size: 300 MB.
SITE SPECIFIC JOB BRIEFING
OSHA requires a site-specific job briefing to take place in advance of work. This applies to contractors and employees alike. Contractors are wholly responsible for the retention and documentation job briefings.
Did you complete a job briefing?
*
*Contractors: If no, please exit this form and comply with your company's job briefing requirements.
Yes
No
NDE Job Briefing Form
First Name
Last Name
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