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ine it. Imagered. Task Hazard Assessment /'L=COMDellv Oversight of Utility Clearance Project Name: Client: Date: Permits Required? None 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 ❑ Hearing Protection ❑ Other: Tools &Equipment: Utility clearing equipment, hand tools, marker flags for utility locations. job/taskREMINDER: Use 4-Sight at the start of, and continuously throughout the . . . . . hazards 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 (final) a task in the sequence they What would the injury be? potential hazards associated with each job step to minimize the risk of are performed injury or environmental impact. Identify any`Stop Work'triggers. 1. Mobilize equipment and • Driving hazards 12 • Inspect vehicles for defects and complete inspection form. 4 personnel to site. • Distracted driving • Implement safe driving practices to prevent transportation incidents. • Parking hazards—Striking • Secure all loads, including equipment,within the cab. objects • Do not operate vehicles in unsafe conditions(e.g., on steep slopes, in deep mud). • Fire • Use of handheld devices while driving is prohibited. Use devices when vehicle is parked. • When reversing, use caution and a spotter, if available. • Use care when parking off pavement, and do not park over tall grass as the grass may catch fire from the hot vehicle exhaust. On- Site Edits: 2. Evaluate area for hazards • Struck by hazards—Vehicle 12 • Ensure all site personnel have received the necessary site-specific safety and 4 (continuous for entire movement awareness training. Familiarize yourself with site entrances and exits. duration of task). • Contact with utilities • Complete AECOM's checklist S3NA-331-FM 1, Underground Utilities&Subsurface • Overhead hazards Installation Clearance Checklist, if applicable. • Slips,trips, and falls, • Utilities in the work area should be cleared by completing the appropriate survey • Heat/cold stress prior to drilling operations. • Biological hazards • Utilize the"buddy system"when working on-site. 1 of 4