Attach 11b_Contractor Installation Access Request_SB Suite Irwin STO.pdf
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DEPARTMENT OF THE ARMY
UNITED STATES ARMY GARRISON
FORT IRWIN, CAS 92310-5000
IMNT-PWE _____ March 2023
MEMORANDUM FOR DIRECTORATE OF EMERGENCY SERVICES
SUBJECT: Fort Irwin Contractor/Commercial Vendor Access Request
1. This office requests that the below named individual(s), employed by __________________ be granted access to Fort Irwin. The purpose for access is for prospective contractors to view sites in the Installation Restoration Program.
PRIVACY ACT STATEMENT
AUTHORITY: HSPD-12
PRINCIPAL PURPOSE: To record names, signatures, and other identifiers for the purpose of validating the trustworthiness of individuals requesting access to NTC & Ft. Irwin, CA. NOTE: Records may be maintained in both electronic and/or paper form.
ROUTINE USES: None.
DISCLOSURE: Disclosure of this information is voluntary; however, failure to provide the requested information may impede, delay or prevent further processing of this request.
NAME DL/ID #, State
* See below for Non- REAL ID Act Compliant
States
Period of Required Access Commencing Ending
Last First MI mm/dd/yyyy mm/dd/yyyy
* REAL ID Act. Unless they bear the imprint `Enhanced Driver's License/Enhanced Identification Card', state issued DLs and ID's from states which are non-REAL ID Act compliant or do not have a current extension must be accompanied by a supplementary identity document for installation access or an escort will be required.
Click here to determine the status of each state/territory. (https://www.dhs.gov/current-status-states-territories) Click here for a list of acceptable supplementary identity documents.
The following are other acceptable forms of ID for visitor installation access: DA Form 1602 (Civilian ID Card and Gold Star Family), a valid US passport or passport card, or a Transportation Worker Identification Credential (TWIC).
Form I-766 with a photograph (Employment Authorization Document) or a valid foreign passport with I-551 stamp or with INS Form I-94 or I94A are also acceptable forms of ID however these visitors require 24/7 escort by their sponsor. DLs/ IDs with the imprint `Not for Federal Identification' ARE NOT acceptable forms of ID and an escort will be required.
2. The POC for this request is David.j.hernandez6.civ@mail.mil or 760-380-3743
David J Hernandez Installation Restoration Program Manager DPW Environmental Division https://www.dhs.gov/current-status-states-territories http://www.irwin.army.mil/Pages/VisitorsTab/Supplementary%20Identity%20Documents.docx mailto:David.j.hernandez6.civ@mail.mil
| David J Hernandez |
| Installation Restoration Program Manager |
| DPW Environmental Division |
File details come from the government source that posted it. Updated .