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STATUS:
APPROVED
267F1 - Corrections for Rohde Office Towers Restrooms (Phase 1 of 8)
General Information
Subcontractor:
Kesoki Painting LLC
Subcontractor Project Manager:
Gonzalo Garcia
Phone #:
7863806422
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)?
NO
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:
Helena Arroyave
Position:
Aux. Adm. Estimator
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
- The OSHA 300 logs are not properly completed — they are missing the signature, printed name, phone number, and date.
- Please use the Basic Safety AHA. More specific AHAs will be requested later. You can find the Basic Safety AHA in the form — please download it, review it, complete the required information, and sign it. That is the AHA that must be submitted through the form.
Kindly make these corrections so we can review your form again.
NEW NOTES//////
NEW NOTES:
- Observation #1 has been properly corrected.
- Observation #2 has not been corrected. Please use the Basic Safety AHA Template.
Thank you.
08/18/2025 14:18 PM
MOBILIZATION APPROVED
08/22/2025 11:08 AM
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