Get Respirator Fit Test Machine Usage Form - Onondaga County

Completing the respirator fit test machine usage form is essential for reserving this important equipment for your agency's needs. This guide will help you navigate each section of the form step-by-step to ensure a smooth and successful submission.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill out the ‘Borrowing Agency’ field with the name of your agency. This identifies the organization that is reserving the respirator fit test machine.
3. Enter the date on which you are completing the form in the ‘Date’ field. This helps track the reservation timeline.
4. In the ‘Agency Representative’ field, provide the name of the person who is authorized to request the reservation.
5. Complete the ‘Title’ field with the representative's job title within the agency to establish authority.
6. Fill in the ‘Daytime Phone Number’ field with a contact number for the representative, ensuring they can be reached during business hours.
7. Enter the ‘Email Address’ to allow for electronic communication related to the reservation.
8. In the ‘Respirator Type/Manufacturer’ section, list the types and manufacturers of the respirators you intend to test, filling in as many entries as necessary.
9. Below the respirator information, enter your name in the designated space to verify who is making the request.
10. Indicate the ‘Pick-Up Date’ when you plan to collect the respirator fit test machine.
11. Specify the ‘Return Date’ by which you will return the machine to ensure compliance with the reservation policy.
12. Acknowledge the statement regarding the equipment's property status by checking or writing your agreement, which reinforces the responsibility for its condition.
13. Sign the form in the ‘Signature - Authorized Agency Representative’ field, confirming that the information provided is accurate and the reservation is authorized.
14. After completion, save the changes made to the form. You can then download, print, or share the form as needed.

Complete your forms online today to ensure your agency is prepared and compliant.