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Data Center Physical Access Request Form
Process Number : FBP-03-003
Effective Date : 8/7/2012
Approved By : A. Michael Berman
The Division of Technology and Communication maintains information assets on behalf of CSU
Channel Islands in access-controlled areas. Physical access to these secured areas is restricted to a
defined set of University employees who are responsible for the operation
of
computing, network, and
telecommunication resources, and have a business need for regular access to these facilities.
Guests who require access to these areas to carry out legitimate business functions may be escorted by
sanctioned T&C staff into these areas. Escorts must be present at all times if security cages are
unlocked or guest requires access into the caged areas.
Prior to accessing a secured area, each requestor must complete, sign and date
the
following
statement:
I understand that my access to T&C information assets is approved solely
for
performance of
my assigned duties as an employee of the University or as contracted
by
the
University,
and
not for any other reason.
I will take appropriate measures to preserve the security of the designated area that I am
authorized to enter
and
the equipment
therein.
I agree that I am responsible for all activities that I carry out during my access period.
I certify that I have read, in its entirety, the Business Practice that pertains to Physical Access to
T&C Facilities, BP-03-003, and do hereby declare that I will abide by those guidelines to the
best of my ability.
I will not allow any unauthorized persons to enter the data center while performing my
functions there.
I certify that I have completed all the necessary training including the fire safety training
administered by Operations Planning and Construction and have received a general overview
on the safety features of the Ojai Hall Data Center.
I understand that lack of compliance with this policy can result in disciplinary action, in
accord with CI human resource policies and collective bargaining agreements.
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Data Center Physical Access Request Form
Process Number : FBP-03-003
Effective Date : 8/7/2012
Approved By : A. Michael Berman
Business Justification
Please indicate what specific areas you require access to:
Data Center (OH1924)
Telecom Closets Only
DC Co-Location Only (OH1915)
All Area Access
Please list each building and room number (SOL 2161, BT 1521, etc.) you require access to:
Requestor:
Print Name:
Signed:
Dept./Div:
Dept./Div:
Date:
Approving Authority (VP, T&C or Infrastructure Manager)
Signed:
Date: