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Imaine it. <br /> Task Hazard Assessment aLCOM Delgeed. <br /> Groundwater Sampling — Bailer 01-01-05-12 <br /> STOP WORK if uncertain about safety or if a hazard or For a more thorough identification of M« 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 <br /> wrong?" using the Hazard Categories I'll al,re�e <br /> scope, personnel or conditions at the worksite to the R PI <br /> supervisor. <br /> plat p PI <br /> Use 4-Sight,AECOM's last minute risk assessment �f-1h�.:J <br /> process continuously throughout the day by asking <br /> yourself and your co-workers to assess your task, ® !`peo.plePl. °way <br /> work <br /> hazards, and mitigations. Amend the THA when :■ <br /> needed. P —the rawerker„Rfi <br /> Px nal Pmtxtive�quipn,errt <br /> . 1pasr <br /> What am I about to do? <br /> What can go wrong? 1 Most hazards need more than one control <br /> What can be done to make it safer? 7 J O / What should you do? Stack your controls <br /> What have I done to communicate the hazards? 1 PPE can NEVER be your only means of protection <br /> Worker Sign On <br /> I 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.LibrarY0_AEC0M.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 4 of 4 <br />