20180822_Visitor_Pass_NASCC_Site_Visit_Only.xls
XLS spreadsheet 35 KB Posted
- Attached to
- Wastewater Treatment Plant (WWTP) Repair project, Naval Air Station (NAS) Corpus Christi, TX.
- Solicitation number
- N6945018R0503
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Text version
FRONTPAGE
| NAS CORPUS CHRISTI | |||||
| GUEST SPONSORSHIP REQUEST | |||||
| PLEASE CHECK THE APPROPRIATE BOXES TO INDICATE YOUR AFFILIATION TO THE BASE | ACTIVE | RESERVE | DEPENDENT | RETIRED | CIVILIAN |
| SPONSOR: LAST NAME, FIRST NAME M |
CASTANEDA, MARCO
| TO: SECURITY OFFICER, NASCC | DATES OF EVENT | HOME NUMBER | |||
| TYPE OF FUNCTION: | HOURS OF EVENT | ||||
| CELL NUMBER | |||||
| NUMBER OF GUESTS | 361-438-0607 | ||||
| LOCATION | 17 | ||||
| Buildings 8, 1260 and 1267 | WORK NUMBER: | ||||
| 361-961-5170 | |||||
| NAME | FULL SSN # | DRIVER LICENSE & STATE OF LICENSE | DATE OF BIRTH | HOME/CELL PHONE | |
| 1 | |||||
| 2 | |||||
| 3 | |||||
| 4 | |||||
| 5 | |||||
| 6 | |||||
| 7 | |||||
| 8 | |||||
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| 17 | |||||
| Guest sponsors are responsible for any abuse that may arise from the guest's use of their credentials to access this installation. You should feel confident that a guest will honor and use this privelege in a responsible manner. Please take the time to communicate all of the policies that you observe while on this installation with each guest. Please be advised that your guest sponsorship priveledges can be revoked if a guest is found in violation of base policies or federal statutes. | |||||
| Sponsor's Signature X__________________________________________ | |||||
| SIGNATURE OF APPROVAL: MA1(EXW/SW) John Hoffmann | |||||
| BY DIRECTION OF SECURITY OFFICER | |||||
| X__________________________________________ | DATE: | ||||
| FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE - Any misuse or unauthorized disclosure can result in both civil and criminal penalties. PRIVACY ACT STATEMENT AUTHORITY: Executive Order 10450, 9397; and Public Law 99-474, the Computer Fraud and Abuse Act. PRINCIPAL PURPOSE: To record names, signatures, and Social Security Numbers for the purpose of validating the trustworthiness of |
Individuals requesting access to Department of Defense (DoD) systems and information. NOTE: Records will be maintained in 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.
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