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11/02 - 11/08/14 - Safety Tailgate - PPE Feedback Final Call <br />Office ,5 &X74�l <br />When you share the responsibility for safety in the workplace, everyone wins. <br />Your signature on this form indicates that: <br />. You have attended and understand the content of the construction safety meeting. <br />• You have taken all daily rest periods since our last safety meeting. <br />• You have not suffered a work-related injury that has not yet been reported. <br />If you do not understand any of the content discussed during the safety meeting, or have not taken a rest break(s), or <br />have an injury that has not been reported, please report it to your supervisor before signing this form <br />Name: (Print) <br />zPySe,n r <br />16iX 4-1 lid <br />iIZ I(!! w f Acv`( <br />��tjt��rU ' 77;zee s <br />arm Chi✓liO _ <br />�� In i ILE-�- <br />{� <br />a e . <br />Signature <br />YEA r <br />