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User Roles <br />Role Employee Due Date Completed Date Supervisor Active <br />Developer Hubbard, Lauren 5/22/2012 1/24/2012 McCarthy, John þ <br />HASP Reviewer Hubbard, Lauren 2/7/2012 1/25/2012 McCarthy, John þ <br />Quality Reviewer Lee, Johannes 2/6/2012 2/6/2012 Lee, Johannes o <br />Job Steps <br />Job Step No.Job Step Description Potential Hazard Critical Action H&S Reference <br />1 Driving to and from sampling <br />locations. <br />1 Striking or being struck by <br />another object or vehicle <br />Follow the 5 Keys of Smith System Driving FHSH Section III-U, <br />Motor Vehicle Safety <br />HS Standard <br />ARCHSGE004, Driving <br />JSA #15 <br />2 Approach residence and <br />communicate with occupant <br />1 Hostile or agitated <br />occupants.  Occupants may  <br />be potentially violent.     <br />Use Stop Work Authority. Never approach a <br />residence alone; always use the buddy <br />system.  Always have a cell phone.  Do not  <br />attempt to enter a residence or communicate <br />with it's occupants, if you feel threatened in <br />any way.    Leave the property and call 911 if  <br />there is clear and present danger.  Call PM  <br />after contacting the appropriate authorities.   <br />Do not attempt to interact with the occupants <br />but leave the area and wait for authorities.   <br />Communicate regurlarly with PM, giving <br />addresses of each residence prior to entry. <br />FHSB Section III-H, <br />Stop Work Authority <br />HS Standard <br />ARCHSGE009 <br />3 Enter home to conduct <br />sampling activities <br />1 Hostile or agitated <br />occupants.  Occupants may  <br />be potentially violent.   <br />Weapons may be present. <br />Illegal drug use may be <br />occurring. <br />Use Stop Work Authority. Never approach a <br />residence alone; always use the buddy <br />system.  Always have a cell phone.  Do not  <br />attempt to enter a residence or communicate <br />with its occupants, if you feel threatened in <br />any way.    Leave the property and call 911 if  <br />there is clear and present danger.  Call PM  <br />after contacting the appropriate authorities.   <br />Do not attempt to interact with the occupants <br />but leave the area and wait for authorities.   <br />Communicate regurlary with PM, giving <br />addresses of each residence prior to entry. <br />Tailgate Meeting HS <br />Standard, PPE HS <br />Standard, Motor <br />Vehicle Safety HS <br />Standard, FHSB <br />Section III-H <br />2 Personal hygiene issues in <br />the residence such as <br />extreme filth, animal and/or <br />pet feces, insect infestation.  <br />Use Stop Work Authority.  Contact PM and  <br />re-evaluate hazards.  Do not attempt to  <br />communicate with occupants of the <br />residence regarding the conditions of the <br />home.  Consult with HR, Legal Department,  <br />H&S, project management team, supervisor <br />and client as necessary to determine the <br />safest approach.  Re-entry may require  <br />additional PPE. <br />3 Visible and excessive rodent <br />feces. <br />Contact PM and re-evaluate hazards.  Do not  <br />attempt to communicate with occupants of <br />the residence regarding the conditions of the <br />home.  If it is determined the re-entry is  <br />possible. Level C PPE must be worn, <br />including a minimum P100 particulate air <br />purifying respirator (APR). <br />Job Safety Analysis <br />General <br />JSA ID 6684 Status (3) Completed <br />Job Name Environment-Air Monitoring Created Date 1/24/2012 <br />Task Description Indoor Air Sampling Completed Date 01/25/2012 <br />Template True Auto Closed False <br />Client / Project <br />Client Arcadis AGMI <br />Project Number 000000100000 <br />Project Name GENERAL OVERHEAD <br />PIC <br />Project Manager