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ATTACHMENT C <br /> MEDICAL EMERGENCY CONTACT SHEET AND <br /> SAFETY PLAN COMPLIANCE AGREEMENT FOR <br /> GROUNDWATER WELL INSTALLATION <br /> AMERICAN FOREST PRODUCTS <br /> STOCKTON, CALIFORNIA <br /> II, have received a copy of the Health and <br /> Safety PIan for this Project I have reviewed the plan, understand it, and agree to comply <br /> with all of its provisions I understand that I could be prohibited from working on the <br /> project for violating any of the health and safety requirements specified in the plan <br /> SIGNED <br /> Signature Date <br /> Firm Dames & Moore <br /> This brief Medical Emergency Contact Sheet will be kept in the Support Zone during site <br /> operations It is in no way a substitute for the Medical Surveillance Program requirements <br /> of the Dames & Moore Health and Safety Program This data sheet will accompany <br /> injured personnel when medical assistance or transport to hospital facilities is necessary <br /> Emergency Contact Phone# <br /> Relationship <br /> Do you wear contact lenses? <br /> AMFOREST 2 17 <br />