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RE PERSONNEL AND CERTIFICATION ISTUS Subcontractor's Health and Safety Program Evaluation Name of Subcontraetor: Address: Activities to Be Conducted by Subcontractor: Evaluation Criteria Medial pogmm meet;OSHA/WESTON criteria Personal protective eeuipnent ewtiWA O.ft.monkorinp aeuiprrent eveilabb,calibrrted and operated Propedy ❑ Acceptable ❑ Acceptabb ❑ Acceptebb ❑ Uivcceptalis ❑ UneccepabM ❑ Urucceptabb Cormnnte: Garment;: C.M.- Safe worldw procedure dead,.p if Tannin,meet.OSHAIWESTON criteria Errrrgency pr000du. ❑ Accwiibb ❑ Acceptable ❑ Acceptabb ❑ Unacceptable ❑ UraeeesPtabb ❑ Unacceptable Comment.: Cormiem.: Conm,,M. Decontamiruuwn Pmcadura Gerroal hath and vM ty Pro,mm.vMuation Additional torment.: ❑Accepable ❑Aceeptabb ❑Subcontractor fee.,reed to seal will contorm ❑ with the WESTON HASP for thio Pm*l. Ureccepabb ❑ Unaccepabb Comments: Comriente: ❑Subcontractor will work under his own HASP which hae been accepted by Corporate Heakh arW Safety. Evaluation Conducted by: Date: Subcontractor Name: Name: Title: Title: Task(s): Task(a): Certification Level or Description: Certification Level or Description: ❑ Medical Currant ❑ Training Current ❑ Medial Current ❑ Training Curant ❑ Fa Teri Currant(Qual.) ❑ Fit Tent Cueent(Quart.) ❑ Fit Test Current(Owl.) ❑ Fit Test Current(Quant.) Name: Name: Title: Tide: Tack(e): Tack(e): Certification Level or Description: Certification Level er Description: ❑ Madioel Current ❑ Training Current ❑ Medical Cunem ❑ Tamirg Current ❑ Fit Tait Current IQual.) ❑ Fit Tat Current(Quant.) ❑ Fit Test C..nt(Qwl.l ❑ Fit Test Current(Quern.) Name: Name: Title: Title: Task(a): Tack(e): Certification Level or Description: Certification Level or Description: ❑ Medical Current ❑ TainiN Current ❑ Medical Currant ❑ Trainiw Current ❑ Fit Tart Camra(Qual.) ❑ Fit Teat Current(Quare.) ❑ Fill Tat Current(Qual.) ❑ Fit Tern Cuwnt(Quant.) Corporate Health and Safety Page 24 of 36