ASAP Information Website PURPOSE IS TO PROVIDE SUPPORT MATERIAL FOR OUR TEAM

SAFETY FORM AND SUPPLIES FOR ASAP VAN

1.  RUBBER GLOVES  (INSERT NUMBER   ) ____________
2. FIRST AID KIT SUPPLIES (LIST INSIDE BOX)
3.        ___________________________________________________
4.        ___________________________________________________
5.       ____________________________________________________
6.      _____________________________________________________
7.      _____________________________________________________
8.  N95 MASKS ___________________________
9. NON N95 MASKS ________________________
10.  BAR OF SOAP   _________________
11. CLOROX WIPES _________________
12. HAND SANITIZER _______________
13. _________________________________________________________
14. __________________________________________________________
15. __________________________________________________________

THERE ARE some great videos at cdc.gov which will review cleaning standards

we recommend you watch them.

I have recieved the above items and I have recieved the safety training for the above

print name______________________________________________________

Signature________________________________________________________

date______________________________________________________________

who gave out these supplies print name ________________________

and sign here______________________________________________________