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HEALTH AND SAFETY PLAN REVIEW/TAILGATE SAFETY MEETING <br /> X6 <br /> By signing below, I certify that I have reviewed the Site Specific Health and Safety Plan, and that <br /> I agree to abide by all requirements of the Plan, including all PPE requirements. C understand that <br /> if I have any questions I should discuss them with my Supervisor, or contact the Health and Safety <br /> Department. I further understand that I have the "Right to Refuse" unsafe work, subject to the <br /> conditions of the company policy. By signing below, I also hereby certify that I am free of drug <br /> and/or alcohol impairment, have attended the Tailgate Safety Meeting for this specific project, and <br /> in all ways prepared for work. <br /> Print Name Sign Name Date <br /> i <br /> 5 <�:4z C- <br /> CRC Environmental Risk Management, Inc. Project#2100-250-2 <br /> American Savings BHA 222 Noah 6!VonWo Street <br /> ' April 6, 1995 Stockton,catifornia <br />