Daily NOIRLab Kitt Peak site access form
Complete this form each day in advance of accessing NOIRLab Kitt Peak facilities.

If your information changes, please edit your responses via the email confirmation link.

If you have any questions please contact:
Kitt Peak COVID Site Safety Coordinator - Vivian Segundo at vivian.segundo@noirlab.edu
Tucson/Kitt Peak Safety Officer - Courtney Lopez at courtney.lopez@noirlab.edu
Kitt Peak EMT/EHS Technician - Zade Arnold at zade.arnold@noirlab.edu

All requests are subject to final approval by Lori Allen.
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Email *
First Name *
Last name *
Today's date *
I acknowledge that I am familiar with the latest updates to the CEPP. If you answer no, please check the latest version of the CEPP (https://noirlab.edu/intra/covid-19/resources if you are inside the NOIRLab firewall; https://noirlab.edu/science/sites/default/files/media/archives/documents/scidoc0010-en.pdf if you are not) and return to the form. *
I am on the approved exception list for entering the facility regularly.
Clear selection
If you need to stop in at 950 N Cherry, please tell us where you will be (check all that apply, and you need prior approval to enter your office).
I am responsible for delivering items to multiple sites on Kitt Peak. *
If the answer to the last question above is Yes, please indicate which sites are expected.
If you are staying overnight, are you in the dorm or a house?
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Planned arrival time at site *
Planned departure time from site *
Place(s) you will access on site *
Please be as specific as possible about building, room, etc.
I am a vendor or contractor coming to NOIRLab at Kitt Peak
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If the answer to the vendor or contractor above is Yes, then enter the name of the Company and the NOIRLab contact below.
Please acknowledge that you must radio Vivian Segundo Monday-Friday when arriving and departing Kitt Peak. If you will be arriving or departing prior to 8am or after 4pm Monday-Friday, or anytime on weekends or holidays, please email Vivian Segundo with your arrival and departure times. vivian.segundo@noirlab.edu *
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Do you answer "NO" to all questions on the questionnaire above? *
(If you answer "yes" to any questions, please inform HR and do not access the site today.)
A copy of your responses will be emailed to the address you provided.
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