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F. OTHER HAZARDS <br /> Heat Stress'? ❑ Yes ❑X No If yes, please specify precautions to be taken: <br /> Cold Stress? ❑ Yes FX No If yes, please specify precautions to be taken: <br /> Excessive Noise? IX Yes F—] NoIf yes, please specify precautions to be taken: <br /> Hearing protection; earplugs or hard covers <br /> Confined Space Entry? Yes X No If yes, attach copy of Confined Space Entry Permit. <br /> FX No If yes, specify precautions to be taken: <br /> Excavations 4' or greater in depth? ❑ Yes <br /> Soil borings only: 2" holes to 10+' <br /> Welding, Cutting &Brazing? F—] Yes FX No If yes, specify precautions to be taken: <br /> Yes No If yes, specify precautions to be taken: <br /> Heavy Equipment Operation? �X <br /> Geoprobe rig: Trained personnel only <br /> Slip, Trip or Fall Hazards? ❑X Yes ❑ No If yes, specify precautions to be taken: <br /> Cone over bore holes until filled <br /> Presence of Overhead Utilities <br /> Are overhead utilities present at the project site? FX Yes ❑ No <br /> *If so, always maintain suitable clearance from overhead lines. Reference manual section 12.' <br /> Specify location: Overhead utils 50+ feet from work area to east. <br /> Presence of Underground Utilities <br /> Have underground utilities been located and marked at the site? ❑X Yes ❑ No NA <br /> If yes, have the requirements of manual section 33 — Subsurface XD Yes F—] No <br /> Appendix 7-4 (Form HS 003) <br /> Page 4 of 12 <br /> Revised: 3/03 <br />