Scribd
Upload
112 views

Application For Construction Safety and Health Program (CSHP)

This document is an application for a Construction Safety and Health Program for a residential construction project with less than 10 workers. It provides details about the project such as the name, address, duration, estimated cost, number of workers, contractor and project owner information. The applicant commits to comply with occupational safety and health standards and guidelines, and to implement a construction safety and health program for the project that provides protective equipment and safety training to workers.

Uploaded by

Jeddel Grace Cortez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
112 views

Application For Construction Safety and Health Program (CSHP)

This document is an application for a Construction Safety and Health Program for a residential construction project with less than 10 workers. It provides details about the project such as the name, address, duration, estimated cost, number of workers, contractor and project owner information. The applicant commits to comply with occupational safety and health standards and guidelines, and to implement a construction safety and health program for the project that provides protective equipment and safety training to workers.

Uploaded by

Jeddel Grace Cortez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 6

Regional Office: DOLE-NCR

Application No: ________

Application for
CONSTRUCTION SAFETY AND HEALTH PROGRAM (CSHP)
(Intended only for residential project/s (2 storey and below) or minor repair works with less than 10 workers.)
Project Name: ______________________________________________________________________
Project Complete Address/Location: ___________________________________________________________
_________________________________________________________________________________________
Project Duration: _____________ Project Start: ________________ Completion Date: _________________
(No. of Calendar days) (Date of estimated start) (Date of project completion)
Estimated Project Cost: ______________________ Number of Workers: _______________________
Name of Contractor (if any):___________________________________________________________________
Contractor’s Address: ________________________________________________________________________
____________________________________________________________ Fax No.:_______________________
PCAB License No.______________ Date of Validity: ____________ Email address: _______________________

Name of Project Owner: __________________________________ Fax No.:_____________________


Project Owner Address: ______________________________________________________________________
______________________________________________________ Email address: ____________________

Submitted by: ____________________________________ ________________________________


Signature over Printed Name Position
**********************************************************************

COMMITMENT TO COMPLY on OSH

I/We __________________________________ and


_________________________________
(Name of Contractor’s Authorized Official and/or Project Owner)
do hereby commit and bind ourself to comply with the applicable
provisions of the Occupational Safety and Health Standards
(OSHS) and Department Order No.13 series of 1998 – Guidelines
Governing Occupational Safety and Health in the Construction
Industry. I/We hereby commit to implement a suitable
Construction Safety and Health Program designed for the
abovementioned project. I/We also acknowledge my/our
responsibilities to provide the appropriate Personal Protective
Equipment (PPE) and job safety and health instructions and
training to all our workers during the duration of the project.
_____________________________________
___________________________________
Name of Project Owner Name of
Contractor
Signature Over Printed Name Signature
Over Printed Name (NOTE: NO FEES REQUIRED FOR APPLICATION, PROCESSING AND
APPROVAL OF CSHP)

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy