Agency Guidelines by YQG6f0

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									                              University of Washington
                              SCHOOL OF PUBLIC HEALTH
                              Department of Environmental and Occupational Health Sciences



                    STUDENT INVOLVEMENT IN EH PROGRAMS

Student:                                                                Date:

Supervisor:                                           Organization:


Please check the appropriate boxes indicating the degree of involvement which this intern has had
with the various activities listed for each of the following program areas.


                                                                        Observe   Participate   Independ.
Air Quality/Air Pollution Control Program                                Only      w/ Staff       Work

1. Ambient Air pollution monitoring
2. Indoor air quality
3. Other:

                                                                        Observe   Participate   Independ.
Community Environmental Health                                           Only      w/ Staff       Work

1.   School inspection, plan review
2.   Mobile home park, camping club, group camp, recreational
     camp sites
3.   Migrant housing
4.   Swimming pools, sampling, field tests
5.   Community Noise survey
6.   Vector investigations, breeding sites, control
7.   Other:

                                                                        Observe   Participate   Independ.
Food Protection Program                                                  Only      w/ Staff       Work

1.   Survey restaurants, bakeries, grocery stores, meat markets,
     tavern, etc.
2.   Temporary food service facilities, e.g., fairs, carnivals, etc.;
     food handling
3.   Investigate suspected outbreak of food-borne illness
4.   Plan review of proposed facility (new)
5.   Field trip with state Dept. of Agriculture or FDA.
6.   Other:
ENVH 482: EH INTERNSHIP                                                    STUDENT INVOLVEMENT
2011 - 2012                                                                              Page 2


                                                                       Observe   Participate   Independ.
Occupational Health & Safety Programs                                   Only      w/ Staff       Work

1. Air Quality, ambient or personnel sampling & analysis
2. Noise / Hearing Conservation
3. Industrial hazards (accident/spill)
4. Ergonomics
5. Other:

                                                                       Observe   Participate   Independ.
Sewage Disposal Program                                                 Only      w/ Staff       Work

1. Site evaluation, perc. tests, soil sampling, etc.
2.   Septic tank and drainfield installation, final inspections
3.   Review of subdivision plans
4.   Investigate system failure, use of dye test
5.   Local sewage collection and treatment systems, visit sewage
     treatment plant
6.   Other:

                                                                       Observe   Participate   Independ.
Solid/Hazardous Waste                                                   Only      w/ Staff       Work

1. Investigate open dump, landfill, sanitary
2. Become familiar with collection systems, i.e., transfer stations,
    use of compactors, etc.
3. Investigate proposed site for new or relocated dump or landfill
4. Investigate suspected hazardous waste site
5. Hazard Materials/Waste (accident/spill) Investigation
6. Other:

                                                                       Observe   Participate   Independ.
Water Supply Program                                                    Only      w/ Staff       Work

1.   Survey private supply system, sample water
2.   Investigate contaminated water system
3.   Survey a community or public water supply
4.   Water quality tests routinely done by local health depts.
5.   Surface water evaluation
6.   Visit water treatment plant
7.   Other:
ENVH 482: EH INTERNSHIP                                                             STUDENT INVOLVEMENT
2011 - 2012                                                                                       Page 3




                                                                                Observe   Participate   Independ.
Compliance Proceedings                                                           Only      w/ Staff       Work

1. Enforcement action
2. Attend legal hearings, deposition, trial, .etc.
3. Other:

                                                                                Observe   Participate   Independ.
Community Relations                                                              Only      w/ Staff       Work

1. Nuisance Complaints
2. Environmental Justice activities
3. Attend public hearings, council meetings, etc.
4.   Participate in information/education meetings, e.g., PTA,
     service clubs, etc.
5.   Other:

                                                                                Observe   Participate   Independ.
Other Env. or Occ. Health Activities (not listed above)                          Only      w/ Staff       Work
     (Feel free to add anything you think is important, e.g., lab. techniques
     – be specific and add as many lines as needed.)
1.
2.   .
3.

								
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