Form CEM-0602 "Project Safety Program Statement" - California

What Is Form CEM-0602?

This is a legal form that was released by the California Department of Transportation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2001;
  • The latest edition provided by the California Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CEM-0602 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

ADVERTISEMENT
ADVERTISEMENT

Download Form CEM-0602 "Project Safety Program Statement" - California

Download PDF

Fill PDF online

Rate (4.3 / 5) 7 votes
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
FIELD OFFICE OR JOB STAMP
PROJECT SAFETY PROGRAM STATEMENT
CEM-0602 (REV 4/2001)
1. CODE OF SAFE PRACTICES (Mark the sections of the C.O.S.P. which apply to this project)
GENERAL SAFETY
TRAFFIC CONTROL SYSTEMS
OTHER SPECIAL CONSIDERATIONS
EQUIPMENT
EXCAVATIONS
ELECTRICAL
ELEVATED WORK AREAS
NIGHT WORK
FIELD TESTING
HAZARDOUS MATERIALS
FACILITIES
CONFINED / ENCLOSED SPACE
VEHICLE OPERATIONS
PROJECT SPECIFIC REQUIREMENTS
MATERIAL PLANT SITES
2. PLANNED, PERIODIC INSPECTIONS (Planned, periodic safety inspections will be conducted as follows)
STAGE
INTERVAL
STAGE
INTERVAL
WORK DAYS
WORK DAYS
WORK DAYS
WORK DAYS
3. PROJECT SAFETY COORDINATOR IS:
4. PROGRAM AGREEMENT
RESIDENT ENGINEER'S SIGNATURE
DATE
CONSTRUCTION ENGINEER'S SIGNATURE
DATE
CONSTRUCTION SAFETY COORDINATOR'S SIGNATURE
DATE
5. EMPLOYEE'S ACKNOWLEDGMENT - (Each employee shall acknowledge reading the C.O.S.P. by their signature)
I HAVE READ THE APPLICABLE CODE OF SAFE PRACTICES
SIGNATURE
DATE
SIGNATURE
DATE
FM 91 1329
USE AN ATTACHED SHEET FOR ADDITIONAL SIGNATURES
For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916)
ADA Notice
654-3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
FIELD OFFICE OR JOB STAMP
PROJECT SAFETY PROGRAM STATEMENT
CEM-0602 (REV 4/2001)
1. CODE OF SAFE PRACTICES (Mark the sections of the C.O.S.P. which apply to this project)
GENERAL SAFETY
TRAFFIC CONTROL SYSTEMS
OTHER SPECIAL CONSIDERATIONS
EQUIPMENT
EXCAVATIONS
ELECTRICAL
ELEVATED WORK AREAS
NIGHT WORK
FIELD TESTING
HAZARDOUS MATERIALS
FACILITIES
CONFINED / ENCLOSED SPACE
VEHICLE OPERATIONS
PROJECT SPECIFIC REQUIREMENTS
MATERIAL PLANT SITES
2. PLANNED, PERIODIC INSPECTIONS (Planned, periodic safety inspections will be conducted as follows)
STAGE
INTERVAL
STAGE
INTERVAL
WORK DAYS
WORK DAYS
WORK DAYS
WORK DAYS
3. PROJECT SAFETY COORDINATOR IS:
4. PROGRAM AGREEMENT
RESIDENT ENGINEER'S SIGNATURE
DATE
CONSTRUCTION ENGINEER'S SIGNATURE
DATE
CONSTRUCTION SAFETY COORDINATOR'S SIGNATURE
DATE
5. EMPLOYEE'S ACKNOWLEDGMENT - (Each employee shall acknowledge reading the C.O.S.P. by their signature)
I HAVE READ THE APPLICABLE CODE OF SAFE PRACTICES
SIGNATURE
DATE
SIGNATURE
DATE
FM 91 1329
USE AN ATTACHED SHEET FOR ADDITIONAL SIGNATURES
For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916)
ADA Notice
654-3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.