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CITY OF STOCKTON RISK SERVICES REQUEST×AUTHORIZATION FOR OCCUPATIONAL EYEWEAR (Name of Employee) (Job Title×Department) (Please Print) In accordance with CAL×OSHA Regulations Z871989, American
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How to fill out prescription safety eyewear request
How to fill out prescription safety eyewear request?
01
Begin by providing your personal information such as your name, contact information, and employee identification number if applicable.
02
Specify the type of safety eyewear you require, including the prescription details for both the lenses and any additional specifications.
03
Indicate whether you require any specific features or accessories for your eyewear, such as anti-glare coating or side shields.
04
If applicable, mention any specific regulations or requirements that need to be met for your workplace or industry.
05
Make sure to include the date and your signature at the bottom of the form.
Who needs prescription safety eyewear request?
01
Employees working in industries or environments where safety hazards are present, such as construction sites or laboratories, may require prescription safety eyewear.
02
Individuals who have a specific eye condition or vision impairment that necessitates the use of prescription lenses for safety purposes may also need to submit a prescription safety eyewear request.
03
Any individual who needs to protect their eyes from potential hazards while carrying out their job responsibilities should consider requesting prescription safety eyewear. This could include professionals like carpenters, welders, or chemists, among others.
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