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Attachment C <br />Field Checklist for Implementation <br />Fill in blanks and circle yes or no as appropriate for each. If an item does not apply, write N/A after <br />question. <br />Site Safety Officer Date <br />Project Location <br />(City) (State) <br />Job No. Weather Conditions <br />1. Is a copy of the site safety and health plan (SSHP) on site? <br />2. Is the personal protective equipment required by the SSHP available <br />and being used correctly? <br />3. Have the work zones been delineated? <br />4. Has a decontamination station been set up as required by the SSHP? <br />5. Are the decontamination procedures being followed? <br />6. Is access to the exclusion zone being controlled? <br />7. Has the site activities' briefing and tailgate safety meeting been <br />provided? <br />8. Is the list of emergency telephone numbers posted at the support zone? <br />9. Are the directions to the nearest emergency medical assistance posted <br />at the support zone? <br />10. Is emergency equipment, as identified in the SSHP, readily available <br />and functional? <br />11. Has the nearest toilet facility been ideentified or a portable facility <br />been set up? <br />YES NO <br />YES <br />NO <br />-YES <br />NO <br />YES <br />NO <br />YES <br />NO <br />YES <br />NO <br />YES NO <br />YES NO <br />YES NO <br />YES NO <br />YES NO <br />