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Parkade level: Between G/L: Typical level: Other: ______________________________ ______________________________ 1.2 THIS PLAN IS APPLICABLE TO THE FOLLOWING HEIGHT(S) ON SITE: Below 10 feet Above 10 feet & below 25 feet Above 25 feet All Elevations 1.3 PERSON COMPLETING THIS FALL PROTECTION PLAN: _________________________________ NAME TITLE 1.4 SAFETY MANAGER: ____________________________________________ 1.5 NOTES: _______________________________________________________________________.

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