Laserfiche WebLink
1 • • <br />' SSB ENVIRONMENTAL CONSULTANTS, INC <br /> HEALTH AND SAFETY PLAN <br /> FIELD PERSONNEL RELEASE FORM <br /> do hereby confirm that I have read and understand <br /> the health and safety plan for Project No SSB 92-1001-01, Beacon Cardlock Station Number 610 located <br />' at 3300 Waterloo Road in Stockton, California I do agree to follow this plan and to make every effort <br /> to make the work place safe I will report any health or safety hazard that I observe to the Safety Task <br /> Leader, Project Safety Officer, or the Project Director. <br /> I do agree to defend, indemnify, and hold harmless SSB Environmental Consultants, Inc, its <br /> owners, employees, representatives, clients, and the property owner for any accidents, sickness, or <br /> injuries resulting from the violation, alleged violation, or non-compliance of this health and safety plan <br /> Name- Title <br /> Signature Date. <br /> Name Title- <br /> Signature Date- <br /> Name Title. <br /> Signature- Date- <br /> Name Title <br /> Signature Date <br />