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nip" <br /> ,� <br /> r <br /> s x <br /> t?J <br /> V• <br /> DAMES 6 MOORE <br /> t <br /> "q PLAN ACCEPTANCE POrM <br /> ' Instructions; This fora is to b, completed by each person sche- <br /> duled to work on the subject project work site and ret-irned to the <br /> office Safety Coordinator who Will Eorward to the 'r7RF. <br /> E� <br /> Job Name: <br /> t <br /> r• [r Job Number: <br /> Location: <br /> f Plan Note: <br /> Ea <br /> - F attest that T have read and understand the contents of the above <br /> pian and agree to perform my work in accordance with it. <br /> E4 <br /> � 4 <br /> Sign d <br /> E� <br /> Print Name <br /> Company/office <br /> s ' <br /> Date } <br /> R� <br /> f <br /> r <br /> Y <br /> r� <br />