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r INSTRUCTION SHEET FOR COMPLETION OF SITE SAFETY PLAN Section of SSP Location/ Action Page Cover Sheet cover D Substitute the client site name, address, date, month where indicated by bracket Site Emer-ency Form i 0 Complete each blank line of this form Hospital Location Map u 0 Attach photocopy of the reap showing the location of the closest hospital D Indicate with a colored marker the most direct route to the hospital D Give detailed driving directions from the site location to the designated hospital 0 Complete Hospital Information box Site Location Map ni D Attach photocopy of site plan with overhead and underground utilities marked D Mark locations of site phone, emergency shutoff switches, and fire extinguishers Introduction D Substitute site specific information in the bracket of the first sentence . Appendix A-1 Appendix D Any changes in project work scope and/or Amendment Sheet A-1 site conditions must be written on this form Appendix A-2 Appendix 0 This sheet must be signed by all Applied Agreement&Acknowledgement A-2 Earth Sciences, Inc personnel who work on site Appendix A-3 Appendix 0 All visitors to the site must read and sign Trainee/Observer Agreement A-3 this form Appendix A-4 Appendix 0 Complete this form (handwritten is okay) to Injury/Exposure Re ort A-4 re ort any incidents related to prpject work Appendix B-2 Appendix 0 Attach a photocopy of appropriate MSDSs MSDSs B-2 for materials present on the site Appendix B-3 Appendix 0 Record results of site air monitoring each Vapor Monitoring Forza B-3 time testing is performed Appendix C-l Appendix 0 Identify equipment and operations where Lockout/ragout Form C-1 lockout/tagout must be performed 0 List on the form the identified equipment and all procedures for lockout/tagout