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U-Haul <br /> Facility Number TCQ-:1-3 <br /> HEALTH AND SAFETY PLAN <br /> Page 21 <br /> SECTION 8.0 <br /> H.D. COVEY,INC. <br /> HEALTH AND SAFETY PLAN <br /> FIELD PERSONNEL RELEASE FORM <br /> I , do hereby confirm that I have read <br /> and understand the Health and Safety Plan for Project No. 97-086T U-Haul Facility Number <br /> M-23, located at 1-70 P TOW' 'Irl'" SE"`k ., California. <br /> I do agree to follow this plan, and to make every effort to make the workplace safe. I will <br /> report any health or safety hazard that I observe to the Senior Safety Officer, Site Safety Officer, <br /> or Project Supervisor. <br /> I do agree to defend, indemnify, and hold harmless H.B. Covey, Inc., its owners, <br /> employees, representatives, clients, and the property owner for any accidents, sickness, or <br /> injuries resulting from the violation, alleged violation, or non-compliance of this Health and <br /> Safety Plan. <br /> Name: Title <br /> Signature: Date: <br /> Name: Title <br /> Signature: Date: <br /> Name: Title <br /> Signature: Date: <br /> Name: Title <br /> Signature: Date: <br />