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":zi_. '.�.u�c_iiE:�L '.� '. <br /> % �• __ -- I ,(� lJ <br /> Date 5�_ � � " � "I I rj � 1 � I Cr_�� L=ad I !•i -_ !/�-���9N1'h^' <br /> Lcca�icn � �„ G <br /> � <br /> 3. <br /> Briefed? Briefed 'o� <br /> Flag,ers i�ames (Y�5 or NO) '� <br /> � � <br /> � S '/, � -- i — <br /> , <br /> Flag,er Brietin�: , . <br /> Job Tasks: Flag;er Responsibilities, Ener;enc� Si�nal_, =ia;;e; Rad�o�, 5p�ciric F�rork z�n_� r�a=�rd` <br /> PP�, h�i�n[ Li;htin;, Planned Equipn=r:: 1�0\'2f^c��L, Emer;zrn�y �scape Plar�s. <br /> C. v2hiCfe I�spection Cneck(isc: '" <br /> � Inspeciion Comments <br /> Drv�r's Name Equipnent T oca_ion Compl=ted? <br /> �. U1��bC�l. . G'vGi 1 � > 7 �* � i/-��� � - - <br /> ��. l�f n �-c'l�nJ I � �'i' � C' I �� �� � <br /> C „ � � I /J'•vJ�� I I <br /> �/. c u � z.•a,vf ' ' 0 C1U�� I _ I <br /> I � <br /> I � � I I <br /> I I - <br /> � D. Checklist :�; - Routine Par� 1 <br /> .. , v�s No � ��es ��l� <br /> � �F� 5. In watzr work I ./ <br /> 1. 1'4ke site vi�iLbztore sLrting vrork � . <br /> 2. Detine actitiy, scope, and limits I � ° Stoo work I �� <br /> I 3. Fevie�v Part 1 6M?s � Contact environmental sta�i for I r <br /> r rzview � <br /> • Permit needed � <br /> Evaluate using de[aifed checklist <br /> = Equipment maintenanc= � � � • 1, Z, and/or 3 and routine <br /> ^ Cir�urbed soil checklisC <br /> = VJaste material removed I --- <br /> = Soill kit I I � �. Locztion <br /> = PzR2RM1lPsneeded I / � �U��J � �7r�'/}c2 5�� <br /> = Usecheckli>tA3androutine z �� j�5� —]�'/�V�' S�l�' <br /> checklist 3 <br /> 4. Is environmental s[arf required? r �� <br /> �10 - continue maintenance � � � �� � <br /> YES - contact environmzntzl stzft ior / ,- f i, � <br /> rzview � ��y j <br /> \_(_� <br />