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II. Health and Safety E�raluation <br /> A. Huard ALSSess"ent <br /> 1. Bac};ground Review: C.,:.T;lete (X} Partial ( } if partial, why? <br /> �✓r/ CGhjfi..r�rrrI .,"�// le'Re O/0 r .t a <br /> ca firmerr inn/i PC�/1[t rl!��t[� �YLr4 lG PXrri r[e�i,ter C rC rr•! LJPre ti <br /> .4, <br /> 2. <br /> 2. Activities Covered Under this Plan <br /> No. Task/SubtaskDesqtion / 1 Schedule <br /> (�,b ryri,11i'ri�, Cpus1rucAl", c�Gy�l��Jl?1Etr f _ <br /> 3. Types of Hazards: (Place a Y/N in each ( } to indicate presence/absence of hazard) <br /> a. PhysioChF--rical (n/) Fla=. able (N) Explosive (N ) Corz ive (n1 ) Reactive <br /> (11 02 Rich (N) 02 Deficient [I]* <br /> Chemically Toxic (V) .Inhal. { `f ) Ingest. (Y ) Cont. Absorb. <br /> (N ) Carcin. (N ) Mutagen (N) Terat. <br /> (N ) CSN.A 1910.1000 Substance <br /> (T!) CSHA specific Hazard. Sub. Standard, Describe <br /> b. Biological (n1 ) Ftiol. Agent (4) other - Plant,insect, animal, [z]* <br /> c. Radiation Ionizing - (N) Internal Expcsua-e (N) External exposure [3]* <br /> Non-ionizing - (rJ) UV; (1J) 1R; (/J) RF; (d) Mi=W;y(4) USER <br /> d. Physical Hazards (� ) [4]* e. Construction Activities (4) [5]* <br /> * The number in the [ ] refers to one of the following hazard evaluation forms. <br /> C=-Vlete hazard evaluation farms for each appropriate Hazard Class. <br /> S. Source/Location of Contaminants and Hazardous Substances <br /> 1. Directly Related to Tasks <br /> ( ) Air ( ! ) Soil �0 ; <br /> ( ) 0the_• Surface ( } S..Water <br /> ( z) G. Water menr Sr7 r ( ) other <br /> 2. Indirectly Related to Work - Nearby Process(s) which could affect team me;,bers: <br /> Client Facility; ( ) Nearby Non-client Facility. Describe /� <br /> ( ) Client briefing arranged. <br />