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Climb ladders to heights>10' Function as a construction"Competent Person" Sustained exposure to wildfire smoke AQIPM 2.5>150 <br /> Tow a trailer on roadway Operate a pneumatic or powder-actuated tool Enter EZ/CRZ during HAMPER cleanup activities <br /> Oversee a hot-work permit system Electrical testing&maintenance(<50 V excluded) Exposure to radioactive isotopes(a,13,y) <br /> Enter a permit-required confined space Work at height near overhead electrical utility lines Onsite risk of emergency chemical spill <br /> Operate a UTV/ATV,aerial lift or fork-lift Derive action levels for VOCs or toxic dusts Applicability of Chemical Anti-Terrorism Standards <br /> Use of unmanned aerial vehicle(drone) <br /> Corporate H&S must also be consulted when Geosyntec subcontractors(under Geosyntec's oversight)perform high hazard/high risk work(such as demolition,blasting,crane lifts, <br /> confined space entry,testing/maintenance of electrical systems,Iockoutltagout,HAZWOPER cleanup activities),OR when supplemental written H&S programs are required for a project <br /> (such as Electrical Safety Program,Lockout Program,Confined Space Entry Program,Emergency Response Plan),OR when a written safety plan must be submitted to a public agency. <br /> Consultation with Corp.H&S is encouraged for all questions/concems regarding worker safety,regulatory compliance,risklliability aspects,or project-specific safety requirements. <br /> Geosyntec H&S Procedure:For more information,see HS-204-Work-Specific Hazard and Risk Assessment,Written Safety Plans. <br /> F.2. GEOSYNTEC FIELD CREW ACKNOWLEDGEMENTS <br /> Please sign below to acknowledge you reviewed and understand this THA,participated in project safety briefing and had an opportunity to ask questions about the information herein. <br /> Printed Name Signature Employee No. Date <br /> SUBCONTRACTOR'S FIELD CREW ACKNOWLEDGEMENTS ā¯‘Applicable Not Applicable <br /> Please sign below to acknowledge this THA was made available to you,and you had an opportunity to ask questions about the information herein. <br /> Printed Name Signature Company Name Date <br /> Geosyntec c T sk Name: <br /> HA Date: <br /> Page 14 <br /> consultants <br />