Laserfiche WebLink
_ ACTIVITYHAZARDY Fuel System Upgrade <br /> DATE PREPARED : 10-16/19 PREPARED BY: DANIEL MILLER "SAFETY <br /> CHOICE` <br /> OPERATION : CONFINED SPACE SUBCONTRACTOR: WESTERN PUMP INC Foryourself, foryour <br /> family, foryourCo-workers <br /> STEP BY STEP PLAN : Access Identification Ergonomic risks <br /> 1 CHECK AIR QUALITY Location Type Hand Injury Potential complete stepsix ❑ <br /> 2 APOINT HOLE WATCH 3972 Valley View Ave. Lifting ❑ <br /> 3 CONDUCT WORK Yorba Linda, CA 92886 Repetitive Motion ❑ <br /> 4 DOCUMENTATION Vibration ❑ <br /> 5 RETRIVAL METHOD Awkward Position ❑ <br /> 6 HAND: PROTECTION PLAN Need for 3 Point Access ❑ <br /> Strategic Risks Evident Risk Needs Special Unique PPE Required Permit Requirements <br /> Planning Permit Type Need/ NA Incl./ NA <br /> Body Harness ❑ Dig permit <br /> Equipment X ❑ Cutting GogglesElHot Work Permit <br /> Exposure to Falls El ❑ Face Shield 1:1 Air Space Permit <br /> Confined Space X ❑ Leather/Kevlar Chaps ❑ Confined Space Permit <br /> Traffic1:1 ❑ Respiratory Protection El Designated Operator <br /> Trenching / Excavation ❑ ❑ Toe/Foot Guards ❑ Critical Lift Plan <br /> Lock-Out / Tag-out ❑ ❑ Ear Plugs/Muffs ❑ Lock Out Tag Out F-1 771 77 <br /> ON <br /> MSDS Attached ❑ ❑ Life Vest/PFD ❑ Prepared and reviewed by: <br /> Utilities ❑ ❑ Welding Hood ❑ Foreman: Date: <br /> Electrical ❑ ❑ Welding Leathers <br /> Travelling PublicEl ❑ Hand Protection Engineering <br /> On the Spot Lift Plan ❑ ❑ Train on the Risk ❑ <br /> Steel Erection ❑ ❑ Right Tool for the Job ❑ <br /> Night Work ❑ ❑ Train on Hand Placement ❑ <br /> Falsework / Shoring ❑ ❑ Issue the Gloves El <br /> Adverse Elements ❑ ❑ Impact w/ Knuckle Protect ❑ <br /> Leading Edge ❑ ❑ Chemical ❑ Superintendent Review Date: <br /> Other: ❑ ❑ Leather (Heavy Duty) ❑ Signature <br /> Other: El ❑ Hi-Vis (Night/ Traffic Ops) ❑ <br /> Page 1 of 5 <br />