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Page I <br />SITE HEALTH AND SAFETY PLAN <br />Hultgren — Tillis Engineers (H—TE) <br />I. GENERAL SITE INFORMATION <br />Site Name: Bouldin Island <br />Site Address: 16701 W. St. Rt. 12, Stockton, California <br />Contact Person: Dario Leekam Phone: 805-341-3907 / 925-685-6300 <br />Site Identification Number: 124.20 Proposed Date(s) of Site Work: Feb. 8 to 12, 2021 <br />II. DESCRIPTION OF ACTIVITY <br />Purpose of Activity: Type of Site <br />❑ Geotechnical Soil Borings F-1 Industrial <br />❑ Gas extraction well installation ❑ Gas station <br />❑ Agricultural well installation ® Other (specify): Levee <br />® Other (specify): CPTs <br />Provide a brief description of the proposed activities: <br />Drill 22 CPTs to approximately 50 feet deep, collect soil samples, and backfill borings with <br />cement grout. <br />Investigation -derived material disposal: <br />Soil: soil cuttings may either be removed or spread out near the exploration holes. <br />Water and Fluids: NA <br />Other: NA <br />III. POTENTIAL HEALTH AND SAFETY HAZARDS <br />Potential Hazards include: <br />Heayy equipment - physical injury/trauma resulting from moving machinery <br />Fall hazard — physical injury from falling into an excavation >4' <br />Unshored excavation — physical injury from collapse of sidewalls in an occupied shallow trench <3' <br />Electrical hazards - nearby overhead wires underground utilities <br />Slippery and/or Bumpy Roads <br />Falls, trips, slips <br />Mosquitoes <br />Dust <br />Particulate Matter (PM) from wildfires or other sources <br />Noise <br />Uneven, muddy, terrain <br />HAZARD EVALUATION <br />Parameter <br />TLV (ppm) <br />IDLH (ppm) <br />LEL (%) skin eyes <br />Health <br />NA <br />NA <br />NA <br />NA <br />NA <br />