Video Surveillance Acknowledgement Form



2056765-37147500 Video Surveillance Acknowledgment FormTo protect the safety of our employees and visitors, area(s) of our facility are monitored and recorded via video surveillance 24 hours a day, seven days a week. There is a live, real-time video feed located in these areas to aid in the investigation process of an accident/near miss situation or for any quality issues that may occur. Only the Plant Manager has on-site access to previously recorded footage.Private areas such as restrooms will never be under surveillance or recorded. By signing this form I am acknowledging that I was involved in an accident/near miss situation or quality issue and I am granting Precision Strip, Inc. the permission to share this video for training purposes throughout the organization. Employee Signature: ________________________________________Employee Name/Date (printed): _______________________________iTrac Alert Number: _________________________________________Plant Manager Signature: ____________________________________Plant Manager Name/Date (printed): ____________________________ ................
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