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Universal Health & Safety Plan For use on all high-risk,industrial and HAZWOPER projects Department of Toxic Substances Control 9 sites ❑ Earthquake ❑ Hurricane ❑ Tornado ❑ Electrical Live Line Contact ❑ Intruder or Internal Violence ❑ Utility Shut-Off Before/During Emergency ❑ Elevator Emergency ❑ Lightning ❑ Vehicle Incident ❑ Emergency Rescue ❑ Medical Emergency ❑ Wildlife Fire ❑ Evacuation ❑ Pandemic Management ❑ Other: ❑ Explosion ❑ Power Outage Communications Yes No N/A Yes No N/A Alarm initiated Local law enforcement agency(police) ❑ ❑ ❑ contacted El El El Floor Marshal/Warden or Emergency Client contacted Coordinator contacted ❑ ❑ ❑ Name: ❑ ❑ ❑ Internal emergency responders contacted Regulatory Body contacted (i.e.,First Aid Providers,Onsite Medic,Rescue Crew) ❑ ❑ ❑ Name: ❑ ❑ ❑ External emergency services contacted Local Resilience Coordinator contacted (i.e.,Fire Department,Ambulance,etc.) ❑ ❑ ❑ Name: ❑ ❑ ❑ Supervisor/Foreman contacted ❑ ❑ ❑ AECOM Incident Reporting Hotline called ❑ ❑ ❑ Concurrent operations contacted Others contacted El El ❑ El El El Response Only take measures that will not put another's safety in ieopardy Yes No N/A Yes No N/A Emergency assessed for appropriate response ❑ ❑ ❑ Appropriate emergency equipment ❑ ❑ ❑ accessed Evacuation conducted Individual designated to provide direction to ❑ ❑ ❑ emergency location for emergency services ❑ ❑ ❑ Roll-Call conducted Spill/Leak/Release control measures ❑ ❑ ❑ initiated El El El Emergency assessed for additional hazards ❑ ❑ ❑ Firefighting equipment used ❑ ❑ ❑ Rescue initiated if safety of others not compromised ❑ ❑ ❑ All ignition sources controlled ❑ ❑ ❑ First aid provided ❑ ❑ ❑ Further evacuation conducted ❑ ❑ ❑ Emergency area contained,barricaded,or controlled ❑ ❑ ❑ Utilities shut off ❑ ❑ ❑ Equipment,machinery,or processes shutdown External emergency services provided if safe to do so ❑ ❑ ❑ (i.e.,firefighting,air ambulance,etc.) ❑ ❑ ❑ Other response: ❑ ❑ ❑ Other response: ❑ ❑ ❑ ©AECOM Restricted Universal Heath and Safety Plan Template(S4(DSC)AM-209-FM-C) Revision 12 September 9,2021 PRINTED COPIES ARE UNCONTROLLED.CONTROLLED COPY IS AVAILABLE ON COMPANY INTRANET.