Laserfiche WebLink
�r ...fir-- ... <br /> Sm <br /> `` 'y�. =�tt;r>.. � '�W`-_ '�"� 'x`.:n �a+i �• �3ew�.`.�' <br /> F c �arih. ,tet °�zv"i :i ';k' y.sf"'-"", •. '9'OL - N• r•; T <br /> uGA <br /> x <br /> APPENDIX A <br /> CERTIFICATION AND ACKNOWLEDGMENT STATEMENT <br /> SAFETY PLAN CERTIFICATION <br /> All Texaco authorized project personnel and subcontractor <br /> personnel are required to make the following certification prior <br /> a� <br /> to conducting work at the Texaco Service Station, located at 440 <br /> West Charter Way, Stockton, California. <br /> I, .[' � �► ric , of <br /> i-r <br /> NAME <br /> r Ire, certify that: <br /> COMPANY <br /> 1. I have read and fully understand the Health and Safety Plan <br /> and my individual responsibilities. <br /> 2. I agree to abide by the provisions of the Health and Safety <br /> Plan. <br /> SIGNATURE <br /> DATE <br /> Asn <br />