STATUS:
APPROVED
294B1 - Lakeview ES- Reroofing
General Information
Subcontractor:
COR3 Mechanical
Subcontractor Project Manager:
Kelly Maniar
Phone #:
321-323-4449
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:
kelly maniar
Position:
Owner
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
1.- The Safety Plan you submitted is not adequate. It must include company policies, procedures, specific PPE requirements, reporting systems, etc.
2.- The required OSHA 300A forms are for the last three years: 2024, 2023, and 2022. You only submitted 2022 and 2024. Please provide the one for 2023.
3.- Please complete the Basic Safety AHA properly, including name and signature on page 14.
4.- Please complete the description of the COI properly.
5.- The SDS you submitted is not adequate.
6.- You submitted the OSHA 30 for one supervisor and the OSHA 10 for one worker. Is this the complete personnel that will be assigned to the project?
7.- Please attach the First Aid/CPR certificate.
09/02/2025 10:42 AM
NEW NOTES//////
1.- CORRECTED
2.- CORRECTED
3.- CORRECTED
4.- CORRECTED
5.- CORRECTED
6.- Send a List of the workers to rq@legocc.com
7.- CORRECTED
09/03/2025 9:13 AM