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C <br /> I <br /> Visually clear proposed Underground and overhead Complete Pre-Mobilization section of Borehole Clearance Review <br /> locations to be cleared. utilities/obstructions. ,_ form and adjust locations to be cleared as necessary <br /> _.... .. ......... _..._.__ ....... ..._... ......._ _ <br /> Set up any necessary traffic Accident during placement or as.a result Use buddy system for placing traffic control. Reference traffic <br /> control. of improper traffic control equipment control plan section of SSP(may include specific requirements <br /> placement. based on encroachment permit) <br /> ......... ......... -... <br /> Jackhammer concrete/AC Electrical shock if not properly grounded Review all equipment prior to use including proper grounding. <br /> (GFI ONLY!),cord/hose is potential trip Keep blade/point away from feet when using. Place cord/hose <br /> hazard,risk to feedtoes from blade/point, away from work area. Have proper PPE including face shield or <br /> risk to skin and face from flying debris, safety glasses,gel-filled wrist guards,and hearing protection. <br /> potential to hit a utility. Risk to hands, Stretching prior to use. Take appropriate breaks and avoid daily <br /> wrist,forearm,and back due to vibrations use. <br /> and strain. Risk of hearing loss. <br /> _ _......_........__.. .... ........ ..._._.. .:............ ._....._................. <br /> j Hand auger sampling Potential to:hit utility,potential trip Have proper PPE including gel-gilled wrist guard. Stretching prior <br /> hazard,risk to hands,wrists,forearms, ._ to use. Take appropriate breaks and avoid daily use. <br /> and back due to over straining. <br /> _.. ... .. ....._. . ..... <br /> Store cuttings(if any)properly Exposure to public. Traffic hazard or Have proper storage containment and labeling available onsite. <br /> in accordance with site-specific obstruction/inconvenience to station Place materials in isolated location away from traffic and other site <br /> requirements. operation Improper storage or disposal. functions. Coordinate proper disposal offsite(where applicable). <br /> Backfill borehole Improper grouting or backfilling can lead If using grout,make sure grout is mixed to specification and <br /> to future vertical conduit for contaminant completely fills hole. Use proper lifting techniques and PPE. Keep <br /> migration. Back strain,trip hazards,eye work area clear of tripping hazards. Ensure presence or other <br /> injury from splashing or release of authorization by inspectors required for grouting. <br /> pressurized grout. Unauthorized <br /> backfilling causes extra work. <br /> - .. _._ _...._ ......__ .._._._...._ ... ._....._.-. .. ....:......... ... :. . ............ ........._. _ ------ <br /> Dispose or store purge water(if Back strain. Exposure to contaminants. Use proper equipment to transport water(pumps,drum dollies, <br /> any)onsite. If disposing through onsite treatment etc.). Where PPE.m accordance with SSP. Review any necessary <br /> system,damage or injury from improper instructions for use of onsite treatment systems. Label',kstorage <br /> use of equipment. Improper storage or containers properly and locate in isolated area away from traffic and <br /> disposal other site functions. Coordinate offsite disposal(where applicable)_ <br /> ..........................................__ <br /> Clean site/demobilize. Traffic. Nuisance or safety hazard left on Use buddy system as necessary to remove traffic control. Leave <br /> site. site clean of refuse and debris. Clearly mark/barricade any holes <br />'r that need later topping off or curing.Notify station personnel of <br /> departure. Map locations and note any cuttings/purge water left <br /> onsite. <br /> j. <br /> ii:\0-chevron\admin\safety\jsa forms\jsa-handauger-jackhammer.doc. <br /> I <br /> F:\SAFETY\Safety and Health Manual (SHM)\SHM App,A-LPS Forms\JSA formSUSA Hand auger-jackhammer.doc <br />