DN Tanks

Task/ Activity Hazard Analysis (THA/AHA)

Task/Activity Name: Aerial Lifts and Scissor Lifts Task/Activity Number: 9 Dept. Construction
Revision #: 2 Revision Date: 11/21/2016
Project Name: Overall Risk Assessment Code (RAC) (Use highest code)
Project Location: Risk Assessment Code (RAC) Matrix
Project Number: Probability
Severity
Contract Number: Frequent Likely Occasional Seldom Unlikely
Catastrophic E E H H M
Date Prepared: 12/5/2015 Critical E H H M L
Prepared by: Ron Toth
Marginal H M M L L
Date Reviewed: 11/21/2016
Negligible M L L L L
Reviewed by: Dan Wallace
Step1: Review each "Hazard" with identified safety "Controls" and determine RAC (See above)

Project Manager: "Probability" likelihood to cause an incident, near miss, or accident and
RAC Chart
Superintendent: Identified as: Frequent, Likely, Occasional, Seldom or Unlikely.
Foreman: "Severity" is the outcome/degree if an incident, near miss, or accident did E = Extremely High Risk

occur and identified as: Catastrophic, Critical, Marginal, or Negligible H = High Risk

Step 2: Identify the RAC (Probability Severity) as E, H, M, or L for each M = Moderate Risk
Description of Work: Use of Aerial Lifts and Scissor Lifts.
"Hazard" on THA/AHA Annotate the overall highest RAC at the top of THA/AHA L = Low Risk

Competent/Qualified Person Required for Programs Below*

Personal Protective Equipment, Aerial/Scissor Lifts, Fall *Must attach Training Documents if Required
APSP Programs:
Protection Task/Activity Qualified
Y ☒ N ☐ Name:
Person:
Hard Hat, Safety Glasses, High Viz. Garment, Signal Person: Y ☐ N ☒ Name:
PPE Required: Steel/Safety Toe Work Boots, Leather Gloves, Rubber
knit gloves, Full body harness, Lanyard or double SRL Fall Protection: Y ☒ N ☐ Name:

Diesel, Gas, Motor Oil, Hydraulic Oil, ABC Fire Crane: Y ☐ N ☒ Name:
Chemicals/SDS Used:
Extinguisher, Coolant fluid Aerial Lift: Y ☒ N ☐ Name:

Ladders: Y ☐ N ☒ Name:
First Aid/CPR
Power Industrial Trucks: Y ☐ N ☒ Name:
Certified Employees:
Rigger: Y ☐ N ☒ Name:
Task/Activity Name: Aerial Lifts and Scissor Lifts Task/Activity Number: 9 Dept. Construction
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List TASK/ACTIVITY Process in sequence
to be performed:*This list is separate from
the hazard list and the orders do not correlate
1. Delivery of equipment (initial
inspection, documentation, and
photos prior to use)
2. Train & certify employees to operate
each type of lift they will use prior to
use
3. Inspect work area that the lift will
operate in
4. Inspect Aerial Lift using Aerial Lift
Inspection Document
5. Inspect Scissor Lift using Scissor Lift
Inspection Document
6. Inspect Fall Protection equipment
and lift anchor point
7. Establish barricades if needed
8. Attach fall protection to lift using
proper approved anchor point
9. Perform Work
10. Proper storage and securing of lift
when not in use or at the end of the
shift
11. Removal of equipment (clean-up
equipment, inspection, and photos.
12. Load out equipment
DN Tanks
Task/ Activity Hazard Analysis (THA/AHA)
REGULATION
HAZARD HAZARD CONTROL RAC
NUMBER
 Inspect Aerial/Scissor Lift prior to use. This inspection must be documented
 Only trained, approved, and authorized Operators are allowed to operate
an Aerial Lift
 Always use the approved access and egress point on the Aerial/Scissor Lift.
Do not climb over the guardrail
Aerial Lift M
 The lift entrance shall always be closed and locked while machine is in use
 Never attach to an anchor point outside of the lift basket when in
operation or use
 Ensure all lift safety devices are working properly
 May need to erect a barricade to keep all nonessential person out of work area
 Never operate on sloped or unleveled surface outside of the lifts safe
operating range
 Only operate lift on inspected and stable ground
 Properly operate equipment and Do not exceed equipment capacity by
weight OR personnel. The weight of everything, include persons, tools,
material, etc… shall be knowing before operating the lift
Roll / Tip Over M
 The machines rated capacity shall be posted and never exceeded
 Inspect work area prior to use to ensure that it is free from severe holes,
ruts, bumps or any other hazardous condition
 All hazardous conditions in lift work area must be mitigated before
operating the lift
 Do not drive over any temporary holes or covers
 Ensure the basket is always clean and free of debris that may cause a slip
or fall
 Small loose parts and pieces will not be allowed to be on the lift floor
 Care shall be taken when entering and exiting the basket to ensure safe
entry and exit. Do not climb on guardrails
Slips, Trips, &  Do not jump down when exiting the Aerial Lift. If in an Aerial Lift, the
M
Falls basket shall be placed on the landing surface and the person is to step
down. If a Scissor Lift, the lift will be retracted and the lift ladder is to be
used.
 Cords, hoses, and tools shall not be left on the basket floor where a
tripping hazard can occur
 Roll cord or hose out neatly against the floor and toe board
Falls > 6’  All workers using an Aerial Lift / Scissor Lift must wear a Full Body Harness M
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 DN Tanks
Task/ Activity Hazard Analysis (THA/AHA)
with a Lanyard or double SRL connected to an approved anchor point
 Always use the approved anchorage points on the Aerial/Scissor Lift; never
tie off to the guardrail or handrail
 100% fall protection is required when in an Aerial/Scissor Lift no matter the
height or if in operation or not
 When transferring from or to an Aerial/Scissor Lift 100% tie-off is required
at all times within 6ft (1.83m) of leading edge or a sloped surface
 Anchorage points for tie-off shall be inspected prior to each use
 No worker is allowed to stand on guardrail, including the toe board or use
another means to increase elevation inside the Aerial /Scissor Lift basket
 Both feet need to be on the basket floor at all times while operating or
working from the lift
 Establish safe location for operating the Aerial/Scissor Lift
Limited view L
 Use a Signal Person if visibility is limited or obstructed when traveling the lift
 Never allow any person or a body part to be between the basket and a fixed
object
 Be aware of many pinch points when entering and exiting the basket
Pinch points  Never hold onto the lift guardrail while lift is moving. Doing so is a sever pinch L
point, use the handhold bar
 Only approved and trained mechanics shall be permitted to repair a Aerial
Lift
 Care shall be taken as to not raise the lift into an overhead obstruction
 Be aware of all persons in close proximity to this work area while moving
the aerial lift
 Always look at surroundings before moving the lift or basket in any direction
Overhead/  Never allow a person to be under a lift at any time; a proper barricade may
L
Crushing need to be erected
 Non-essential personnel shall remain outside of lift work area where the
Aerial Lift is moving
 All material shall be secured inside Aerial Lift / Scissor Lift basket to
prevent the material from falling out of the lift or onto any person
 An appropriate 2 1/2 lbs. (1.14kg) ABC fire extinguisher will be readily
available within 50 feet (15.24m) of lift base unit
Fire L
 No open flames or potential sparks when refueling the equipment
 No flammable or combustible fuels will be allowed in a Confined Space
Spills  Proper maintenance of equipment is essential to avoid any spills L
 Do not use a piece of equipment that has a leak
 Always have a plan on how to contain and clean any leak or spill that may
occur

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 DN Tanks
Task/ Activity Hazard Analysis (THA/AHA)
 Have a spill kit available
 Have spill response people trained and pre designated at the start of each
job
 Stay at least 20' (6.1m) from all electrical lines. If closer encroachment is
needed, special precautions and plans must be established with project
manager and Safety Director
 Never use metal to attach an electrical tool to the equipment
Electrical  Only GFCI protected tools and cords can be used L
 Operators shall be trained in how to charge and care for a battery on the
lift if an electric lift
 Operators shall be trained in how to charge and care for a battery on an
Aerial Lift
 Regardless of the temperature all employees must properly hydrate and
Heat stress cool down as necessary L
 Follow Heat Illness Prevention Program
 All workers must wear Hearing Protection when exposed to noises over 85
Noise L
decibels
 Inspect the equipment when it arrives
 Never try to do repairs unless you are qualified
Pressurized
 Stay clear of hydraulic fluids. If injected, seek medical attention L
Lines immediately.
 Have SDS sheet for hydraulic fluid immediately
 When operating a lift that has an internal combustion engine, you must
make sure that the exhaust cannot contaminate any persons breathing air
Atmosphere L
 Internal combustion engines are not allowed in a Confined Space without
written approval from the Safety Director

Training Requirements/Competent
Tools Required: Equipment to be Used: Inspection Requirements:
or Qualified Personnel
 Aerial/Scissor Lift:
 Aerial/Scissor Lift:
 Aerial/Scissor Lift Documented
Documented
 Fall Protection  Fall Protection:
 Fall Protection: Documented
Visual/Documented

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 DN Tanks
Task/ Activity Hazard Analysis (THA/AHA)
Task/Activity Name: Aerial Lifts and Scissor Lifts Task/Activity Number: 9 Dept. Construction

By signing below, each employee acknowledges that they have reviewed this complete Task/Activity Hazard Analysis.
Employee Name (Please print) Employee Signature Date Reviewed

Supervisor that provided this THA/AHA Training to the above Employee(s):

Supervisor Name Supervisor Signature Date Reviewed

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