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® Stantec Field Level Risk Assessment (RMS2) <br /> Seven (7) Day <br /> This form is intended for projects of up to 7 consecutive days on one site. If work will last longer than the days provided on <br /> this form, please start a new RMS2 to refresh hazard awareness. <br /> Project Number: 185706245 Date: u I ii/_u/_s <br /> Project Name: Supplemental Site Investigation <br /> Project Location: South Nolnte bite, Stockton, GF. <br /> Description of Work: Oversee On Target Precision Locating in clearing boreholes for utilities or other obstructions. Oversee <br /> Cascade in advancing 43 boreholes to 12 ft bgs for collection of soil and/or grab groundwater samples. <br /> Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 <br /> HASP/RMS1 reviewed with staff on Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> site <br /> Review of STOP Work Authority Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> with staff&subs <br /> Emergency plan adequate and Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> communicated <br /> Tools and appropriate PPE Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> inspected before use <br /> Last Minute Risk Assessment <br /> process reviewed Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> If the answer to any of the questions above is not"Yes"Stop work and contact your supervisor. <br /> Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 <br /> Field crews have certifications on Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> site N/A❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ <br /> Utility locates on site and Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> understood N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ <br /> Yes 1:1 Yes El Yes El Yes El Yes El Yes El Yes ElWorking alone plan in place N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A❑ N/A ❑ N/A ❑ <br /> Work permits completed Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> N/A❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ <br /> Client site safety meeting Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> conducted/attended N/A❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ <br /> Are there additional critical risks, <br /> JSA tasks or energy hazards? If Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> yes, update the JSA and N/A❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ <br /> communicate to the team <br /> • • • • • • • • ASSESSMENT RISK +)STOPANDTHINK <br /> (LIVIR•-. • -• • • - • • • •. • _ Q LOOK AROUND <br /> •• • • IkItw(1the work area safe? <br /> Will Zwprk endanger pher$7 <br /> h)a <br /> t:o <br /> -� WI[pfher pftpk-Jlasrq Calle h*ZWM? <br /> • iii • i • ®ASSESS RISK <br /> Do Garry undo 1-1 the Wak? <br /> • wl[likhngormanuall ndllrrgbe qured7 <br /> Potennalt.slps,try',or falls? <br /> • • • •. • • • • • • • Are[heredrinngor%vlw a conoerfe. <br /> FFave mneidered arlundergrounds lon? <br /> • • • • •• •' • M-ngoor pressurized equlpmem? <br /> gowrong? <br /> •• • . • <br /> CO N 7RDL R IS K <br /> What can I do to oontrol beta W- <br /> DoI here t1w right lod4+. <br /> .•. • • •• Are you ready to work safely? Is the SSVP(Sare work Praclice)aopropnar� <br /> Always rernemberyour Do l here ttea°p wiate PPE? <br /> Stop Work Authority. RWMMenCy prong in plNe? <br /> � �• <br /> ••. • • •. 0BE61NfRESUMEWORK <br /> I(3 Stantee 11y re gnsuri• Ik;oro rsum— <br /> Last Updated:April 2021 Document Owner:HSSE <br /> Printed copy uncontrolled—current version on The Lens Page 1 of 7 <br />