Laserfiche WebLink
KXaZan & ASSOCIATES , INC . <br /> SITE DEVELOPMENT ENGINEERS <br /> KRAZAN& ASSOCIATES,INC. <br /> HEALTH& SAFETY PLAN <br /> FIELD PERSONNEL RELEASE FORM <br /> 1, do hereby confirm that I have read and understand the Health&Safety Plan <br /> for Project Number 034-17016, located at 16888 McKinley Avenue,Lathrop,California. I agree to follow <br /> this plan and to make every effort to make the workplace safe. I will report any health or safety hazard that I <br /> observe to the Safety Task Leader, Project Safety Officer, or the Project Director. <br /> I do agree to defend, indemnify, and hold harmless Krazan & Associates, Inc., its owners, employees, <br /> representatives, clients, and the property owner for any accidents, sickness, or injuries resulting from the <br /> violation, alleged violation,or non-compliance of this Health& Safety Plan. <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> Name: Title: <br /> Signature: Date: <br /> 215 W.Dakota Avenue•Clovis,California 93612•(559)348-2200•FAX(559)348-2190 <br /> With Offices Serving the Western United States <br /> 034170/6 SSI Lathrop HASP Final.doc <br />