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I' i9 I <br /> a <br /> Attachment 3 <br /> SUBCONTRACTOR TRAINING AND MEDICAL SURVEILLANCE RECORD <br /> Iz <br /> Subcontractor: <br /> Address: <br /> Employees Assigned to Project: <br /> ij •i <br /> i <br /> I <br /> li p I <br /> i <br /> js <br /> I certify the above employees assigned to this project have received training and medical surveillance <br /> according to the Health and Safety Plan and the Occupational Safety and Health Administration Standard <br /> on Hazardous Waste Operations and Emergency Response(29 CFR 1910.120): <br /> f <br /> Name(printed): <br /> *Signature: <br /> Title: <br /> Date: d <br /> a <br /> *Subcontractor Field Supervisor or Manager only. <br /> a <br /> d <br /> 1 <br /> SECOR International Incorporated - 18 - HASRdrilGng <br /> I <br /> f <br />