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10 <br /> <br />1.2 ACKNOWLEDGMENT <br />I acknowledge having reviewed this Site-Specific Health & Safety Plan, understand its contents, <br />have been allowed to ask questions and have them answered, and agree to abide by it. <br />Additionally, I am currently in training and medical surveillance requirements specified in 8 CCR <br />§5192, Hazardous Waste Operations and Emergency Response. <br />(Please Print Clearly) <br />NAME / SIGNATURE DATE COMPANY AFFILIATION <br />1. <br />2. <br />3. <br /> <br />4. <br /> <br /> <br /> <br /> <br /> <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />11. <br />12. <br />13. <br />14. <br />15. <br />16. <br />17.