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SIGN-OFF PAGE <br /> I have read the Site Safety Plan and fully understand the hazards associated with the <br /> following job: <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 Mill Creek Associates should any unsafe acts <br /> be witnessed by me while I am on this site. <br /> PRINT NAME SIGNATURE DATE <br /> Safety Plan approved by: <br /> Site Safety Officer Project Manager <br /> Additional Page for Chemical or Physical Hazards <br /> Chemical Hazards <br /> PAGE 9 <br />