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Universal Health & Safety Plan <br /> For use on all high-risk,industrial and HAZWOPER projects <br /> Department of Toxic Substances Control <br /> Soar Environmental Consulting Inc. <br /> Subport Supplier Number:267577 <br /> Scope of Work: High-Risk Tasks performed? Contractor Site Safety Officer&Contacts: <br /> Describe Contractor's Scope of Field Work See SWP Cover Sheet for List of High-Risk Tasks Provide Name and Cell Phone <br /> Phase Is Z Yes(List) 1. Extreme heat 2. Exposure Jon K Sarquis, 559.547.8884 <br /> to vehicular traffic. <br /> ❑ No <br /> Required Subcontractor Documents: <br /> PM must verify that the following documents are in-place for each subcontractor; check to verify. <br /> ❑x Copy of their Project/Site-specific ■ Copy of task specific THAs/JHAs and Z Copy of the signed contract <br /> health and safety plan inspection/tailgate forms <br /> • Copy of their business license and ❑ Copy of their Corporate Safety Z Other Acknowledgement of the <br /> training certificates(task specific) Management Manual cultural sensitivity/resources training <br /> Subport Review: ❑X Approved—Skip to next Subcontractor <br /> ❑ Conditionally Approved- Identify conditions and controls below. <br /> Check'common subport conditions'that apply,add additional conditions,and describe how the conditions will be met <br /> Subport Conditions(check or add any that apply) How will the condition be met? <br /> ❑ AECOM Safety Plan must cover Subcontractor's work, and Subcontractor must <br /> provide a THA for their tasks <br /> ❑ PM must verify that Subcontractor adheres to AECOM safety plan <br /> ❑ Subcontractor variance is required-the form can be found at this link: <br /> https://mvecosystem.aecom.com/ppf/forms/Forms/S3NA 213 FM2 Subcontractor <br /> %20Variance%2OForm.docx <br /> ❑ Supervision required <br /> ❑ Special Conditions apply(related to Demolition, Diving, Underbridge Inspection Unit <br /> work, and Rope Access Work <br /> ❑ Other conditions apply(Identify) <br /> ©AECOM Restricted <br /> Universal Heath and Safety Plan Template(S4(DSC)AM-209-FM-C) 16 <br /> Revision 12 September 9,2021 <br /> PRINTED COPIES ARE UNCONTROLLED.CONTROLLED COPY IS AVAILABLE ON COMPANY INTRANET. <br />