COMPLIANCE INFO_1985-1996 - Laserfiche WebLink

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a f s q �• a.v •� __,R R• .�, •e:! �t rt° i • _M " PB Application an J'ab K icztian Farm M4 -,Cameactlen Isisislitles Trenches E=vsdens Buildings Straftres Feftwmt Salfeldlnq -� —. ....�.. _-ata-. A'x••. ...- Stitt of California _� ,_ . .–_ �.. _ �___ - _ ----•- -, , .;- ..,-� ' Department of industrial Ddsilt _ District (Rome} Data Division of O=pational Safety Sections 6500.6501 and 6502 of the California Labor Code require that certain supply and MatthoOlvision review. information necessary to evaluate the safety at activities which by their nature invot" substantial risk of injury may not be the worksite subject to permit requirements. Apermit will not toissued until evidence perform adwithoutanorm itissuadby00S7LThe Labor Code requires Mat meapplicant has been demonstrated that the place of employment will be safe and healthful. 'Applicant" refers to me employer applying for the Permit Employ, Post–Pisani Construction Address: 3633 Seaport Blvd. W,pst SacraL•tento A. 95691 Ptftc ___�. 1_ 6 3 7 2 – 7 4 4 9 _ Steve Pisani Project Safety Camact Employers it Iva .0 K a r l e= L. _L i t Meaphorw11e safety .Coordinator -T44 Eaployers Stan Carnritcau's Uctim Nt 919 51 Check Appltabie ibmtt "Applica * refers to the employer applying for the Permit Applicant is: General Contractor Option . General Building Contra=r Initial this blank If applicant elects to assume responsibility forobtaining a __X_ General Engineering Contractor single permit to cover one multi-employer project e.g., a high-rise Specialty Contractor construction projecL The duties of employers at the site to obey safety and Specialty Contractor Type health taws are not changed by this election. A list of employers on site will 5)'The applicant understands that failure to comply with any of the above listed 1 be attached by the Oivision to this application and the list will be updated Other as necessary. Type Of Permit Soughs: i advance Of start-up date. A phone all marbe used to main Madeadline out will not Annuli Multiple Project (If projects to be covered are similar in all important _Single Proisa aspects: work is performed by the same employer and intormtion concerning � Jae Scut Moullution Only each project covered is provided.) For which meet Me requnreasou at 3 California Administrative Cade.®, Section 1504. ® at: s ®uiidiy _. Structure t 3) The Division will be notified of signiftastdianges in information provided with this ® Manottfr it — Building ._ Structure Jt application It such changes might of ed safety of thin activity. :.- Y_ Trencn and/or Sravanon .._. _ Tower Crane Erection. Dismandirig »• +r •ea¢+n �yas•ar,+.r..' � . i•+►_ e..�• - mow•-+ran�.ws� �.•�+qa• � -•..ere+ ... J � ¢ e S+. �""awj y. v..u.y.� ..•a .e+�- �.L ••f"S..kY %mss' •. ..+:,y a}�°''Y ® Saffaiding anal at Falsewor t and/or yerticM Shoring Any permit based on this application is issued with the understanding that the 4) The appticantunderstands that under the permit program. OOSH schedules routine applicant has knowledge of occupational safety and health orders applicants to the inspections by authorized personnel for Me purpose of verrtymg Mat holders of projects) described In this application and attacnmems. and that the applicant and permits are meeting their ontigahon to provide a sate work plus for their supervising personnel will take special care us insure compliance with safety orders ------ employees. The Division reserves the ngnt to revoke a permit it it is unable to reviewed with Me applicant sty the Oivisiosathe application process.. _ .. prompts! verity compliance with the tams and carmttiont at Me permit and its e issuance of the permit is also conditioned upma the following Issuance. 1) upon initiation of any new project not do=bed in this application, the holder of an 5)'The applicant understands that failure to comply with any of the above listed 1 annual permit will provide the Division vklt a completed Project 0estxiption Form ', , ccndltess for obtaining a permit could result in denial. suspension or revocation of •tea 1 describing the new protea prior to the stat tot work, preferably at least one week in the Permit *Employers may appeal mese actions to the Director of the Department of i advance Of start-up date. A phone all marbe used to main Madeadline out will not Industrial izbons (Coliform labor Code. Section 6500 et seq., and a California . be considered valid notice unless followadiswriti writing �-�._ Administrative Code. Section 341). Description Form Is the applicant conducting tiny activities to be covered by this permit application in � Z The applicant has implemented a writes accident prevention program and Cade of Sate Practices partnership or joint venture with any other persons or corporation conducting -- mines requiring permits? Yes . No _JL 14 W Qnre d ' which meet Me requnreasou at 3 California Administrative Cade.®, Section 1504. t 3) The Division will be notified of signiftastdianges in information provided with this Have airy permits for any project to be covered by this permit application previously p applied 4er or obtanned9 Tet ® No It yes., man ®s,.: from what Jt application It such changes might of ed safety of thin activity. :.- district office in whose name 4 _ »• +r •ea¢+n �yas•ar,+.r..' � . i•+►_ e..�• - mow•-+ran�.ws� �.•�+qa• � -•..ere+ ... J � ¢ e S+. �""awj y. v..u.y.� ..•a .e+�- �.L ••f"S..kY %mss' •. ..+:,y a}�°''Y Faint CaUOSHA S-81