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Task Hazard Assessment AECOM Imagineed Sub-Slab Vapor Implant Install 01-01-22-02 Project Name: Client: Date: Permits Required? Work (list): Location: This THA must be fully reviewed with all staff members. All job steps, hazards, work practices, and PPE are clearly understood and have been implemented. All necessary revisions have been written on the THA. Required PPE: ❑ Hard Hat ®Safety Glasses ® HiVis Vest ®Safety Toe Boots ® Gloves: Leather, nitrile ® Hearing Protection ❑ Other: Tools&Equipment: Hammer drill,drill bits,GFCI Shop-Vac,extension cords Implant fittings, hand tools Cement REMINDER: Use 4-Sight at the start of, and continuously throughout the job/task to identify additional and/or hazards to act on! 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. 1. Pre-mobilization, Equipment la.Injury from equipment 5 1a.If using rental equipment, ensure that PM or person responsible for scheduling rental 4 Inspection malfunction equipment requests that the vendor inspects the equipment prior to site delivery to ensure all appliances are in working order and fit for use On- Site Edits: 2. Setup Hammer Drill 2a. Injury from improper operation g 2a. Prior to acceptance of equipment from the vendor(if rented equipment), review the 4 operating procedures and maintenance logs with the vendor representative(if applicable). 2b. Wear appropriate PPE(i.e., eye protection, long pants, nitrile sampling gloves 2b. Contact with cutting tools g (inner), leather gloves(outer), hard hat, hearing protection, shirt with sleeves, steel-toed 4 boots.) No loose sleeves—may get caught in rotating drill. 2c. Noise-related hearing loss g 2c. Minimize duration of exposure by taking breaks or alternating operators. Wear 4 hearing protection. 2d. Electric shock causing injury or 10 2d• Utilize protective equipment as follows: 4 electrocution 0Plug into GFCI-protected outlet or GFCI-protected extension cord. • Use appropriate gauge extension cord. Amperage issues from electric motor could trip breaker • Make sure cord is in good shape. • Ensure water used in coring doesn't affect electric cords or equipment. 2e. Rotating machinery g 2e. Review and understand the following: 4 • Make sure bit is sharp and bit is securely in place. • Place the drill bit on a debris-free level surface before starting. DCSA Task Hazard Assessment Form Version 1—October 22,2018 1 of 5