Laserfiche WebLink
Ima <br /> ine it. <br /> Task Hazard Assessment aLCOM Delgeed. <br /> Groundwater Sampling — Bailer 01-01-05-12 <br /> Project Name: Client: Date: <br /> Permits Required? Work <br /> (list): Location: <br /> This THA must be fully reviewed with all staff members. All job steps, hazards, work practices, and PPE are clearly understood and <br /> have been implemented. All necessary revisions have been written on the THA. <br /> Required PPE: ® Hard Hat ® Safety Glasses ® HiVis Vest ®Safety Toe Boots ® Gloves: Leather, nitrile,cut ❑ Hearing Protection ❑Other: <br /> resistant <br /> Tools&Equipment: Hand tools YSI Pump <br /> REMINDER: Use 4-Sight at the start of, and continuously throughout the job/task to identify additional and/or hazards to act on! <br /> Job Steps Potential Hazards Risk Critical Actions To Mitigate Hazards Risk <br /> List all steps required to perform How could you be hurt? (initial) List control measures required to eliminate, control or protect against the (final) <br /> a task in the sequence they What would the injury be? potential hazards associated with each job step to minimize the risk of <br /> are performed injury or environmental impact. Identify any`Stop Work'triggers. <br /> 1. Visually clear proposed 1 a.Exposure to biological hazards: 6 la.Identify and avoid hazardous plants and animals on site. Look for signs(spider webs, 4 <br /> sampling locations insects, poisonous plants and droppings, etc.).Wear cut resistant gloves, insect repellant, use a broom or a rake to <br /> animals. Injuries could include move vegetation, not your hand or foot, move slowly <br /> anaphylactic shock, allergic <br /> reactions, rabies. 4 <br /> 1 b.Identify, mark and avoid slip, trip and fall hazards(holes, obstructions protruding from <br /> 1 b.Slip/trips,falls due to uneven 6 ground, or debris). Contact PM immediately and do not proceed if any conditions are <br /> terrain resulting in broken observed that cannot be controlled to make well sampling in the area safe. <br /> bones or torn ligaments. <br /> 1 c. Struck by vehicle resulting in 4 <br /> severe trauma or death 10 1 c.Visually inspect roadway for moving equipment if walking and set up vehicle as a <br /> barrier if driving. Set up exclusion zone around each well. Don reflective vest. <br /> On- <br /> Site <br /> Edits: <br /> 2. Open well casing/flush- 2a.Cuts/lacerations/crushing, 6 2a.Avoid touching sharp material/edges.Wear cut resistant ANSI 2 gloves. Keep face, 2 <br /> mount covers and well plug bruises hands,fingers, and feet clear when opening and closing well cover. Inspect ground <br /> lock. before kneeling. Don knee pads. <br /> 2b.Back strain from improper 4 2b.Stretch before working. DO NOT use awkward positioning. Keep back straight. Take 2 <br /> lifting regular rest/stretch breaks. Change position regularly. <br /> 2c. Stand upwind from the well opening to avoid vapor exposure. Loosen well cap slowly, 2 <br /> 2c.Vapor exposure resulting in 4 keeping control if pressure is released due to vapors. Keep face out of line-of-fire. <br /> DCSA Task Hazard Assessment Form <br /> Version 1—October 22,2018 1 of 4 <br />