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Task Hazard Assessment AECOM Imagineed DRILLING, GROUTING, MONITORING WELLS 01-01-03-07 job/taskREMINDER: Use 4-Sight at the start of, and continuously throughout the Job Steps Potential Hazards Risk Critical Actions To Mitigate Hazards Risk List all steps required to perform How could you be hurt? (initial) List control measures required to eliminate, control or protect against the potential hazards (final) a task in the sequence they What would the injury be? associated with each job step to minimize the risk of are performed injury or environmental impact. Identify any`Stop Work'triggers. high traffic areas and in areas with blind spots where traffic is difficult to observe. Chock wheels ensure outriggers/jacks are used. 2d. Contact with overhead utilities. 10 2d. Keep a minimum of 15 feet from overhead power lines(20 ft. if 230-285 KV, 25 ft. if 4 285-345 KV, 35 ft. if 345-500 KV) Check HASP to ensure client/site does not have stricter requirements. Mast shall be down when rig is in motion. 2f. Hydraulic failure causing 10 2f. Place secondary containment on ground under rig. Ensure that secondary 3 release to the environment. containment is setup with'berms/barriers'or containment is securely clipped onto the rig tracks/wheels to protect from any fluid leaking off the plastic. On- Site Edits: 3. Commence drilling 3a. Cuts, contusions or broken 6 3a. Never place hands,fingers,feet under the bottom of an auger flight,or other location 2 fingers due to contact with where these heavy items could be set down or could fall suddenly. moving parts 10 3b. Ensure rotating parts are properly guarded. Remove loose clothing and jewelry that 4 could become entangled in moving parts. Use a long handled shovel to remove cuttings 3b. Entanglement from the auger/rods. 3c. Noise 6 3c.Wear hearing protection while equipment is in use. 2 - 3d. Stretch before working. Bend and lift with legs and arms, not back. Team-lift any 4 3d. Back strain/overexertion 8 items that are awkward or over 50 pounds. when unloading equipment 8 3e. Have bystanders maintain a 5 foot distance from the operation at all times. Set up 4 3e. Contusions to face or eyes work area the mast plus 5 feet and no less than 30 feet. Wear all required PPE. due to flying/shattering objects 8 3f.Wear leather or thick puncture-resistant gloves, communication between driller, 4 3f. Hand positioning/pinch points helpers, and logger. All pinch point hazards should be labeled on rig with warnings. DCSA Task Hazard Assessment Form Version 1—October 22,2018 2 of 6