STATUS:
APPROVED
267F1 - Corrections for Rohde Office Towers Restrooms (Phase 1 of 8)
General Information
Subcontractor:
Professional Flooring Contractors
Subcontractor Project Manager:
Frank Ciriago
Phone #:
9544445578
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:
Kearra Millonig
Position:
Admin Asstistant
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Not approved – Please correct the following observations and resubmit:
- Use the BASIC SAFETY AHA template, which can be found in the Mobilization Checklist form. Specific AHAs will be collected at a later stage.
08/05/2025
//////NEW NOTES//////
1. Mobilization cannot be approved at this time because, instead of the Basic Safety AHA, the Mobilization Checklist PDF was submitted again. That document is not the required one. Please read the instructions carefully and make the necessary corrections so I can approve your mobilization.
08/13/2025
Mobilization approved.
08/13/2025 10:54 AM