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NAME OF TRIP

SUPERVISOR

STATUS

EMAIL

MOBILE NUMBER

ADDRESS

(e.g., academic, graduate student)

Academic

Engr. Erison C. Roque

DATES OF TRIP

DESTINATION/PURPOSE OF TRIP

CONTACT PHONE NUMBER DURING TRIP

San Mateo Land Fill / Plant Visit

October 2016

Name:

Address:

Name:

Name:

SECONDARY CONTACT IN CASE OF EMERGENCY


Phone numbers:

Email:

LIST OF INDIVIDUALS ON TRIP


Name:

Name:

ADAMSON UNIVERSITY SECURITY OFFICE CONTACT DETAILS


Name of Safety
Officer:

Contact Details of Safety


Officer:

Hazardous Situation/Activity

University Security Contact


No.

University Registrar

Potential Risk

Control Measures
1

University Insurance if any:

Transport:
Travel during trip

Delays, accidents causing injury, individuals


getting lost

Brief group on itinerary and schedule


Ensure adequate staff/student ratio
Check whether any participants have special health/access
requirements
Check travel timetable
Carry mobile phones
Have emergency telephone numbers available
Issue individual tickets when possible
Check Insurance is in place

Research and book in advance


Be aware of emergency escape routes

Keep group together as far as possible; any unsupervised


parts of the schedule to be advised in advance

Risk of dehydration/hypothermia, sunburn

Keep group informed of what the trip will entail and advise
participants to come suitably dressed/equipped

Exposure Assessment to Hazards

Risk of illness

Keep group informed of what hazardous materials are there

Exposure Assessment to Chemicals

Risk of illness

Keep group informed of what hazardous chemicals are there

Local issues:
Unsuitable type or locations of accommodation

Personal danger, inconvenience or discomfort

Crime

Accident or assault causing injury

Weather conditions

Further hazards

Truly yours,

Noted by:

ROGER JAYSON MERCADO


Group 2 Leader

ENGR. ERISON C. ROQUE

ASEAN ENG. EVELYN Q. RAGUINDIN PECE

Chairperson, ChE Department

`Dean, College of Engineering