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r <br /> TAIT ENVIRONMENTAL MANAGEMENT, INC. <br /> SAFETY COMPLIANCE AGREEMENT <br /> I have reviewed the plan,understand it, and agree to comply with all of the health and safety <br /> requirements I understand that I may be prolubited from working on the project for violating <br /> any of the requirements Visitors will be required to be escorted in the restricted access zone <br /> Visitors must comply with Tait Environmental Management, Inc escort directions while on site <br /> at all times Non-compliance with escort directions will not be tolerated, and violators will be <br /> requested to leave the site immediately <br />' d <br /> I have been approved to wear a respirator by a physician base on medical examination I have <br /> been trained in the appropnate use, care, and storage of respiratory equipment I have been <br /> respirator fit tested, and I have my respirator available for use in the field I understand that I am <br /> to use the equipment supplied to me by my employer I further understand that this equipment is <br /> provided solely for my benefit with the intent to minimize my exposure to potentially hazardous <br /> conditions In the event of such usage, I agree to indemnify and hold harmless Tait <br /> Environmental Management, Inc and all of its employees from and against any and all losses, <br /> demands, claims, liabilities, lawsuits, damages, costs, and expenses arising, in any way, from the <br /> use of the equipment <br /> Thank you for your cooperation <br /> I <br /> Name Company Date Signature <br /> 1 <br /> 5t0+1 4, To-,4 —3/17/11 <br /> 'IfiCk S7chc"Ie' �V#4/ 1 -r7—f9— 0, e, r/7T <br />