STATUS:
APPROVED
304E MIC-RE26-CM-MDC Medical Campus
General Information
Subcontractor:
Stucco Drywall Contractors, Inc.
Subcontractor Project Manager:
Bernardo Gomez
Phone #:
7863680456
Email:
SECTION #1: Job-Site Specific Accident Prevention Plan
Please download the documents you wish to review.
Key personnel
Emergency List
OSHA 300
Appointment Letter
Basic Safety AHA:
7.-
Do you plan to perform work at heights greater than 6 feet at any time using ladders, scaffolds, or any aerial work platform (AWP)?
YES
8.-
Do you plan to perform any excavation work at any point during your project?
NO
9.-
10.-
Do you anticipate performing any electrical or demolition work at any stage of your project?
NO
Attach a copy of your Certificate of Insurance (COI):?
SECTION #3: Equipment Certification (If Applicable)
Do you plan to use any of the following equipment during your activities on the project?
Scissor Lift Use? | Boomlift? | Forklift? | Welder? | Heavy Equipment? |
|---|---|---|---|---|
NO | NO | NO | NO | NO |
If you answered “Yes” to any of the previous questions, please attach the certificate(s) of the operator(s) below.
Person Responsible for Submitting the Information:
Name:
Bernardo Gomez
Position:
Vice President
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
1.- The document you submitted is not a Safety Plan. Please provide a proper Safety Plan.
2.- Use the Basic Safety AHA provided in the form.
3.- Include an appropriate Fall Protection Plan that covers responsibilities, types of equipment to be used, rescue procedures, etc.
4.- The OSHA certificate you attached is 20 years old. It is recommended to renew OSHA 30 every 5 years. At this time, this is a NOTE, not an observation.
5.- The OSHA 10 cards submitted cannot be verified. Please send the credentials of the OSHA trainer (OSHA 500 or 502). Send the email to rq@legocc.com.
03/19/2026 2:20 PM
Observations:
1.- CORRECTED
2.- CORRECTED
3.- CORRECTED
4.- NOTED
5.- The OSHA 10 cards submitted cannot be verified. Please send the credentials of the OSHA trainer (OSHA 500 or 502). Send the email to rq@legocc.com.
03/20/2026 11:45 AM
Observations:
1.- CORRECTED
2.- CORRECTED
3.- CORRECTED
4.- NOTED
5.- CORRECTED
03/23/26 11:22 AM