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EMPLOYEE ACCESS TO EXPOSURE AND MEDICAL RECORDS NOTIFICATION FORM
This form is to be read and completed by an employee upon first entering employment with Maviro USA Inc. This form is to become part of an employee’s personnel file.
Maviro USA Inc. (Maviro) collects and maintains records concerning the materials you may be exposed to in the workplace during your employment, and records related to your medical status as required by regulatory requirements or for other legal purposes. These records include air monitoring data, Material Safety Data Sheets (MSDSs), audiometric testing results, physician opinions on your physical ability to wear a respirator, and medical information concerning the severity of any injuries you might sustain during your employment, among others.
Access to these records are limited to health care professionals and those members of Maviro management who have a legitimate business need to access them for purposes such as making job fitness determinations, injury classification decisions, etc.
These records are stored at either the Maviro-contracted occupational health care facility and/or under controlled access conditions at the Maviro Divisional facility and/or Corporate Office. Any such records that are not stored or archived at a health care professional’s facility are under the control of an Maviro Division Management member who is to ensure only those with a legitimate business need to access those records does so.
You have the right to access these records. Contact the HSE representative or Manager at your Division or Region to learn how and when you may have access to your records.
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I hereby acknowledge that an electronic copy of the Maviro Employee Handbook has been made available to me in a location and format which will be accessible to me at any time during the term of my employment with the company. For the purposes of this handbook, “Maviro” or “Company” shall refer to all subsidiaries and/or divisions of Maviro including Maviro, Inc., Maviro Catalyst, Inc. and Amazon Environmental, Inc.
I further acknowledge the handbook describes important information about Maviro, that I have had a full opportunity to review its contents and ask any questions I may have had prior to signing this acknowledgment, and understand that I should consult the Human Resource Department if I have any questions during the term of my employment with the Company.
I have entered into employment with Maviro voluntarily and acknowledge that it is for no specified length of time. Accordingly, either I or the Company may terminate the employment relationship at will, with or without cause, at any time, for any reason or no reason. I understand that neither the Employee Handbook nor any other Maviro policy, practice or procedure is intended to provide any contractual obligations related to continued employment, compensation or employment contract.
Since the information, policies and benefits described in the handbook are necessarily subject to change, I acknowledge that revisions to it may occur, except to Maviro’s policy of employment-at-will. I understand that the Company may change, modify, suspend, interpret or cancel, in whole or part, any of the published or unpublished personnel policies or practices, with or without notice, at its sole discretion, without giving cause or justification to any employee, and such revised information may supersede, modify or eliminate existing policies. The sole authority to add, delete or adopt revisions to the policies in this Handbook shall rest with the Head of Human Resources upon approval by the CEO or CFO. Any written or oral statement by a supervisor or department director contrary to the policies contained in the Handbook are invalid and should not be relied upon by any employee.
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If I believe someone has violated this policy, I shall promptly bring the matter to the immediate attention of:
Maviro Human Resources
CFO (Chief Financial Officer)
(713) 485-5193 ext.106
(763) 283-5291
humanresourceUS@maviro.com
1102 Howard Drive
Deer Park, Texas 77536
If I am a witness to, or become aware of any violations of this policy, I shall immediately bring the matter to the attention of any member of management or the Health, Safety and Environmental team. Additionally, I may share my concerns with:
If I am a witness to any acts, I believe to be actual or potential workplace violence, I shall IMMEDIATELY bring the matter to the attention of any member of management. Additionally, I may share my concerns with:
(713) 485-5193 ext.106;
EEO: EEO
1 Voluntary Self Identification Form
The Equal Employment Opportunity Commission (EEOC) requires organizations with 100 or more employees must invite applicants to self-identify gender, and race and complete an EEO-1 report each year. Completion of this data is voluntary and will not affect your opportunity for employment or terms or conditions of employment. This form will be used for EEO-1 reporting purposes only and will be kept separate from all other personnel records only accessed by Human Resources Department. Please return completed forms to the Payroll Department.