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4 .4 EMERGENCY CONTACT LIST Key contact personnel : Client: PILOT TRAVEL CENTERS , LLC Jones Covey Group, Inc . Site Project manager: Mike Gathright ( 909 ) 730- 2098 Jones Covey Group, Inc . Site Superintendent : Roberto Plaza ( 909 ) 229 -7433 SECTION 5 . 0 JONES COVEY GROUP, INC . HEALTH AND SAFETY PLAN, FIELD PERSONNEL RELEASE FORM : 5 . 1 1 have read and understand the health and safety plan for Oil Water Separator Replacement at PILOT / FLYING J #618 , 1501 N . Jack Tone Road Ripon, CA 95326 I do agree to follow this plan, make every effort to keep this worksite safe . I will report any health or safety hazards I observe to the site Superintendent. I do agree to defend, indemnify, and hold harmless Jones Covey Group, Inc; its owners, employee, representative, safety dept. clients, and the property owner for any accidents, sickness, or injuries resulting from a violation of the safe work practices included in this book. Name : Title : Signature : Date : Name : Title : Signature : Date : Name : Title : Signature : Date : Name : Title : Signature : Date : Name : Title : Signature : Date : Name : Title : Signature : Date : Name : Title : Signature : Date : 7