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/�RCJaDIS Design&Consultancy <br /> TEAM Chevron - Job Safety Analysis fornaturaland <br /> built assets <br /> JSA Description:Waste Containerization and Sampling Date of JSA Development:2/9/2022 <br /> Project Name:Chevron Facility#211606 PMCoW: <br /> Site Address:311 S.5th Ave,Sterling,CO Project No: 30045694 <br /> evelopment Team(Include employer&email if not employed by Arcadis.) <br /> Austin Ramm Environmental Engineer 1 <br /> Reviewed By(Include employer&email if not employed by Arcadis.) Position/Title: Review Date(MM/DD/YYYY) <br /> Paul Vallin Project Engineer 02/14/2022 <br /> Permits/Plans Required(general, <br /> Specialized,etc.): <br /> Specialized tools/equipment: <br /> MINIMUM REQUIRED PERSONAL Hazardous Atmosphere Respiratory Protection — <br /> PROTECTIVE EQUIPMENT ❑ Photoionization Detector(PID) ❑ Half-face Air Purifying Respirator <br /> Z ANSI/ISEA 107-2010 Class 2 or 3 vest or <br /> ANSI/ISEA 107-2015 Type R, Class 1 or 2 El Flame Ionization Detector(FID) ElFull-faceAir Purifying respirator <br /> vest ❑ Dust Monitor ❑ SCBA or Supplied Air <br /> Z Long pants ❑ LEL/Oz Meter Fall Protection <br /> Z Long-sleeved shirts <br /> E] HzS Meter ❑ Personal fall arrest system designed or <br /> 0 Safety glasses,wraparound or with side <br /> approved <br /> shields labeled with ANSI Z87.1 rating,or Hearing Protection a qualified person other <br /> means of fall protection determined by <br /> a certification card for lenses and frames ❑ Ear Plugs(noise 80 db) qualified person <br /> Z Safety footwear meeting ASTM F2413-05 Hand Protection <br /> standard with chemical or oil resistant ❑ Ear Muffs with Ear Plugs(noise 105 db) <br /> soles Body Protection ❑ Chemical resistant gloves per SDS <br /> 0 High visibility work gloves(when high ❑ Chemical resistant cloting recommended on ❑ Cut-resistant gloves or liners <br /> visibility glove options exist for a particular SDSI-7f <br /> glove type) LTJ Leather/Work gloves <br /> 0 Hard hat that complies with ANSI Z89.1 ❑ Chain saw chaps ❑ Welding gloves <br /> ❑ Snake chaps or boots marketed as"snake ❑ Leather gloves,insulated <br /> rrASK SPECIFIC: Personal proof13 <br /> Protective Equipment (PPE) ElANSI/ISEA 107-2010 Class 3 vest or Q Nitrile gloves <br /> Determination* ANSI/ISEA 107-2015 Type R,Class 2 vest if ❑ Impact resistant gloves <br /> low light conditions or traffic flow at 50 mph mot Protection <br /> Eye Protection ] or more <br /> Must Comply with ANSI Z87.1 ElANSI/ISEA 107-2010 Class 2 or 3 El Safety shoes or boots with metatarsal guards <br /> BREAKAWAYvest or ANSI/ISEA 107-2015 Q Safety boots with puncture-resistant midsoles <br /> ❑ Impact Goggles Type R,Class 1 or 2 vest or that have built-in puncture resistance(PR <br /> ❑ Flexible goggles Q Sunscreen lotion>=SPF30 rated) <br /> ❑ Welding goggles/helmet or face shield. Q Insect repellant(DEET:flying insects) ❑ Safety boots with electric hazard(EH) <br /> Tinted lenses required protection(standard in most footwear) <br /> El Insecticide(Permethrin:ticks) <br /> ❑ Laser safety glasses ❑ Rubber-sole boots or grips <br /> El US Coast Guard approved personal flotation <br /> MIIII device(PFD)—Type I,II or 111 ❑ Chemical resistant boot covers <br /> ❑ Type E Hardhat(Electrical) ❑ Lace-up safety boots conforming to ASTM <br /> F2413-05 or equivalent in non-US <br /> ❑ Hardhat with chin strap,miner's helmet with ❑ Chemical protective goggles that comply with jurisdictions <br /> chin strap or mountaineering helmet with chin ANSI Z87.1 Heat, Flame, Flash Fire or Arc Hazard <br /> strap <br /> ❑ Face Shield over safety glasses <br /> ❑ Cooling vest <br /> ❑ Fire retardant clothing(FRC) <br /> *If an item is checked,it is relevant for all job steps. If an item is specific to a particular job step it must be noted in the Critical Actions) <br /> column in the JSA. <br /> Waste Containerization and Sampling JSA_pv Page: <br /> 1/4 <br />