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DATE <br /> Delineate exclusion zone <br /> Check subcontractor PPE- <br /> Hard hat <br /> Safety glasses(with side shields) <br /> Hearing protection <br /> Safety vest <br /> Work gloves <br /> Sampling gloves <br /> Protective coveralls(specify,Tyvek, Nomex,etc.) <br /> Safety boots <br /> Respirator <br /> Subcontractors- <br /> Subcontractor has own HASP or field SOPs on-site(when required) <br /> Confirm sub. equipment(e.g., drill rig,ext. cords)is in sound working condition <br /> Drilling subcontractor:drill rig kill switch identified, located and tested <br /> Overhead hazards identified and addressed <br /> On-Site Work <br /> Proper PPE worn by site workers <br /> Breathing zone monitoring performed and recorded <br /> (Specify any new hazards identified on-site not addressed by site HASP. If new hazard cannot be mitigated by the existing scope-of- <br /> work and/or available equipment on-site, stop work and immediately contact the site project manager.) <br /> (Sign and date at the end of the field work.) <br /> Name: <br /> Signature: <br /> Date: <br /> REPORT ALL INCIDENTS AND NEAR MISSES IMMEDIATELY <br />