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A • <br /> Job Safety Analysis <br /> _DPE Test <br /> JSA Type ®SAR Operations ❑ Transport ❑Office ❑Constriction ® New ❑Revised Date 03/30/00 <br /> Co Dept Div Org Unit Loc <br /> Work Type Environmental Work Activity GWE and/or SVE Pilot Testing <br /> Personal Protective FgntpmepL(PPFl- <br /> Minimum PPE is Level D including safety glasses or goggles,hard hat,steel-toed and shank boots,hearing protection and gloves(type dependent <br /> onlob-specific requirements) <br /> Additional PPE may be required in the Health&Safety Plan(HSP) Also refer to the HSP for required traffic control,air momtormg,and <br /> emergency procedures <br /> Develo ment Team Position/Title Reviewed By Position/Title Date <br /> Field staff must review lob-specific work plan and coordinate with project manager to venfy that all up-front logistics are completed prior to starting <br /> work including, but not limited to, permitting, access agreements, and notification to required contacts (e g site managers, inspectors, clients <br /> subcontractors, etc) A tailgate safety meeting must be performed and documented at the beginning of each work day Self Performance Safety <br /> Analysis(SPSA)procedures must be used throw hout the proiect Weather conditions heat cold rain lightning)must also be considered <br /> O Job Ste s ® Potential Hazard © Critical Actions <br /> Mobilize with proper Vehicle accident Lifting hazards Delay Follow safe driving procedures Employ safe lifting <br /> equipment/supplies for testing or improper performance of work due to procedures Make sure sub-contractors are aware of their <br /> improper equipment onsite responsibilities for labor,equipment and supplies Review <br /> HSP and nernut conditions andather agc ess PPE <br /> Set up necessary traffic control Struck by vehicle during placement Use buddy system for placing traffic control Reference <br /> Vehicle accident as a result of improper traffic control plan section of HSP(may include specific <br /> traffic control a ui ment placement requirements based on rmits <br /> Unload and set up test equipment Struck by vehicle Trip hazards Accident Place equipment away from pump islands or other high <br /> when maneuvering equipment Lifting traffic areas Store hoses,electrical cords neatly and <br /> hazard Electrical hazard Adverse protect with traffic control equipment(cones,barricades, <br /> impacts to station sales etc) Provide as-needed hand signals and guidance to <br /> driver when placing testing equipment trailers or other <br /> large equipment Visually inspect equipment(fire <br /> extinguisher on board/available on site,no damaged hoses <br /> or electrical lines,pressurized hoses secured with whip- <br /> checks or adequate substitute,all vapor and/or water hoses <br /> firmly connected,equipment grounded9) Use proper <br /> lifting techniques Use GFIC on generators or other <br /> __ _electrical equipment and inspect cords ___ <br /> Set up exclusion zone(s)and work Struck by vehicle during set up Sliplfall Implement exclusion zone set-up instructions of HSP Set <br /> station hazards up work station with clear walking paths to all testing <br /> locations Face oncoming traffic _ <br /> Gauge water levels and product Back strain,inhalation or dermal exposure Don any additional PPE and initiate air quality monitoring <br /> thickness(where applicable) to chemical hazards Repetitive motion in accordance with the HSP Maintain safe distance from <br /> Traffic hazards well heads Bend at knees,not waist Decontaminate <br /> equipment between each measurement Face oncoming <br /> traffic <br />