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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 /> 20. Personal Acknowledgement <br /> By signing below,the undersigned acknowledges that he/she has reviewed the AECOM Health and Safety Plan for the <br /> Department of Toxic Substances Control <br /> site. The undersigned also acknowledges that he/she has been instructed in the contents of this document and understands the <br /> information pertaining to the specified work and will comply with the provisions contained therein. The employee understands <br /> that they are NOT to perform any work that they have not been adequately trained for and that they are to stop work if it is <br /> unsafe to proceed. Finally,the employee understands to notify the Site Supervisor and the Incident Hotline at 800-348-5046 <br /> for any incident, including ANY injury even if no first aid or medical treatment is required. <br /> &16� Print Name Clearly Signature In Organization Date <br /> 20.1 Disclaimer <br /> This HASP, and each of its provisions, is applicable only to, and for use only by, AECOM, its affiliates, and its subcontractors. <br /> Any use of this Plan by other parties, including, without limitation, third-party contractors on industrial sites or projects where <br /> AECOM is providing engineering, construction management,or similar services, without the express written permission of <br /> AECOM,will be at that party's sole risk, and AECOM Corporation shall have no responsibility. The existence and use of this <br /> Plan by AECOM shall not be deemed an admission or evidence of any acceptance of any safety responsibility by AECOM for <br /> other parties unless such responsibility is expressly assumed in writing by AECOM in a specific project contract. <br /> ©AECOM Restricted <br /> Universal Heath and Safety Plan Template(S4[DSC]AM-209-FM2-C) 70 <br /> Revision 15 October 18,2023 <br /> PRINTED COPIES ARE UNCONTROLLED.CONTROLLED COPY IS AVAILABLE ON COMPANY INTRANET. <br />