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/. tubcontracter-s Mealth and Sa4ety Program Evacuation <br /> Mame and address of subcontractor: r7� c i{ �E=�v <br /> Activities to be conducted by subcontractor: I'Q A-,AVTJA <br /> EVALUATION CRITERIA <br /> Item Acceptable Unacceptable Comments <br /> Medical Program meets OSHA/WESTOM Criteria (✓) ( ) <br /> Personal Protective Equipment Available. <br /> a. meets OSHA criteria, (kA ( ) <br /> b. is as specified in WIHASP ( ) ( ) <br /> on-Site Monitoring Equipment Available, <br /> Calibrated and Operated Properly W) ( ) <br /> Safe Working Procedures Clearly Specified (A�) ( ) <br /> Training meets OSHA/WESTOM Criteria (✓) ( ) <br /> Emergency Procedures ( y) ( ) <br /> Decontamination Procedures I.,) ( ) <br /> General Health and Safety Program Evaluation (✓) ( > <br /> Additional Comments: <br /> Evaluation conducted by: �- STfJA-T, +L° Date: 104 <br /> C. <br /> C. Subcontractor <br /> Medical Fit Test Training Certificat, <br /> Mame Title Tasks) Current Current Current ltvel or <br /> Dust. quant. ) I Description <br /> a I b b I c. <br /> I I <br /> t I I c ) c ) c ) ( ) c ) <br /> I I <br /> a I I c ) c ) c ) c ) c <br /> I I <br /> I I <br /> c I I c ) c ) c ) c ) ( <br /> I I <br /> I I <br /> r I <br />