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Universal Health & Safety Plan <br /> For use on all high-risk,industrial and HAZWOPER projects <br /> Department of Toxic Substances Control <br /> Discuss as Applicable Severity <br /> Modify THA as Needed Probability 5.Catastrophic 4-Critical 3-Major 2-Moderate 1 -Minor <br /> Check Zif reviewed or mark N/A 5-Frequent t a 5 <br /> ❑ Biological/Chemical/Electrical <br /> 4-Probable r 8 4 <br /> Hazards 3-Occasional 9 6 3 <br /> ❑ Decontamination Procedures 2-Remote I B 6 4 2 <br /> ❑ Ergonomics-Lifting, Body 1-Improbable 5 3 2 1 <br /> Position <br /> ❑ Lock Out/Tag Out Risk Rating(Probability x Severity) Risk Acceptance Authority <br /> ❑ Short Service Employees- Rlsk is tolerable,manage at local level <br /> visual identifier and mentor/ 5 to 9(Medium) Risk requires approval by Operations LeadlSupervisor& Safety Manager <br /> oversight assignment <br /> ❑ Simultaneous/Neighboring a to 26 h) Risk uires the roval of the Operations Manager&SafetyDirector <br /> Operations <br /> severity—Potential Consequences <br /> ❑ Slip/Trip/Fall Hazards People Pro Public <br /> p party Damage Environmental Impact [mapelReputatlon <br /> ❑ Specialized PPE Needs Catastrophic Fatality,Multiple Major >$W USD, Offsite impact requinng Government <br /> Incidents Structural collapse ternedialion intervention <br /> El Traffic Control critical Permanent impairment, s$250K to SIM Onsite impact requiring Media intervention <br /> Longterm injuryrillness USD remediation <br /> E] Waste Management/ USD Major LostrRestncted Work K to S250K Release <br /> a limit <br /> ve wner intervention <br /> Decontamination Moderate Medical Treatment >S1 K to S10K USD Release below community or local <br /> reportable limit attention <br /> El Weather Hazards/Heat Stress/ Minor First Aid </r$1 K USD Small chemical release Individual complaint <br /> contained onsite <br /> Cold Stress <br /> Probability <br /> ❑ Work Permit Requirements: N/A Frequent Expected to occur during task/activity alt 0 <br /> Probable Likely to occur during taslUactivity 1/10 <br /> ❑ Other: Occasional May occurdunngthe taskractivity 11100 <br /> N/A Remote Unlikelytooccur during task/activity 111,000 <br /> Improbable Highly unlikelytooccur,but possible during tasklactivity 1!10000 <br /> Using the Matrix: <br /> 1. Identify basic steps of the task and associated hazards. <br /> 2. Calculate the initial risk rating. <br /> 3. Identify control measure to eliminate or reduce the hazard's risk and calculate the <br /> residual risk rating. <br /> 4. If the risk rating (after controls are implemented)cannot be reduced to 4 or lower, <br /> additional approvals are needed before the activity can begin. <br /> ©AECOM Restricted <br /> Universal Heath and Safety Plan Template(S4[DSC]AM-209-FM2-C) <br /> Revision 15 October 18,2023 <br /> PRINTED COPIES ARE UNCONTROLLED.CONTROLLED COPY IS AVAILABLE ON COMPANY INTRANET. <br />