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Smith Environmental <br />SIGN -OFF PAGE <br />SITE SAFETY PLAN <br />I have read the Site Safety Plan and fully understand the hazards associated with the following <br />job: Gardner Property <br />I will comply with the minimum safety requirements set forth in the Site Safety Plan. I agree to <br />notify the responsible employee of Smith Environmental should any unsafe acts be witnessed by <br />me while I am on this site. <br />PRINT NAME SIGNATURE DATE <br />Safety Plan approved by: <br />Tom J. Lutterman, Project Manager <br />PAGE, 14 <br />Site Safety Officer <br />