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Policies and SUBJECT PACE <br /> Procedures Stockton Hazardous Work Policy 7 of t5 <br /> Potential Hazards ❑ other: <br /> ❑ Possible falling objects ❑ Airborne dust/mists ❑ Welding fumes <br /> ❑ Exposure to Hot Surfaces/Hot Materials ❑ Moving Vehicles ❑ Overhead beams/piping <br /> Exposure to noise levels at or above (85 dBA) 0 Slippery/Wet Surfaces <br /> El Vapors/fumes Flying particles/objects/fragments <br /> ElChemical Substances EJGlare/high intensity light <br /> Fall from Height ❑ Exposure to electrical hazards <br /> ❑ Sharp Objects ❑ Flammable Atmosphere <br /> Ad�itlonal Perml s ❑ Elevated Work [] Confined Space [] Other <br /> R� L111"ed: ❑ Roof Access ❑ Hot Work <br /> MM Out - <br /> ,PPE Required: <br /> ❑ Aluminized Jacket/Apron Hard hat ❑ Safety Glasses or Goggles <br /> El 0 High Temperature Resistant Face Shield Steel toe shoes/boots <br /> ❑ Leather-Heat resistant Gloves ❑ Ear Plugs/Hearing Protection <br /> ❑ Protective sleeves(Cotton) Cut resistance Gloves (Keviar) <br /> Other: <br /> Precautions and Safe uards:`Re ulred <br /> Note:All level 2 and 3 Hazardous Work requires a meeting to review all hazards and ensure all <br /> necessary precautions are taken. <br /> Some'ltem&.on the below checklist may not be a licable in situations' Indicate-those b' <br /> FreCaUtIQns Y Pp Y <br /> Checklist: wnq: NIA on those items. <br /> Has all necessary PPE been Y N N/A Have the pumps and other Y N N/A <br /> made available? ❑ ❑ ❑ energy sources been locked ❑ ❑ ❑ <br /> out and tagged? <br /> Has the area been Y N N/A Have the valves been Y N N/A <br /> barricaded and warning ❑ ❑ ❑ properly positioned,tagged, ❑ ❑ ❑ <br /> -signsposted? and locked out? <br /> Have the necessary lines Y N NIA Has any residual pressure Y N N/A <br /> been disconnected and ❑ ❑ ❑ been bled? ❑ ❑ ❑ <br /> properly drained? <br /> Has the heat tracing been Y N N/A Have the necessary blanks Y N N/A <br /> turned off? ❑ ❑ ❑ been installed? ❑ ❑ ❑ <br /> Has ERT members been Y N NIA <br /> notified of work taking <br /> place? ❑ ❑ ❑ <br /> EmergencyC_ommurncation Procedure Notify Morada Fire Department--209-931- <br /> 3107 <br /> My signature below acknowledges that I have received training, understand my responsibilities, and will <br /> perform my duties in compliance with the Stockton GAF Hazardous Work Policy. <br /> Hazardous Work Team <br />