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a <br /> • ATTACHMENT 1 <br /> HEALTH &SAFETY APPROVAL FORM <br /> WORK ASSIGNMENT. GROUNDWATER MONITORING WELL INSTALLATION <br /> U-HAUL FACILITY#709-50 <br /> 2701 North Wilson Way <br /> Stockton, California <br /> I have read understand, and agreed with the information set forth in this Health and Safety Plan and will follow the <br /> direction of the Site Health&Safety Officer(SHSO) <br /> Field Team Member Name Signature Company Date <br /> Approvals <br /> Site Health&Safety Officer(SHSOCompany Date <br /> Field Team Leader <br /> Health&Safety Program Coordinator <br /> • <br />