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n. Health and Safety Evaluation <br /> A. Hazard Assessment <br /> 1. Background Revie,4: Complete Partial ( ) If partial, why? <br /> 2. Activities Covered Under this Plan <br /> No. Task/Subtask Descr:Ption Schedule <br /> AE>4c 09A'-097 6w <br /> 2 bov2. Soil s.vmPt-�ivG <br /> 3. Types of Hazards: (Place a Y/N in each ( ) to indicate presence/absence of hazard) <br /> a. PhysioCherucal (.-I Flammable (-✓) Explosive (•v ) Corrosive (�-) Reactive <br /> (,v) 02 Rich (.t�) 02 Deficient [i]* <br /> Chemically Toxic ( y) Inhal. (y ) Ingest. (y ) Cont. (y ) Absorb. <br /> (y ) Carcin. (,tA Mutagen (-y Tercet. <br /> (�v) OSHA 1910.1000 Substance <br /> (.x.) OSHA Specific Hazard. Sub. Standard, Describe <br /> b. Biological Etiol. Agent ( aa' other - Plant,insect, animal, [2]* <br /> c. Radiation Ionizing - (•v) Internal Dcposure ( -!,p MKternal exposure [3]* <br /> Non-ionizing - (4,) UV; (,v) IR; (v) RF; MicroW; (tij LASER <br /> d. Physical Hazards ()/) [4]* e. Construction Activities (,v) [5]* <br /> * The number in the [ ] refers to one of the following hazard evaluation forms. <br /> Complete hazard evaluation forms for each appropriate Hazard Class. <br /> B. Sauce/Iex.ation of Contaminants and Hazardous Substances <br /> 1. Directly Related to Tasks <br /> ( ) Aur ; (y) soil P05 137YF /.v SO/L <br /> ( ) Other Surface ; ( ) S. Water <br /> ( ) G. Water ; ( ) Other <br /> 2. Indirectly Relater] to Work - Nearby Process(s) which could affect team menbers: <br /> (,v) Client Facility; W) Nearby Non-client Facility. Describe <br /> (y) Client briefing arranged. <br /> 3�38� <br />