JOB SAFETY & ENVIRONMENTAL ANALYSIS S t o p t h e j o b a n y t i m e a n y o n e i s c o n c e r n e d a b o u t s a f e t y . S t o p t h e j o b i f a n y o n e i d e n t i f i e s a h a z a r d n o t r e c o r d e d o n t h e J S E A . B e a l e r t t o a n y c h a n g e s i n p e r s o n n e l , c o n d i t i o n s a t t h e w o r k s i t e , o r h a z a r d s n o t c o v e r e d b y t h e o r i g i n a l J S E A . I f i t i s n e c e s s a r y S T O P T H E J O B , r e a s s e s s t h e t a s k a n d h a z a r d s , a n d a m e n d t h e J S E A a s n e e d e d . Rev. 10/14/08 tDate Completed: Shift: First Person Completing Form: Carl Snelling Project Name & Site Location: Red River/31 7 & SF D r Job/Task Description: Cut Turn Radius Concurrent or Multi-Crew Activity(ies): Yes No Description: Permits Required None Confined Space Critical Lift Energy Isolation (LOTO) Excavation Hot Work Other Permit(s) Required: EMERGENCY RESPONSE Emergency contacts Name(s) & Contact Number(s) Equipment/Job location GPS coordinates, site location or directions for emergency response Describe Muster Point Site H&S Manager Bill Thorn Project Manager Colm McPHearson Law Enforcement Medical Responders Fire Department Josh Harris -- 318 -6314 Hazardous Spill Response Janice Goodyear – 318 -9748 Intersection of County Road 31 7 & Sunflower Drive Lay-down yard Equipment (crane, forklift, etc.) Model / Serial / ID#: Operator Limitations (e.g., Max. Wind Speed, weight, etc.) Dozer 785769 Ronaldo Jenks None Dump Truck Ford Luis Alverado None Dump Truck Ford Vlad Wosjewski None J O B H A Z A R D S - C O N V E R S A T I O N P O I N T S C h e c k a l l t h a t a p p l y and give details as needed in the J o b S e q u e n c e / H a z a r d s / M i t i g a t i o n Section on page 2 W o r k A r e a H a z a r d s E n e r g y I s o l a t i o n – L O T O / W o r k i n g a t H e i g h t s ( c o n t ’ d . ) Confined space concerns LOTO training verified Scaffolding shift inspection complete Moving equipment or vehicles Walkthrough & discussion of LOTO Area cordoned off below work Lighting levels too high/low Blocked in & locked out (verification) Rescue personnel & procedures in place Extreme heat or cold Breaker open and locked Other: Severe weather (snow, ice t-storms) Mechanical energy released H o t W o r k / W e l d i n g / Excessive wind Assured grounding Fire extinguisher / equip at job location? Wet, slippery, or muddy ground Trapped dead legs of pressure Fire watch Ignition sources / static / grounding Risk of trapped/non-isolated Energy Combustibles / LEL below work area Other: Other: Fire blanket T a s k H a z a r d s D r i v i n g / M o t o r i z e d E q u i p m e n t / Ground rod for welding machine Ergonomic concerns (bending, lifting, etc.) Seat belts used at all times Ground lead as close to weld as possible Potential for slips trips and falls Condition of road or route Hot work near flammable sources Caught between hazards Spotter / safety watch required Other: Hand tool inspection Unattended operation E x c a v a t i o n s / T r e n c h i n g / Fire hazards Vehicle inspection Utility locate performed Others working overhead / below All loads secured Lines located/ marked/drawings reviewed Other jobs in area / area cordoned off Other: Confined Space concerns Other: H e a v y E q u i p m e n t / C r a n e s / Approved shoring on hand P e r s o n a l P r o t e c t i v e E q u i p m e n t Permit required (critical lift, etc.) Proper sloping Hard hat, safety glasses, safety-toed boots, hi-visibility clothing/vest Current Operator certification on file Area / Trench roped off (barricades) Face shield, goggles Equipment Daily Inspections done Proper egress provided Hearing protection Equipment swing radius clear Competent Person review Gloves (rubber/leather/cotton) Positioning and outrigger location addressed Other: Respiratory Protection (SCBA or APR) Overhead power lines, utilities etc. E l e c t r i c a l S a f e t y / Eyewash Station location identified Air horn or other communication Grounding and Bonding required Other: Signal man / spotter GFCI for electric power tools E m e r g e n c y a n d C o m m u n i c a t i o n Pinch locations Ensure safe distance is maintained while performing inspection of energized equipment No cell phones/PDAs/Pagers while driving Soft, hard, muddy, wet, sloped ground Other: Emergency action plan reviewed Area cordoned off Other: Other: P e r s o n n e l C o n c e r n s W o r k i n g a t H e i g h t s / New employees / Inexperienced workers Man lift inspected Workers Fit For Duty (medications, sleep, physical limitations, distractions, etc.) Fall protection plan reviewed (competent person) Language barriers addressed Proper tie-off points identified Other: Full body harness and lanyard / lifeline E n v i r o n m e n t a l I s s u e s Fall protection equipment inspected Spill mitigation or containment Ladder Safety addressed MSDS review Walking/working surfaces (wet, slippery, icy) Other: Scaffolding weight capacity identified Co Rd 317 – rough condition, soft shoulders Co Rd 317 – heavy traffic flow