Blm Risk Management Worksheet

Form 1112-5 UNITED STATES (May 2001) DEPARTMENT OF THE INTERIOR BUREAU OF LAND MANAGEMENT RISK MANAGEMENT WORKSHEET

1. Organization and Location Billings Field Office 2. Page __1____of___3___ 3. Operation / Task 4. Beginning Date: 5. Ending Date: 6. Date Prepared Review RMA prior to each Ongoing January 19, 2005 Field Operations field project

7. Prepared by (Name / Duty Position) Nancy Bjelland, Billings Field Office CDSO

8. Identified Hazards 9. Assess the 10. Control Measures Developed for Identified 11. Assess the 12. How to Implement the 13. Supervisors and Evaluation Hazards: Initial Hazards: (Specific measures taken to reduce Hazard’s Controls: (May Be Filled in by: (Continuous Leader Checks, Risk the probability of a hazard) Residual Risk: By Hand) Buddy System, etc.) (Be Specific) L M H E (Be Specific) L M H E (Be Specific) (Be Specific) Slipping, tripping or falling on rocky or Be aware of conditions. Wear lug soled Tailgate sessions, Supv, CDSO uneven terrain. boots with good ankle support. Walk, don’t reminders prior to field run. Side step down hill. Carry hand tools season. on downhill side.

Snakes, insect bites, encounters with Walk slowly through brush. Be aware of wild animals and poisonous plants Training on poisonous Supv, CDSO, Buddy System surroundings. Wear long sleeved shirt, long plants and animal pants, leather boots. Avoid scented encounters. Seasonal lotions. Know your plants. Carry reminders. medication if allergies exists. Be bear aware and know how to react if encountered by bears or other wild animals.

14. Remaining Risk Level After Control Measures Are LOW MEDIUM HIGH EXTREMELY HIGH Implemented: (CIRCLE HIGHEST REMAINING RISK LEVEL) (Line Supervisor) (Branch Chief) (District Manager (Must be State Director/Associate) 15. RISK DECISION AUTHORITY: (Approval/Authority Signature Block) (If Initial Risk Level is Medium, High or Extremely High, Brief Risk Decision Authority at that level on Controls and Control Measures used to reduce risks) (Note: if the person preparing the form signs this block, the signature indicates only that the appropriate risk decision authority was notified of the intial risk level, control measures taken and appropriate resources requested; and that the risk was accepted by the decision authority.)

______(Signature)

CONTINUED 8. Identified Hazards 9. Assess the 10. Control Measures Developed for 11. Assess 12. How to Implement the 13. Supervisors and Evaluation Hazards: Initial Identified Hazards: (Specific measures taken the Hazard’s Controls: (May Be Filled in by: (Continuous Leader Checks, Risk to reduce the probability of a hazard) Residual Risk: By Hand) Buddy System, etc.) (Be Specific) L M H E (Be Specific) L M H E (Be Specific) (Be Specific) Unsafe tool use Make sure handles on tools are in good Use tools for purpose Supv, Project Lead, Buddy condition prior to use. If handles are intended. Wear PPE. System cracked, broke or have mushroom Proper training prior to heads, dispose of or repair prior to use. use. Keep axes and other cutting tools sharp. Chop away from body. Wear gloves, boots. Wear goggles to prevent eye injury.

Use of power tools could cause Wear long sleeved shirt, long pants, Same Same personal injury or create a fire gloves and boots. Obtain proper training hazard. for specific tool use. Make sure tool edges are sharp. Use proper guards. Keep fire extinguisher equipment and first aid kit nearby.

Cuts, scrapes and splinters from Use gloves, long sleeved shirt, long Same Same fencing materials. pants, and boots. Keep first aid kit close by.

Sprains, strains from lifting loads, Use proper lifting techniques. Avoid Same Same swinging tools, etc. twisting when swinging tools. Wear boots when digging with spade or post hose diggers. Use legs not back to lift and carry tools or supplies to work site. Weather related illness or injury. Extreme heat or cold Wear clothing suited to weather. Carry and drink plenty of water. Know signs of heat stroke, heat exhaustion, frostbite, Check weather forecast Same hypothermia and know how to treat. prior to going to the field. Take first aid Lightning or thunderstorms. Watch for approaching storms. Get to courses as required. 2 CONTINUED 8. Identified Hazards 9. Assess the 10. Control Measures Developed for 11. Assess 12. How to Implement the 13. Supervisors and Evaluation Hazards: Initial Identified Hazards: (Specific measures taken the Hazard’s Controls: (May Be Filled in by: (Continuous Leader Checks, Risk to reduce the probability of a hazard) Residual Risk: By Hand) Buddy System, etc.) (Be Specific) L M H E (Be Specific) L M H E (Be Specific) (Be Specific) vehicle if possible. Stay away from trees, metal objects and high ground. Be aware of possible flash flooding.

Compliance/LE efforts could result Do not engage in confrontation. Walk Review established Same in confrontations with verbal and/or away. Use radio or cell phone communications abusive public. communication to contact Law protocol prior to each Enforcement if needed. Notify field season. supervisor immediately.