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STATUS:
APPROVED
299A1 - Lawton Chiles ES
General Information
Subcontractor:
H2I Group
Subcontractor Project Manager:
Patricia Hays
Phone #:
904-805-3860
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 | YES | 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:
Patricia Hays
Position:
Sr. Project Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
- Please attach your company’s Safety Plan. You submitted the JHA analysis, which is only part of the company’s risk analysis and does not constitute a Safety Plan.
- Please attach the OSHA 300A for the years 2022, 2023, and 2024.
- Please attach the Basic Safety AHA, which was provided in the form on our website.
- Please provide the OSHA 30 certifications for the supervisors who will be on the project.
- Please provide the OSHA 10 certifications for the workers who will be on the project.
09/05/2025 1:38 PM
- Please attach your company’s Safety Plan. You submitted the JHA analysis, which is only part of the company’s risk analysis and does not constitute a Safety Plan. NOT CORRECTED
- CORRECTED
- Please sign and add competent person (page 14) AHA.
- CORRECTED
- CORRECTED
10/24/25 9:53 AM
- Please attach your company’s Safety Plan. You submitted the JHA analysis, which is only part of the company’s risk analysis and does not constitute a Safety Plan. UNDER REVISION
- CORRECTED
- Please sign and add competent person (page 14) AHA. NOT CORRECTED
- CORRECTED
- CORRECTED
10/29/25 9:59 AM
- Please attach your company’s Safety Plan. You submitted the JHA analysis, which is only part of the company’s risk analysis and does not constitute a Safety Plan. UNDER REVISION
- CORRECTED
- CORRECTED
- CORRECTED
- CORRECTED
11/21/25 11:50 AM
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