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Ground Zero Analysis, Inc. <br /> HEALTH AND SAFETY PLAN <br /> SIGN-OFF PAGE <br /> I have read the Health and Safety Plan and fully understand the hazards associated with the <br /> following job: Olivarez Property #1086 <br /> I will comply with the minimum safety requirements set forth in the Health and Safety Plan. I <br /> agree to notify the responsible employee of GZA should any unsafe acts be witnessed by me <br /> while I am on this site. <br /> PRINT NAME SIGNATURE DATE <br /> PAGE 11 <br />