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CG ICS SITE 1.Incident Name 2.Date/Time Prepared 3. Operational Period 4. Safety Officer(include method of <br /> SAFETY PLAN(SSP) contact) <br /> HAZARD <br /> ID/EVAL/CONTROL <br /> 5. Supervisor/Leader 6.Location and Size of Site 7. Site Accessibility 8.For Emergencies Contact: 9.Attachments:Attach MSDS for each <br /> Land❑Water❑Air❑ Chemical <br /> Comments: <br /> 10.a. 10.b. 10.c.Potential Injury&Health 10.d. Exposure 10.e. <br /> Job Task/Activity Hazards* � Effects Routes Controls:Engineering,Administrative,PPE <br /> Inhalation ❑ <br /> Absorption❑ <br /> Ingestion ❑ <br /> Injection ❑ <br /> Membrane ❑ <br /> Inhalation ❑ <br /> Absorption❑ <br /> Ingestion ❑ <br /> Injection ❑ <br /> Membrane ❑ <br /> El <br /> Inhalation ❑ <br /> Absorption ❑ <br /> Ingestion ❑ <br /> Injection ❑ <br /> Membrane ❑ <br /> Inhalation ❑ <br /> Absorption❑ <br /> Ingestion ❑ <br /> Injection ❑ <br /> Membrane ❑ <br /> El <br /> Inhalation ❑ <br /> Absorption❑ <br /> Ingestion ❑ <br /> Injection ❑ <br /> Membrane ❑ <br /> 11.Prepared By: 12.Date/Time Briefed: *HAZARD LIST: Physical/Safety,Toxic,Explosion/Fire,Oxygen Deficiency, ICS-208-CG SSP_ <br /> Ionizing Radiation, Biological,Biomedical,Electrical,Heat Stress,Cold Stress, B (rev 9/06): <br /> Ergonomic,Noise,Cancer,Dermatitis,Drowning,Fatigue,Vehicle,&Diving <br /> Pae of <br />