Laserfiche WebLink
HEALTH AND SAFETY EVALUATION <br /> Hazard Assessment <br /> Background Review: ❑ Complete ❑ Partial If partial why? <br /> Activities Covered Under This Plan: <br /> No. Task/Subtask Description Schedule <br /> 1 Phase I Environmental Assessment Facility walkthrough(nspection,interviews, <br /> (Due Diligence) record review, local agency contacts <br /> 2 Limited Phase II Environmental Collection of surface soil samples, shallow soil <br /> Assessment (borings), sampling or installation of <br /> groundwater monitor wells,surface water <br /> Types of Hazards: SITE SPECIFIC <br /> ❑ Numbers refer to one of the following hazard evaluation tom... Compote hazard evaluation form for arch appropriate hazard alae. <br /> Physiochemical ID Chemically Toxic 0 Radiation 51 Biological 2❑ <br /> g <br /> 13 Inhalation 11 Carcinogen Ionizing: ❑ Etiological Agent <br /> 11 Flammable <br /> ❑ Ingestion ❑ Mutagen ❑ Internal exposure ® Other(Plant, insect, animal) <br /> ❑ Explosive ❑ Contact ❑ Teratogen <br /> ❑ External exposure <br /> ❑ Corrosive ❑ Absorbtion <br /> ❑ ReactiveNon-ionizing: <br /> ❑ OSHA 1910.1000 Substance 11 Physical Hazards <br /> (Air Contom:nan:s) ® UV ❑ IR <br /> 11 Oz Rich <br /> ❑ Construction Activities <br /> ❑ Oz Deficient <br /> ❑ OSHA Specific Hazard Substance ❑ RF ❑ MicroW <br /> Standard <br /> (Refer to HASP Fonn 04HASP.894 for Ustbrg.) ❑ Laser <br /> Source/Location of Contaminants and Hazardous Substances <br /> Directly Related to Tasks Indirectly Related to Tasks — Nearby Process(es)That Could Affect Team Members: <br /> ❑ Air ❑ Client Facility <br /> ❑ Other Surface ❑ Nearby Non-client Facility <br /> ® Groundwater Describe: <br /> ® Soil <br /> ® Surface Water <br /> ❑ Sanitary Wastewater ❑ Client Briefing Arranged <br /> ❑ Process Wastewater <br /> ❑ Other <br /> Corporate Health and Safety Page 4 of 36 <br />