Highlands Ranch Volunteer Registration

Douglas County Household Chemical Roundup
Shea Stadium ● 3270 Redstone Park Circle
Highlands Ranch, CO 80129
Aug 11, 2018

Thank you for volunteering for the 2018 Household Chemical Roundup! Please complete this form and RETURN BY July 30, 2018 so that we may accommodate you to the best of our ability. If you have any questions or are unable to attend after you have registered, please call (720) 200-1592. You’ll be hearing from us soon with more information about the event.

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*We will try to accommodate your request.

*We will try to accommodate your request.

*We will try to accommodate your request.

Do you have any other training or skills that may be useful? (E.g., Spanish- or other language ability, CPR, etc.)

Please list any physical restrictions or limitations you have that may affect your ability to work.

I hereby acknowledge that I am VOLUNTEERING for the Household Chemical Roundup managed by Tri-County Health Department (hereinafter "TCHD"), and will serve in a VOLUNTARY capacity. I understand that the term VOLUNTARY means actions or services I render at the Household Chemical Roundup will be given free of charge. I further acknowledge that I have not been appointed to any position with TCHD, either express or implied, nor have I entered into a "contract of hire": with TCHD, either express or implied. Furthermore, I understand that because my relationship with TCHD, or any other entity participating in the Household Chemical Roundup, is not that of an employee-employer relationship, that therefore I am not entitled to workers' compensation benefits, or any other benefit, in my capacity as a VOLUNTEER. I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE “HOUSEHOLD CHEMICAL ROUNDUP SAFETY PROCEDURES” AND TERMS AND CONDITIONS OF THIS VOLUNTEER ACKNOWLEDGEMENT. I CERTIFY THAT ALL OF THE ABOVE INFORMATION IS CORRECT.
For the most part, the items we handle at the Roundup are items that we come into contact with regularly. Handled carefully, they should present little risk. Volunteers can avoid safety hazards by staying alert, exercising common sense and performing tasks carefully. Here are our guidelines for a safe event.

1. All volunteers are required to wear proper attire at the Roundup. Volunteers must wear shoes or boots, pants, and a shirt. Sandals and shorts are NOT allowed.

2. Watch for moving cars and people unloading or moving items. Don’t assume other volunteers are paying attention to you. Take care to avoid bumping a person who is carrying a heavy or open container. A collision can have serious consequences for anyone nearby.

3. For your safety, wear your personal protection equipment (PPE) whenever you are in the work zone. Remember to remove your PPE and wash your hands when leaving the work zone.

4. Lift items carefully. Lift with your legs, not your back. To lift heavy items, use a cart or dolly or ask another person to help you.

5. Always open containers away from you and others, and pour liquids slowly.

6. Don’t smell or taste any products. DO NOT TOUCH UNKNOWN PRODUCTS. If you have a question about a product that arrives at your station, ask your station manager.

7. Stay alert. Take breaks and get snacks/drinks as needed. Water coolers will be located at each station; the lunch area will have juices and snacks.

8. Avoid uncontrolled spills.
 Keep all products on plastic sheeting.
 Take care to drain empty containers (oil, etc.) completely before placing them in the dumpsters. No matter how busy things get, avoid the temptation to save time by throwing containers into the dumpster from a distance.
 If a measurable amount of product is spilled at your station, alert the station manager so that absorbent can be poured on it and it can be scooped up to prevent work areas from becoming slippery. Exception: Acid spills at the battery station should be cleaned up with a neutralizing agent.

9. Eat ONLY in the designated lunch area. Remove your personal protection equipment and dispose of the Tyvek suits and chemical resistant gloves in the provided disposal containers. Before eating, wash your hands at the portable hand wash unit near the lunch area.

10. If you or a fellow volunteer is injured, tell your station manager who will seek assistance from the on-site Fire Department Hazmat Team or the Hazardous Waste contractor.

11. Site evacuation – If the site requires evacuation, you will hear a single blast of the emergency horn. Stop what you are doing and follow your station manager’s exit instructions. DO NOT attempt to direct Roundup participants; Fire Department personnel will evacuate them.

12. Please ask Roundup participants to shut off their engines while vehicles are being unloaded.

13. Smoking is prohibited onsite.

call (720) 200-1592 or ekennedy@tchd.org

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