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GEOMATRIX <br /> PROJECT HEALTH AND SAFETY FIELD MEETING FORM <br /> Date: Time: Project No. <br /> F Project Name: <br /> Location: <br /> Meeting Conducted By: <br /> Topics Discussed: <br /> Physical Hazards: <br /> Chemical Hazards: <br /> State of California Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65) <br /> information for the site: (Applicable warning is checked) <br /> J <br /> WARNING: This area contains a chemical known to the State of California to cause <br /> cancer. <br /> 1 ✓ WARNING: This area contains a chemical known to the State of California to cause <br /> birth defects.or other reproductive harm. <br /> Personal Protection: <br /> Decontamination: <br /> Special Site Considerations: <br /> Emergency Information: <br /> Hospital Location: <br /> ATTENDEES <br /> L' Name/Company(printed) Signature <br /> I <br /> I . <br /> E <br /> Meeting conducted by: <br /> Signature <br /> IAPR01ECn6508.0001document16508-04.doc 16 <br />