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Task Hazard Assessment AECOM Imagineed <br /> Summa Canister Sampling 01-01-22-04 <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 ❑ Hearing Protection ❑ Other: <br /> Tools&Equipment: Summa canister Wrenches Tubing <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. Set up equipment 1a.Muscle strain 6 1a.Use proper precautions(lift with legs, not back)when lifting equipment into/out of 4 <br /> vehicle. If lifting >50 Ibs, use the buddy system. Avoid twisting, stooping, and/or <br /> extended reaching positions when handling or moving equipment. <br /> 1 b.Equipment damage 3 1 b.Use a solid work surface when assembling summa canisters to avoid dropping or 2 <br /> damaging equipment. Work from the ground surface,floor, or the tailgate of the truck <br /> when applicable. Adhere to laboratory assembly instructions. Use correct size <br /> wrenches to connect fittings. Ensure wrenches are properly seated on fittings prior to <br /> loosening or tightening fittings. <br /> 1c. Pinch points, lacerations 6 1c.Wear leather gloves to prevent hand injury in case the wrench slips off a fitting or 1 <br /> while cutting tubing. <br /> 1 d.Tool/equipment failure caused 3 1 d.Conduct physical inspection of all equipment. Worn or broken tools should be 1 <br /> by use repaired or replaced. <br /> On- <br /> Site <br /> Edits: <br /> 2. Collect Sample 2a.Slips, trips,falls 6 2a.Maintain clean and organized work area; keep walking paths clear of equipment and 3 <br /> debris. <br /> DCSA Task Hazard Assessment Form <br /> Version 1—October 22,2018 1 of 3 <br />