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Ground Zero Analysis,Inc. <br /> SITE SAFETY PLAN <br /> SIGN-OFF PAGE <br /> I have read the Site Safety Plan and fully understand the hazards associated with the <br /> r Lines 1430 Cherokee Lane Lodi CA <br /> following job: Former Ti e <br /> I will comply with the minimum safety requirements set forth in the Site 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 /> Safety Plan approved by: <br /> John P. Lane, Corporate Safety Officer <br /> PAGE 14 <br />