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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2103
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2900 - Site Mitigation Program
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PR0543854
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COMPLIANCE INFO
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Last modified
6/11/2021 4:58:27 PM
Creation date
6/11/2021 3:35:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0543854
PE
2960
FACILITY_ID
FA0024935
FACILITY_NAME
FORMER CHEVRON 94054
STREET_NUMBER
2103
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12308029
CURRENT_STATUS
01
SITE_LOCATION
2103 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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JOB HAZARD ASSESSMENT <br /> 5 Stantec <br />6. REVIEW, APPROVAL AND DISTRIBUTION <br />Employee Review <br />All employees required to perform work on this project will review the Risk Management Strategy and <br />sign below acknowledging that they have been advised of the hazards, controls and PPE required, and <br />have reviewed the applicable SWPs. Employees in field who identify additional hazards not listed above <br />shall notify the project manager of the hazard and confirm the controls that will be used prior to <br />proceeding. Document any on-site changes and communications in the task specific JSA or HASP <br />modification log. <br />Please designate Team Lead for field activities below. <br />Reviewed <br />by: <br />Print Name <br />Print Name <br />Print Name <br />Print Name <br />Sucheon Sung <br />Signature Date <br />Signature Date <br />Signature Date <br />Signature Date <br />Print Name Signature Date <br />(Site Health & Safety Officer) <br />Approvals <br />Prepared <br />by: <br />Approved <br />by: <br /> <br />Print Name <br /> <br />Signature Date <br /> <br />Print Name (Project Manager) Signature Date <br />Distribution: Original: Project File <br />Copies: Field Staff
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