APPENDIX A Activity Hazard Analysis

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APPENDIX A Activity Hazard Analysis Note: Activity Hazard Analysis will be prepared and inserted prior to the start of work APPENDIX B Forms Risk Mitigation Two-Week Look-Ahead form Safety plan for week ending: Project/ Location: Plan Prepared by: Next Two Weeks Scope of work : Contractor: Meeting date: Dated: Identified Risks/Exposures/ hazards : Control Measures: Additional Activity hazards Analysis Required: Subcontractors Mobilizing/Demobilizing: Audit/Inspections Scheduled: Competent Person Changes:Planned Orientation/Training : Recommendations/Comments/Concerns: Note: This information should be incorporated into the meeting minutes. __________________ _________________________________ __________________________ ________________________________________ ________________________________ ______ _______________________ ________________________________________ ________________________________ ______ ________________________________________ __________ ________________________________________ ________________________________ ______ ________________________

Face Shield Vehicular Traffic or Traffic Barricades Cones Signs Flagmen Lane closure Chemical Goggles Heavy Equipment Communication with equipment operator ... Rubber Boots Extension cords properly secured Work zone free of debris ... Health and Safety Site Inspection Form Inspector: Inspection Date: Section 1: Project Description Project Name:

  Form, Analysis, Activity, Inspection, Traffic, Work, Zones, Inspection form, Hazards, Activity hazard analysis, Work zone