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Supplier Requirements Manual - AK Steel

Supplier Requirements Manual - AK Steel

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<strong>AK</strong> STEELSAFETY SENSITIVE CONCERN CONFIRMATIONThis is to confirm that I am taking_____________________________________ as prescribed by my personalphysician and that I have been advised as to the side effects of suchprescribed medication by my physician and the extent such side effects mayhave on my safe job performance.In consideration of safety concerns from my taking this medication whileworking and being permitted access to the __________________ Works, Iconfirm that I will not take this medicine within six (6) hours ofcommencing work as well as during the work turn._______________________________________Employee_________________Date<strong>AK</strong> <strong>Steel</strong> <strong>Supplier</strong> <strong>Requirements</strong> Page 49 of 55Revised 01/13

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