Mask Distribution

N95 Respirator Request Form
In response to the new Emergency Temporary Standards (ETS), the Simi Valley Chamber has partnered with the State of California as a distribution center to provide a one-month supply of N95 respirators to businesses for unvaccinated employees.

The Background

On June 17, the Occupational Health and Safety Board approved amendments to the Emergency Temporary Standards (ETS) for COVID-19 prevention. The new language states:

Upon request, employers shall provide respirators for voluntary use in compliance with subsection 5144(c)(2) to all employees who are not fully vaccinated and who are working indoors or in vehicles with more than one person.
Name *

First Name Last Name
Company
E-mail *
Phone Number

Area Code Phone Number
# of Unvaccinated Employees *
# of Masks Requested *
Comments
Should be Empty: