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II. Health and Safety Evaluation <br /> :j <br /> A. Hazard Asses., I <br /> it <br /> 1. Background Review: Cerplete ) Partial ( ) If partial, why? <br /> l� <br /> 2. Activities Covered Under this Plan <br /> i, <br /> No. Task/Subtask Desczzption �' Schedule �t <br /> Sd'+ S k M n SUMMv�QX(` l <br /> ? JF <br /> 3. Types of Hazards: (Place a YIN in each ( ) to irate presence/absence of hazard) <br /> a. Physiochemical (N) Flammable ( tJ) Explosive CorrosiveReactive <br /> )) <br /> ( N) 02 Rich (�/) 02 Deficient {I]* ( N} <br /> ii <br /> Chemically Toxic ( Y ) Inhal. Ingesta ( '( )., Cont. (Y ) Absorb. <br /> (�! ) Carvin. (N) Mutagen (N ), Test. <br /> f (N } OSHA 1910.1000 Substance <br /> ( l�) OSHA Specific Hazard.i1Sub.EStandard, Describe <br /> b. Biological ical f� E'tiol. - <br /> og ( ) Agent ( ) Other Plant,insect, <br /> animal, [2]* <br /> c. Radiation Ionizing - ( N} Internal Dq:d ure (.Al) External exposure [3] <br /> Non-ionizing - (/�/) UV; (r/) % ( N) RF I* (IU) MicxoW% (n/) LASER <br /> d. Physical Hazards (Y) [4]* e. Construction Activities ( ) [5]* <br /> * The number in the { ] refers to one of the following hazard evaluation forms. <br />° C=qplete hazard evaluation forms for each appropriate Hazard Class. i <br /> 3 <br /> r <br /> B. Source/Laxation of Contaminants and Hazardous Substances <br /> 1. Directly Related to Tasks <br /> ! <br /> t ) Air Soil 4 r n <br /> Other Surface ( ) S. Water w <br /> G. Water Soy m D 1 r ( ) Other' <br /> 2. Indirectly Related to Work - Nearby Process(s) which could affect team mer.bers: <br /> ( CClient Facility; Ne <br /> arby Non-client Facixityy. Describe <br /> (�) Client briefing arranged. i <br /> 1 <br />