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II. Health and Safety Evaluation <br /> A. Hazard Assessment <br /> 1. Bac}uground Review: Complete ( ) Partial ( } If partial, why? <br /> 2. Activities Covered Under this Plan <br /> No. TasVSubtask Description Schedule <br /> 0001 <br /> 3. 'lopes of Hazards: (Place a Y/N in each ( ) to indicate presence/absence of hazard) <br /> a. PhysioChemical Flammable (N ) Explosive (,)) Corrosive (N) Reactive <br /> (�} } 02 Rich ()K) 02 Deficient [1]* <br /> Chemically Toxic ( Y ) Inhal. { Y) Ingest. Cont. ( Y) Absorb. <br /> {� ) Carcin. (,v) Mutagen (rv) Terat. <br /> OSHA 1910.1000 Substance <br /> (�1) OSHA Specific Hazard. Sub. Standard, Describe <br /> b. Biological Etiol. Agent Other - Plant,insect, animal, [2]* <br /> c. Radiation Ionizing - (�1 ) Internal lure *) External exposure [3]* <br /> Non-ionizing - (�) UV; (,U ) IR; (,u } RF; {rU ) MicroW; LASER <br /> d. Physical Hazards (Y } [4]* e. Construction Activities (tj ) [5]* <br /> * The ra_unber in the [ ] refers to one of the: following hazard evaluation forms. <br /> Cmplete hazard evaluation forms for each appropriate Hazard Class. <br /> B. Scarce/Location of Contaminants and Hazardous Substances <br /> 1. Directly Related to Tasks <br /> ( } Air Soil ; <br /> { ) Other Surface ( ) S. Wates ; <br /> ( ) G. Water ( ) other <br /> 2. Trriirectly Related to Work - Nearby Process(s) which could affect team members: <br /> ( ) Client Facility; ( ) Nearby Non-client Facility. Describe A1012c <br /> ( ) Client briefing arranged. <br />