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ATTACHMENT 1 <br /> HE-kLTH & SAFETY -kPPROV AL FORM <br /> WORK ASSIGiNMENT <br /> WELL INSTALLATION <br /> U-Haul Facility 9709-50 <br /> 2701. North Wilson Way, Stockton, CA <br /> 1 hai,e i ead under stand, and aga eed tiwli the infoi nxitiou set forth in this Health and Safety+Plan and ik all follow the <br /> du ection of the Site Health &Safe) Officer (SHSO) <br /> Field Team Member Name Signature Company Date <br /> a <br /> !V l <br /> C1 <br /> Approvals <br /> Site Health&Safety Officer SHSO Company <br /> Blaes Environmental <br /> Field Team Leader <br /> Blaes Environmental <br /> Health&Safe Program Coordinator <br /> Daniel Blaes Blaes Environmental <br />