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ACTIVITY HAZARD ANALYSMUSPS VMF Fuel System Upgrade <br /> TY BY <br /> DATE PREPARED : 10/16/19 PREPARED BY: DANIEL MILLER „SAFE <br /> CHOICE>, <br /> OPERATION : ELECTRICAL CONDUIT SUBCONTRACTOR: WESTERN PUMP INC Foryourself, foryocar° <br /> family ;for your t` orkets9 <br /> STEP BY STEP PLAN : Access Identification Ergonomic risks <br /> 1 INSTALL CONDUIT _ Location Type Hand Injury Potential completestepsix X <br /> 2 _ 3972 Valley View Ave Lifting ❑ <br /> _.. <br /> 3 Yorba Linda, CA 92886 Repetitive Motion ❑ <br /> 4 <br /> Vibration ❑ <br /> 5 Awkward Position ❑ <br /> 6 HAND'.PROTECTION.PLAN Need for 3 Point Access X <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 /> EquipmentEl ❑ Cutting Goggles ElHot Work Permit <br /> Exposure to Falls ❑ ❑ Face Shield ❑ Air Space Permit <br /> Confined Space ❑ ❑ Leather/Keviar Chaps ❑ Confined Space Permit <br /> Traffic ❑ ❑ Respiratory Protection ❑ Designated Operator <br /> Trenching / ExcavationEl ❑ Toe/Foot Guards El Critical Lift Plan <br /> Lock-Out / Tag-out ❑ <br /> El El <br /> Plugs/Muffs ElLock Out Tag Out <br /> MSDS Attached ❑ ❑ Life Vest/PFD ❑ Prepared and reviewed by: <br /> UtilitiesEl ❑ Welding Hood El Welding 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 ❑ <br /> Adverse ElementsEl ❑ Impact w/ Knuckle Protect El <br /> Edge El ❑ Chemical ElSuperintendent Review Date: <br /> Other: El ❑ Leather (Heavy Duty) El <br /> Other: El ❑ Hi-Vis (Night/ Traffic Ops) ❑ <br /> Page 1 of 4 <br />