Construction Site and Lodging Exemption Form
Section I of the March 16th Amended Public Health Order states that Residential and Commercial Construction Sites may otherwise continue to operate so long as in compliance with this Order if they receive an express, written exemption from the Public Health Director after providing her sufficient information, in her sole discretion, to ascertain compliance with this order.

Section E of the March 16th Amended Public Health Order states that all short-term lodging, including, but not limited to hotel, motels, short-term rentals (30 days or less), bed and breakfast establishments, lodges and retreats shall cease operations, unless otherwise authorized in writing by the Public Health Director for emergency or quarantine purposes, or to provide lodging for essential federal, state, county, or local personnel.

In order to streamline the process of compliance and allow certain jobsites and short-term lodging properties to remain open we request that jobsite and lodging managers fill out this form in order to process requests.
What is your Business Name? *
Your answer
First and Last Name *
Your answer
Contact Email *
Your answer
Contact Phone Number *
Your answer
Job Site Location Information 1. Enter all addresses including town/city at which you are working. 2. Add number of employees that are working at each location next to the address(es). 3. Add whether each address is indoor or outdoor or both. 4. List out all subcontractors. YOUR RESPONSE(S) SHOULD LOOK LIKE THIS: 200 Georgia Ave, Gunnison/8/Outdoor/Subcontractor, Subcontractor
Your answer
Lodging Property Location Information 1. Enter address of the location you are obtaining an exemption for 2. Add number of people you are obtaining an exemption for for each location next to the address(es). 3. Add the type of personnel that you are trying to obtain an exemption for. YOUR RESPONSE(S) SHOULD LOOK LIKE THIS: 200 Georgia Ave, Gunnison/8/Federal, County
Your answer
Describe the hours of operation at the job site
Your answer
Have you excluded all at-risk individuals (age 60+ or underlying medical conditions) from work on these sites? *
What is the maximum number of people allowed at the job site or lodging property at any given moment? (cannot be more than 10) *
Your answer
All visitors to Gunnison County have been directed to return home immediately. Please decribe how your job site or lodging property is complying.
Your answer
Have you implemented Environmental Cleaning Procedures in accordance with CDC guidelines? CDC guidelines can be found here: http://bit.ly/2wWS6lb *
The order requires that proper hand hygiene and sanitation must be readily available to all attendees and employees. Describe how proper hand hygiene and sanitation, including the sanitation of port?a potties and the people using them, and how often sanitation efforts will occur each day. Please describe how your jobsite or lodging property will comply with this requirement and what will be done to maintain compliance:
Your answer
How are you ensuring social distancing? Be as specific as possible. *
Your answer
Are you supplying disinfectant and/or hand washing stations at each Job Site Location or in rooms and common areas of the Lodging Property? *
Are you screening your employees each day for coronavirus symptoms and excluding them if sympomatic? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms