JOB HAZARD ANALYSIS WORKSHEET LTSL REV 000 – MAY 2018

L-TEC SYSTEMS LTD

(I) BASIC JOB INFORMATION
DATE: SITE: BRECHIN CASTLE SUB STATION JOB: RADIATOR PLINTH
LOCATION: Indoor □ Outdoor □ Both □
ADDRESS: POINT LISAS
TASK/ ACTIVITY: Demolish Plinths and Excavation & blockwork

(II) WORK SEQUENCE HAZARDS CONTROL MEASURES CONTROLS IN PLACE

*Step No. 1
Site survey and tool box meeting 1a, 1b, 1f, 1i, 1j, 5a, Safe footing, aware of surrounding Yes □ No □
*Step No. 2
Remove gravel and geo fabric 1a, 1b, 1f, 1i, 1j, 5a, 6a, 5b, 5c PPE, aware of surrounding, Yes □ No □
*Step No. 3 Safe lifting techniques, Equipment inspection, competen Yes □
Excavate material 8a, 8b, 6a, 3c, 3d No □
Operators. Ensure area is isolated
*Step No. 4 Jackhammer Plinth 8a, 8b, 8e, 8g, 7a PPE, restricted access to site Yes □ No □
*Step No. 5
Blockwork 1c, 1i, 2b, 5a, 5b, 5c, 5d, PPE, proper lifting techniques Yes □ No □
*Step No. 6
Yes □ No □
Proper
MSDS for all chemicals, properly labelled containers Yes □ No □
Materials Used
Proper Shovels, backhoe, cutting saw
Yes □ No □
Equipment Used
Planned By Block: Designation: MSA Block: Designation: Block: Designation: Block: Designation:
Signature: Signature: Signature: Signature:

GENERAL HAZARD GUIDE

1. Physical Environment 2. Gravity 4. Chemical 6. Electricity 8. Mechanical 9. Biological

a) Uneven ground
b) Open drains
c) Slippery conditions
d) Steep terrain
e) Over-grown vegetation
f) Protruding objects
g) Buildings/Structures
h) UV light
i) Poor housekeeping
j) Limited workspace
k) Poor ventilation
a) Falling from a height
b) Falling Objects
c) Falling Structures
d) Climbing obstructions
3. Kinetic/Vehicular
a) Fast/Slow moving traffic
b) Driving conditions
c) Moving loads
d) Vehicular stability
e) Unsecured loads
a) Confined spaces a) Live apparatus a) Equipment failure a) Dogs, bees, snake, etc.
b) Toxic or poisonous b) Induction/back feed b) Flying objects b) Hazard to pedestrians
c) Flammable or explosive c) Static charge c) Tension loads
d) Corrosive d) Ground gradients d) Moving parts 10. Other
e) Compressed gases/liquids e) Flash potential e) Sharp objects a) Hot objects
f) Caught in/between b) Poor illumination
5. Body Mechanics 7. Noise g) Struck by/against c) “Hot Spots”/Violence
a) Slips or Trips a) Chronic >85dB h) Trapped in d) Lacerations/Abrasions
b) Lifting /twisting strains b) Explosive e) Other utilities
c) Repetitive strains c) Distraction levels f) Heat/Cold Exposure
d) Excessive force/exertion
(IV) PERSONAL PROTECTIVE EQUIPMENT REQUIREMENTS
NA □ Head □ Face □ Hearing □ Respiratory □ Eyes □ Fall Protection □ Positioning Device □ Work Gloves □ Insulated Gloves □ Coveralls □

Feet □ Aprons □ Spats □ Reflective Vest □ Fire Retardant Clothing □ OTHER:……………………………………………………………………………………………………………

(V) TRAFFIC & PEDESTRIAN CONTROL REQUIREMENTS
NA □ Traffic Cones □ Flag Men □ Caution/ Danger Tape □ Cordon Off □ Barricades □ Road Signs □ Hazard Lights □ State Police □
OTHER:…………………………………………………………………………………………………………………………………………………………………………………
(VI) WORK PERMIT REQUIREMENTS
WORK PERMITS REQUIRED: Yes □ No □ PERMIT TYPE: Environmental Permit □ #…………….…………… Hot Work □ #………………………… Limitation of Access □ #………………….. ..

12kV PTW □ #……………………. …. Control PTW □ #……………………… ….Permit to Test □ #……………………….. . Statutory □ Police □ #.................................... Reg. Corp □ #........................................

OTHER □ #…………………...…………………………………..
(VII) GENERAL JOB REQUIREMENTS
 On Site Survey conducted? Yes □ No □  Worker(s) First Aid trained? Yes □ No □ NA □  Vehicles inspected and maintained? Yes □ No □ NA □

 Job Briefing conducted? Yes □ No □  Personal protective equipment inspected? Yes □ No □ NA □  Tools and/or Equipment for work inspected? Yes □ No □

 Workers HSE oriented? Yes □ No □  Fire Fighting Equipment readily available? Yes □ No □ NA □  Info on permits communicated? Yes □ No □ NA □

 First Aid Supplies readily available? Yes □ No □  Access and Egress identified and clear? Yes □ No □  Hazards communicated to MOP? Yes □ No □ NA □
(VIII) ADDITIONAL INFORMATION
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JHA CONDUCTED BY: (Block Letters) DESIGNATION: SIGNATURE: DATE:

SHELDON LAWRENCE SUPERVISOR TIME:

JHA DISCUSSED WITH: (Block & Signatures) 1. ………………………………………….. 2. ………………………………………….. 3. ………………………………………….. 4. …………………………………………..

5. ………………………………………….. 6. ………………………………………….. 7. ………………………………………….. 8. ………………………………………….. 9. ……………………………………………

Reviewed by Section Head after Job Completion:

Block: Signature: Date:
……………………………………………………………………………………………………………………………………………………………………………………………………………