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ATCAssociates SITE SAFETY PLAN <br /> SIGN-OFF PAGE <br /> I have read the Site Safety Plan and fully understand the hazards associated with the <br /> following job: Smiths Canal Pumping Station <br /> I will comply with the minimum safety requirements set forth in the Site Safety Plan. I agree <br /> to notify the responsible employee of ATC should any unsafe acts be witnessed by me while I <br /> am on this site. <br /> PRINT,NAMESIGNATUf2E DATE <br /> e <br /> i <br /> Safety Plan approved by: <br /> Jeanne Homsey,Project Manager Tom Lutterman, Site Safety Officer <br /> PAGE 15 <br />