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rm- <br /> ., � �'6 ` : 'fi' ' r ', !.i" M " a',�» & °x ti �a'.p r;�y,, "rf �,"'*'x^�,c-pct^ K - <br /> NO <br /> Non-chemical hazards: <br /> confined space drill rig__!_ noise,, traffic_ <br /> underground utilities X overhead lines X backhoe x <br /> other construction equipment X ',00isonous insects <br /> poisonous animals_ dangerous animals_,,,_ ticks <br /> high crime area_ slip/fall hazards_ welding__ <br /> heat/cold stress_ excavation >5ft X trench >4ft X <br /> leaking containers electrical` hot surface__ <br /> low light conditions_ lifting hazard X_ <br /> other <br /> If confined space entry was checked.above, of what type is <br /> the confined space? <br /> Ala- subsurface subsurface vault_ manh.hole_ basement <br /> trench_ excavated pit_ other. <br /> Chemicals ut .ized to perform on-site tasks {include <br /> chemicals used to maintain equipment:) : <br /> TSP seen, fuel for egMipment, etc. <br /> Safety engineering controls incorporated into the design of <br /> remediation system(s) , if applicable: <br /> t <br /> 8 <br />