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SMTH 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: <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 SMTH should any unsafe acts be witnessed by <br /> ' me while I am on this site. <br /> PRINT NAME SIGNATURE DATE <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> ' Safety Plan approved by: <br /> ' Tom J. Lutterman, Site Safety Officer John P. Lane, Project Manager <br /> PAGE 12 <br />