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Q <br /> 11111FEnvironmental Consullanls, 1't:c. <br /> Heattlt & Safety Platt <br /> Page: 9 <br /> - WIM Envirottlttetttal Coltsullants, Inc. <br /> Health and Safety Platt <br /> Acceptance Sheet <br /> This form is to be completed by each person to work on the subject site. Complete and <br /> return to the project's Health and Safety Officer. <br /> Job Number. <br /> Client Project - <br /> Date <br /> I have read and understand the contents of the above indicated Health and Safety Plan <br /> and agree to perform my work in accordance with it. <br /> Signed <br /> Print Name <br /> Company/Office <br /> Date — <br /> waea��rw <br />