Health & Safety Survey * 1. What local do you belong to? Barnegat Bay Head Beach Haven Berkeley Brick Central Regional Eagleswood Island Heights Jackson Lacey Lakehurst Lakewood Lavallette Little Egg Harbor Long Beach Island Manchester Ocean County Vocational Technical School Ocean Gate Ocean Pinelands Plumsted Point Pleasant Beach Point Pleasant Borough Seaside Heights Seaside Park Southern Regional Stafford Toms River Tuckerton * 2. What HEALTH issues are present in your building or classroom? Temperature Air Vents Toxic Materials / Chemicals Mold/Moisture Housekeeping / Sanitation Supplies Pest Control Paperwork / Workload None Other (please specify) * 3. What SAFETY issues are present in your building or classroom? Student Behavior Class Size Parking Lot / Inclement Weather Cleanup Crowded Hallways Electrical Safety Lighting Fixtures Items Properly Fastened No-Skid Surfaces Loose Flooring / Ceiling Tiles Dangerous Machinery Short Term Personal Injury Accommodations Long Term Disability Accommodations None Other (please specify) * 4. Does your local / building have a Health & Safety committee? Yes No I'm Not Sure * 5. Do you have a specific contact person in your local / building that you can report health and safety concerns? Yes No I'm Not Sure * 6. Would you be interested in attending a workshop or seminar that provides more information about your concerns? Yes No * 7. Would you be interested in serving on your local's Health & Safety Commitee? No Yes ( Please provide your name and contact information.) Done