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SAFETY COMPLIANCE AGREEMENT, BRIEFING FORM, <br /> AIR MONITORING LOG, AND CALIBRATION CHECK SHEET <br /> FOR GALLI PAD - UNION ISLAND <br /> I have read the Health and Safety Plan for the project and I understand it, and agree to comply with all of its <br /> provisions. I understand that I could be prohibited from working on the project for violating any of the health <br /> and safety requirements specified in the Plan. <br /> Name Signature <br /> D&M Site Manager <br /> D&M Site Safety Officer <br /> D&M Site Personnel <br /> D&M Site Personnel <br /> SAFETY ISSUES <br /> DISCUSSED <br /> Yes No <br /> Protective Clothing/Equipment <br /> Chemical and Physical Hazards <br /> Control Methods <br /> Air Monitoring Action Levels and Requirements <br /> Nearest Phone <br /> Hospital Name/Address/Directions <br /> Meeting conducted by: Date: <br /> Attendees' Names (print) Signatures <br /> DAILY INSTRUMENT CALIBRATION CHECK SHEET <br /> DATE INSTRUMENT BATTERY ZERO CALIBRATION READING CALIBRATED BY <br /> CHECK OK? ADJUST OK? GAS(PPM) (PPM) <br /> FIELD MONITORING ACTIVITY LOG <br /> DATE ACTIVITY MONITORED TIME LOCATION READING ACTION READING BY <br /> GALLI.140 9 <br />