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0 ARCADIS Job Safety Analysis <br /> Mfrastrucrure Water-Environment SuildinQs <br /> 'JOB STEPS 2 POTENTIAL HAZARDS 3 CRITICAL ACTIONS TO MITIGATE HAZARDS RESPONSIBLE <br /> PERSON(S) <br /> Chemical - Respiratory . Keep face clear of preserved sample bottles when filling. Keep <br /> irritation from vapor/gas face clear of wellhead and work upwind of wellhead, if feasible. <br /> inhalation. <br /> • STOP WORK IMMEDIATELY and contact site supervisor if <br /> vapors/gas are noticed in breathing zone or conditions change. <br /> Chemical-Eye irritation . Locate eye wash prior to conducting work to wash out eyes in <br /> from contaminated case of fluid contact. <br /> groundwater or free <br /> product splashing on face <br /> or body causing. Raise and lower bailer slowly to eliminate splashing liquids. <br /> • Use decanter to transfer media into sampling containers. <br /> • Pour water slowly into containers,stop before overflowing. <br /> Chemical - Dermal . Do not touch contaminated water with ungloved hands. <br /> irritation from contact <br /> with potentially . Wear Nitrile gloves over Type II cut-resistant gloves to prevent <br /> contaminated media. particulates/liquids from contacting hands and causing irritation. <br /> Each Job or Operation consists of a set of steps.Be sure to list all the steps in the sequence that they are performed.In Column 2,specify the equipment or <br /> other details to set the basis for the associated hazards. <br /> A hazard is a potential danger.What can go wrong?How can someone get hurt?Consider,but do not limit the analysis to the 10 Hazard Classes(Motion, <br /> Temperature,Gravity,etc.):Examples are:Motion—victim is struck by or strikes an object;Gravity—victim falls to ground or lower level(Includes slips and <br /> trips);Chemical—inhalation/skin exposure hazards to lead and benzene,etc..Specify the hazards and do not limit the description to a single word such as <br /> "Caught." <br /> ' Aligning with the first two columns,describe what actions or procedures are necessary to eliminate or minimize the hazards.Be clear,concise,and specific.Use <br /> objective,observable,and quantified terms.Avoid subjective general statements such as"Be careful"or"Use as appropriate." <br /> ° Identify the individual(s)by name responsible for ensuring mitigation efforts are implemented. If it is everyone's responsibility,indicate"Team". Modify/update in the <br /> field to ensure adequate coverage if personnel were yet to be determined during the planning phase. When mitigation action is complete AND before work starts, <br /> responsible person should initial next to their name to verify and document completion of action. <br /> To keep health & safety an TRACK, %echanical <br /> before every task, STOP and--_ °iia° f�ec�redi <br /> u © n n © l <br /> A <br /> a o <br /> G <br /> �1 - See <br /> Think through the task }}' v <br /> <-Cj> Recognize the hazards <br /> Assess the risks <br /> ti <br /> .W Control the hazards <br /> Keep health & safety first in all things p�a��0d 8!nloglcati Ca��iG <br /> `7 have read this JSA, and I understand the hazards and safe work practices associated with the task. If conditions change or an <br /> additional hazard is recognized, I will Stop Work and notify the Site H&S Officer immediately:" <br /> Seed JSA-Well Gauging and Sampling_020714.docx -3- <br />