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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 <br /> User Roles <br /> . . Due .. Date Supervisor Active <br /> Developer Hubbard, Lauren 5/22/2012 1/24/2012 McCarthy,John Rl <br /> HASP Reviewer Hubbard, Lauren 2/7/2012 1/25/2012 McCarthy,John p <br /> Quality Reviewer Lee,Johannes 2/6/2012 2/6/2012 Lee,Johannes ❑ <br /> Job Steps <br /> .• Step No. Job Step Description Potential Hazard Critical Action H&S Reference <br /> 1 Driving to and from sampling 1 Striking or being struck by Follow the 5 Keys of Smith System Driving FHSH Section III-U, <br /> locations. another object or vehicle Motor Vehicle Safety <br /> HS Standard <br /> ARCHSGE004,Driving <br /> JSA#15 <br /> 2 Approach residence and 1 Hostile or agitated Use Stop Work Authority. Never approach a FHSB Section III-H, <br /> communicate with occupant occupants. Occupants may residence alone;always use the buddy Stop Work Authority <br /> be potentially violent. system. Always have a cell phone. Do not HS Standard <br /> attempt to enter a residence or communicate ARCHSGE009 <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 /> 3 Enter home to conduct 1 Hostile or agitated Use Stop Work Authority.Never approach a Tailgate Meeting HS <br /> sampling activities occupants. Occupants may residence alone;always use the buddy Standard,PPE HS <br /> be potentially violent. system. Always have a cell phone. Do not Standard,Motor <br /> Weapons may be present. attempt to enter a residence or communicate Vehicle Safety HS <br /> Illegal drug use may be with its occupants,if you feel threatened in Standard,FHSB <br /> occurring. any way. Leave the property and call 911 if Section III-H <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 /> 2 Personal hygiene issues in Use Stop Work Authority. Contact PM and <br /> the residence such as re-evaluate hazards. Do not attempt to <br /> extreme filth,animal and/or communicate with occupants of the <br /> pet feces,insect infestation. 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 Contact PM and re-evaluate hazards. Do not <br /> feces. 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 />