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7' <br /> r� DAMES & MOORE <br /> PLAN ACCEPTANCE FORM <br /> Instructions: This form is to be compl eted' by each person scheduled <br /> to work on the subject project work site and returned to the Office <br /> Safety- Coordinator who will forward to the WRHSO. <br /> W <br /> Job Name: Chevron Pipeline Co. <br /> Job Number: 06715-008-003 <br /> Location: Tracy, California <br /> f Plan Date: February 10, 1987 <br /> i <br /> I attest that I have read and understand the contents of the above <br /> t� plan and agree to perform my work in accordance with it. <br /> --------------------------------- <br /> Signed <br /> k <br /> - -------------------- <br /> PrintName <br /> C ------ -------------- <br /> <� Camp an y 1 Of i c e <br /> ---------- <br /> --------------------------- <br /> Date <br /> r <br />