New Jersey Department of Health

QUARTERLY REPORT

OF RIGHT TO KNOW COUNTY LEAD AGENCIES

Name of Agency

Quarter

1st	3rd

2nd	4th	Year

A.	SURVEYS/FACT SHEETS
C.	DISTRIBUTION OF RTK MATERIALS
1.	Surveys
1.	Library
a.	Right to Know/DHSS
2.	Health Fair
(Public Employers)
3.	County Event
(1) Received
4.	Other
(2) Requested
D.	TRAINING/SEMINAR/WORKSHOPS
(3) Distributed
1.	Training
b.	Community Right to Know/
2.	Seminar/Workshop
DEP (Private Employers)
E.	LEPC ACTIVITIES
(1) Received
1.	Meeting
(2) Requested
2.	Drill
(3) Distributed
F.	INSPECTIONS
2.	Hazardous Substance Fact Sheets
1.	Public Employers
a.	Requested
2.	Private Employers
b.	Distributed
G.	RTK PUBLIC RELATIONS
(Incl. copy of Announcement/
B.	OUTREACH TO EMPLOYERS
Notice/Press Release)
1.	Site Visits
1.	Television
a.	Public
2.	Newspaper
b.	Private
3.	Radio
2.	Phone Calls Made
4.	Other
a.	Public
H.	REQUESTS FOR INFORMATION
b.	Private
1.	Letters
2.	Phone Calls
Other Activities (New Employers Found, Meetings, Etc.) ‑ Give Description:

Completed By (Print Name)

Title

Signature	Date

OCC-54

JUL 12	Distribution: Original-NJDOH Copy-DEP Copy-Agency

OCC-54, Quarterly Report of RTK County Lead Agencies

OCC-54, quarterly report, right to know, county lead agencies, RTK, occupational health

EWhite

2002-11-01

NJDOH