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.._............_.._.......... Visually clear proposed drilling Underground and overhead Complete Pre-Mobilization section of Borehole Clearance Review locations utilities/obstructions. form and adjust drilling locations as necessary. Set up any necessary traffic Accident during placement or as a result of Use buddy system for placing traffic control. Reference traffic control. improper traffic control equipment control plan section of SSP(may include specific requirements placement. based on erinits). Assist with set up of drill rig. Damage caused by drill rig while Make sure driller ensures clear pathway to drilling location and accessing set-up location. clearance for raising mast. Provide as-needed hand signals and guidance to driver to place rig. Visually inspect rig(fire extinguisher on board,no oil or other fluid leaks,cabling and associated equipment in good condition,pressurized hoses secured with whip-checks or adequate substitute,jacks in good condition?). ---- - --- - _.... ....... ..._......_ .... ........ _..... _ ..........---$ ... ......_......_...__...._... Set up exclusion zone(s)and Injury or exposure to public or other onsite Implement exclusion zone set-up instructions of SSP. Set up work work stations(drilling and personnel. Slip/fall hazards. stations with clear walking paths to and from rig, logging/sample collection)_ ...._....._........ . ..... ....... ...... ......................... _.._...._.. .-- ..__... ---...__....._....._----- Clear upper five feet of Back strain,exposure to chemical hazards, Don any additional PPE and initiate air quality monitoring in borehole. hitting an underground utility accordance with the SSP. Use proper lifting techniques and tools. Clear boring to full diameter and to 5 ft depth.Complete the Pre- Drilling section of the Borehole Clearance Review form. _ ... ....... ........_.......................... ....... ......................_ .... --- - Perform SPSA. Changes in anticipated subsurface Reconcile air monitoring results with current PPE and SSP conditions.Consider worst case scenario. guidance. ......_._............._....__.._.__._._........__............_..... .—_.._........__._..__._._................_._....._-......_......_..............__.._.....__......_..........._...._._.._.._...........__......._..._. _. - Commence drilling borehole. Cross-contamination from previous hole. Decontaminate sampling equipment after collecting a sample and back strain,heat or cold,eye injury, decontaminate drilling augers/rods after drilling a borehole.Use exposure to chemical hazards,hitting an proper lifting techniques. Use PPE and monitoring in accordance underground utility, trip and fall, with SSP. Monitor drilling. Keep work area clear of tripping or catastrophic equipment failure,clothing slipping hazards. Perform periodic visual inspections of drill rig.. becoming entangled with the drilling Do not wear loose fitting clothes that can become entangled with equipment. the drilling equipment. Do not put your body near drilling ......___.............__._equipment while the equipment_is mo__in ----- ^— Collect samples in accordance Cross-contamination,improper labeling or Decontaminate sampling equipment between each sampling run. with sampling plan. storage. Label samples in accordance with sampling plan. Keep samples stored in proper containers,at correct temperature,and away from work area. _..._._.............._.................._....................._._.........._........................._....................._.................................._._........._......_....................._.._.................__._..._..................._.........._...........__...-.._........_......._................................_................_._........-.........._......._....-_-._........................-...--.........---..__..._....._......--- ............ Store cuttings properly in Exposure to public. Traffic hazard or Have proper storage containment and labeling available onsite. accordance with site-specific obstruction/inconvenience to station Place materials in isolated location away from traffic and other site re uirements. operation. Improper storage or disposal. functions. Coordinate proper disposal offsite(where applicable). 9._.........._. p . ................... Construct well. Back strain,eye injury,trip hazard. Cross- Use proper lifting techniques and PPE. Keep pathways from well contamination. Non-approved supplies to borehole clear of tripping hazards. Confirm construction. construction with project manager. Make sure casing and other materials are clean before going into borehole. Ensure presence or other authorization by any required inspectors for well i n s tal l ati on/g .rou t i..n......g. _......- --- . __-_.._...........____.- ---................._........-._._.._._..-- -._......._._._.-._........_...............-.............._.... ._.. —..__... _.._..._...._.._....I----..........._.................._...._.....----.......... ........_....... .. ... ... --- ---_� Install well vault. Back strain,eye injury,trip hazard, Use proper lifting technique and equipment to install well vault. particulate inhalation. Non-approved well Wear proper PPE(including steel-toed boots and eye protection). box installation. Complete well vault smooth to grade to eliminate trip hazard (if slightly elevated to prevent storm water intrusion,make sure to slope concrete skirt smoothly and gradually). .._....-._....-------....._.............._._._.......-...--.... ..._.-.._......_._.....-._.._..._......._..........__..............._...._...__.._...._._._._.....---.._.....__.........._.........._.....-......._..............................._......- ...........---....._.._.._.._........_._.............. - .....- Develop well Physical injury from mechanical failure. Make sure equipment is in good working order. Wear PPE in Trip hazard.Exposure to contaminants. accordance with SSP. Keep work area orderly.Decontaminate all Cross-contamination. equipment going into well. —_. . . Dispose or store purge water Back strain. Exposure to contaminants. If Use proper equipment to transport water(pumps,drum dollies, onsite disposing through onsite treatment system, etc.). Wear PPE in accordance with SSP. Review any instructions damage or injury from improper use of for use of onsite treatment systems. Label storage containers equipment. Improper storage or disposal. properly and locate in isolated area away from traffic and other site functions. Coordinate offsite disposal(where applicable). _.... ....... . ......._.......... ._.......... ._. Clean site/demobilize Traffic. Nuisance or safety hazard left on Use buddy system as necessary to remove traffic control. Leave site. site clean of refuse and debris. Clearly mark/barricade any well heads that need later work or concrete curing.Notify station personnel of departure,Map well locations,site structures,and location of drilling wastes. i:\admin\safety\jsa forms\jsa-monitoring well installation.doc j �E� �� 1 1 1 1 1^��1�� c�1lt• _ f- 17iz.�ft�iTwTtF�Ti1. F:\SAFETY\Safety and Health Manual (SHM)\SHM App A-LPS Forms\.ISA forms\JSA Boring-Well Installation.doc