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Ground Zero Analysis,.Inc. } <br /> SITE SAFETY PLAN <br /> SIGN-OFF PAGE <br /> I have read the Site Safety Plan and fully understand the hazards associated with the <br /> following job: 641 W.-Lockeford St. Lodi- CA <br /> 5 <br /> I will comply with the minimum safety requirements set:forth in the Site Safety Plan. I <br /> agree to notify the responsible employee of GZA should any unsafe acts be witnessed by me <br /> while I am on this site. <br /> PRINT NAME SIGNATURE DATE <br /> . - 1 <br /> a <br /> 4 <br /> Safety Plan approved by: <br /> John Lane, Corporate Safety Officer <br /> ' r <br /> PAGE 12 <br />