Mobile Shower Service Site Partner Survey
WAVE Project mobile shower service site partner survey
Please complete this form to assist with the site partner planning and evaluation process.
Name of organization
Organizational contact name:
First and last
Organizational contact phone number:
Organizational contact email:
Organizational web site:
Macomb County, MI
Oakland County, MI
Wayne County, MI
Address of service site:
Hours of Operation
Please list the days/times in which you offer services
Can the organization provide documentation of current liability insurance (listing WAVE Project as an additional insured) that will cover the mobile shower service event(s)?
Commercial General Liability insurance with a limit of not less than $1,000,000 per occurrence for bodily injury, property damage, personal injury and contractual liability. Professional Liability insurance covering acts, errors, mistakes or omissions arising out of or related to the Services, with a limit of not less than $1,000,000 per claim.
Site foot/vehicle traffic
Privately owned lot
Street (permit not required, not metered)
What services are provided by the site partner/organization?
Average number of people served?
Service site partner resources:
Please select all available site resources that the organization is willing to provide (at the cost of the site partner).
Black water (wastewater from the toilet) disposal: RV Park, Marina, approved waste water dumping site in your city, onsite waste disposal company (porta potty)
Cleaning supplies (list provided)
Dumpster/trash receptacle access
Event tent/pop up canopy
Event volunteers- Four volunteers from your organization to assist with the Mobile Shower Service per event.
Grey water (wastewater from the shower) disposal offsite partnership
Hygiene kits for guests (~50)
Indoor staging/waiting area for guests
Landline telephone access
Mobile shower service volunteers (4 per service date)
Onsite sewer clean out/sewer drain access (opened and certified by prior to event) for black/grey water disposal (city approved)
Power/electric (extension cord) access
Refreshments for guests/volunteers (meal, snacks, drinks, etc.)
Secure indoor (climate controlled) trailer overnight or extended parking/storage (16' trailer)
Secure on-site storage for Mobile Shower Service supplies
Secure trailer overnight or extended parking/storage (16' trailer)
Water: Exterior hose bib access
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This form was created inside of WAVE Project.