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3500 - Local Oversight Program
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PR0545688
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Last modified
5/21/2020 11:31:03 AM
Creation date
5/21/2020 9:43:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
WORK PLANS
RECORD_ID
PR0545688
PE
3528
FACILITY_ID
FA0003634
FACILITY_NAME
CANTEEN CORPORATION
STREET_NUMBER
1500
Direction
N
STREET_NAME
SHAW
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14326008
CURRENT_STATUS
02
SITE_LOCATION
1500 N SHAW RD
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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i <br /> TRAINEE/OBSERVER AGREEMENT FORM <br /> Applied Earth Sciences is committed'to providing a safe working environment for all employees. In addition, <br /> AES will comply with OSHA requirements for employee safety training prior to working on any hazardous <br /> site. <br /> The follQwing section is IQ br,filled <br /> . r <br /> Agreement between: <br /> Name: S.SJ and Applied Earth Sciences, Inc. <br /> Because we have your safety in mind, you will be considered a trainee/observer until all training criteria are <br /> met. This means you must complete all training requirements prior to performing work activities on site. As <br /> a requirement of the training program,you will be asked to visit sites as an observer. You must be supervised <br /> on all of these site visits. <br /> As an on-site traineelobserver, your signature below indicates your agreement to these restrictions. <br /> You may not: <br /> 1. Perform work functions of any type. <br /> 2. Handle any equipment/tools and/or supplies of any type. <br /> I agree to adhere to the above conditions in all instances while on site as a trainee/observer. <br /> Signature Date <br /> ------------------------ — ---------------------------------__ <br /> Thi i n ------ <br /> ' fill i r <br /> As supervisor/escort to the above trainee/observer, I agree to the above restrictions and agree not to request <br /> him/her to perform activities contrary to those restrictions. <br /> Signature Date <br /> f <br /> 9, <br />
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