Belte r r a Cor p or at ion S afety M an ual D oc I D C H S M BE L 2 0 1 7 Pa g e 4 68 of 53 8 Doc u m e n t Identif icat ion F R M 019 P age Nu m b e r 2 of 2 Doc u m e n t C r e ation Dat e J a nua r y 1 2013 Im p le m e n tat ion Dat e J a nua r y 1 2013 I t i s the r e sponsi bil it y o f y o u a nd y ou r supe rvisor t o moni tor y our p ro gre ss a nd a djust the w orkloa d a s re c omm e nde d I t i s y our r e sponsi bil it y to re port a n y c onc e rns or diff iculti e s im media tel y t o y our sup e rvisor or ma n a ge r EMP L OY EE RE F USED TO ACC EP T TH I S O F F ER F OR MOD I F I ED W ORK Empl o y e e s Si g na tu re Da te Ma na g e rs Si g na tur e Da te I MP ORTAN T Modi fie d duti e s will be re view e d e ve r y two we e k s a t a mi nim um Empl o y e e sh a ll prov ide a ph y sicia n s note with ne w r e strictions l im it a ti on s e ve r y two w e e ks unl e ss other wise spe c ifie d b y th e ph y sici a n Empl o y e e will not ex c e e d the r e strictions of the p h y sicia n without prop e r a uthoriz a ti on of the ph y sicia n o r a r e vised P h y sica l Ass e ssm e nt R e po rt Empl o y e e must r e port a n y pa in a nd or discomf or t ex pe rie nc e d while pa rti c ipating in t he li g ht dut y progr a m T y pe o f lig ht dut ies w il l be prov ided a s a va il a ble S upe rvisor a nd br a n c h m a na g e r o r a d e sig n a te w il l be c onsul ted w he n d e signi ng the r e turn to wor k p rogr a ms