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Task Hazard Assessment AECOM °e;vgred: <br /> DRILLING, GROUTING, MONITORING WELLS 01-01-03-07 <br /> Mar• . <br /> STOP WORK if uncertain about safety or if a hazard or For a more thorough identification of Hierarchy of Controls <br /> additional precaution is not recorded on the THA. hazards, ask"What else could go <br /> Be alert, recognize and communicate any changes in Wrong?" using the Hazard Categories f= .""" <br /> scope, personnel or conditions at the worksite to the Substitution { � <br /> supervisor. <br /> Use I AECOM's last minute risk assessment Controls — {bra [h.hand <br /> process continuously throughout the day by asking <br /> yourself and your co-workers to assess your task, ` k"" <br /> hazards, and mitigations. Amend the THA when <br /> P4euce eh.neikn wdh <br /> needed. r ` � , ,....,.v��.n;..Eq,�...M <br /> What am I about to do? <br /> What can go wrong? / Most hazards need more than one control <br /> What can be done to make it safer? 7 L!� / What should you do? Stack your controls <br /> What have I done to communicate the hazards? PPE can NEVER be your only means of protection <br /> Worker Sign On .. <br /> 1 participated in the on-site review and fully understand the content of this Task Hazard Assessment. Visitors review task hazards and acknowledge understanding <br /> Printed Name Signature <br /> 1. Supervisor: 1. <br /> 2. 2. <br /> 3. 3. <br /> 4. 4. <br /> 5. 5. <br /> 6. 6. <br /> 7. 7. <br /> 8. 8. <br /> 9. 9. <br /> 10. 10. <br /> Submit a new THA for addition to the DCSA THA Library or send THA improvement suggestions to DCSA.THA.LibrarvCcD_AECOM.com <br /> Include a copy of the new THA or a photo of the THA modifications as appropriate. <br /> DCSA Task Hazard Assessment Form <br /> Version 1—October 22,2018 6 of 6 <br />