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Geosyntec' DRAFT <br /> consultants <br /> TASK HAZARD ANALYSIS (Ver.2,June2015) <br /> Geosyntec HS Procedures referenced herein are available on Geosyntec's H&S <br /> SharePoint site and should be consulted,as appropriate,per project-specific needs.This TEHA prepared per HS-106-Accident Prevention Program,HS-204-Task Hazard Analysis,and <br /> meets the requirements for a"Site-Specific Health and Safety Plan"per Geosyntec HS Procedures and regulations referenced herein(see Section B.14.). <br /> PART A - SITE SAFETY PLAN <br /> A.1. PROJECT/TASK INFORMATION <br /> TASK: Surveying <br /> Project Name: Rough and Ready Island Groundwater Monitoring Plan Project Number/Org: WR2501 B <br /> Project Address: Rough and Ready Island,Port of Stockton,California <br /> Description of Task& Survey and mark historical coordianates for well locations <br /> Worksite: <br /> Geosyntec Personnel Name Desktop Office Phone Mobile Phone <br /> Site Lead/HS Officer Jennifer Martin 916-637-8346 916-205-6833 <br /> .................................................................................................................................................................................................................................................................................................................................................................................. <br /> Project Manager Nicole Gotberg 916-637-8347 916-798-7346 <br /> .................................................................................................................................................................................................................................................................................................................................................................................. <br /> Project Director Anju Wicke 510-285-2703 415-720-3320 <br /> .................................................................................................................................................................................................................................................................................................................................................................................. <br /> HS Coordinator Richard Hodges (916)637-8349 (916)945-1654 <br /> .................................................................................................................................................................................................................................................................................................................................................................................. <br /> HS Mngr. Dale Prokopchak 804-332-6376 804-349-8067 <br /> .................................................................................................................................................................................................................................................................................................................................................................................. <br /> Corp.HS Director Dale Prokopchak 804-332-6376 804-349-8067 <br /> Client Contact(s): <br /> Subcontractor(s): ❑ Not Applicable Z Applicable,provide contact information below: <br /> Marrow Surveying 1 916-372-8124 <br /> A.2. EMERGENCY RESPONSE Based on analysis of worksite factors,client/regulatory requirements,availability of emergency services. <br /> Consider all Relevant Risk Factors&Response Procedures(fire%xplosion,medical,chemicals/spills,security,site factors,weather,communications). <br /> EXPLANATORY NOTES,CLARIFICATIONS: <br /> Available Means of Jobsite Emergency Z Verbal Z Mobile Phone ❑Land Line ❑2-Way Radio ❑On-site alarm/signal <br /> Communication/Alerting system <br /> ❑Other: <br /> To Summon Emergency Services Z DIAL 911,for external responders ❑Other: <br /> Police,Fire,Ambulance <br /> Other Emergency Contacts,as needed N/A <br /> (such as security,spill responder,utility): <br /> Nearest Emergency Medical Services Hospital Name:St.Joseph's Medical Center <br /> ................................................................................................................................................................................................................... <br /> Address: 1800 North Carolina Street,Stockton,CA 95204 <br /> ................................................................................................................................................................................................................................................................................. <br /> Phone#:(209)943-2000 Z See Attached Directions <br /> For Non-Emergency Urgent Care Contact WorkCare at 888-449-7787 <br /> Job-site Evacuation Procedure, Safely leave Site/work area and meet at Valero gas station parking lot(1789 West Charter Way,Stockton,California) <br /> Rally Point,Place of refuge: and contact/locate all site workers/field staff. <br /> Special Emergency N/A <br /> Equipment/Procedures <br /> IMPORTANT:After initial emergency response actions and incident stabilization,contact appropriate project personnel listed in Part A.1. <br /> A.3. SUMMARY OF WORK STEPS, HAZARDS, CONTROLS Based on PART B,"HAZARD ANALYSIS," and worksite/client/project factors. <br /> Summary/outline of work steps/hazards/controls,with references to applicable Sections in Parts B and C,as applicable: <br /> WORK STEPS HAZARDS CONTROLS <br /> Drive to/from site Distracted driving,fatigue,getting lost, Figure out your route to/from site prior to driving, <br /> reckless/careless drivers on the road get rid of distractions(cell phones,loud music), <br /> stay alert and aware of surroundings <br /> Geosyntec° THA 1 —<Surveying> 12.10.2020 <br /> consultants <Rough and Ready Island WMWP,WR2501A> Pagel <br />