STATUS:
APPROVED
299A1 - Lawton Chiles ES
General Information
Subcontractor:
James Blinds
Subcontractor Project Manager:
Bryce Williams
Phone #:
937-869-8880
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:
Josh Irwin
Position:
Vice President
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
1.- Please submit the Safety Plan; the document you sent is not a Safety Plan.
2.- Please use the Appointment Letter Template; using the same list of key personnel as an appointment letter is not acceptable.
3.- Please use the BASIC SAFETY AHA as indicated in the form.
4.- Please submit the COI that includes General Liability.
08/19/2025 9:08 PM
NEW NOTES////////
- Observation #1 – Corrected.
- Observation #2 – Corrected.
- The AHA submitted was rejected. Please review and use the Basic Safety AHA.
- Observation #4 – Corrected.
08/20/2025 9:32 PM
MOBILIZATION APPROVED
08/20/2025 6:14 PM