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� t <br /> SITE HEALTH AND SAFETY PLAN <br /> Complete all the following information. If providing a different Site Health and Safety plan, the <br /> following information must be included: <br /> GENERAL SITE INFORMATION <br /> NAME: <br /> Guggenheim-Stockton <br /> SITE ADDRESS: <br /> 1423 Bradford Street,Stockton,Califorina <br /> CONTACTPERSON: PHONE#: <br /> Manuel Uribe 510-365-5351 <br /> SITE IDENTIFICATION#: PROPOSED DATE(S)OF SITE WORK: <br /> XXXX <br /> DESCRIPTION OF INSPECTION ACTIVITY <br /> Purpose of Activity Type of Site <br /> D Monitoring well installation D Industrial <br /> D Domestic well installation D Gas Station <br /> D Gas Extraction well installation D Landfill <br /> D Agricultural well installation D Parcel <br /> IR Other. Soil Borings ID Other (.nmmerrial <br /> Provide a brief description of the proposed activities: Vertical Soil Boring Samples <br /> Investigation derived material disposal: E) Soil D Water D Other <br /> Revised 4/3/14 <br />