Wrps Job Hazard Analysis Checklist

WRPS JOB HAZARD ANALYSIS CHECKLIST

Prepared By (print first and last name) (Signature) (Date) Work Package: Procedure No.: **Standing JHA No.:

Work Scope/Description: Specific Work Location(s): Specific Hazard Analysis and Safety Work Requirements Known and/or Potential hazards have been evaluated at the task level with applicable tasks, non-skill based controls and method of control implementation is identified below. The GHA shall be reviewed for additional skill based controls relating to the hazards identified, and implemented by the FWS and work team as applicable. Approvals:

Field Work Supervisor Industrial Safety Rep. (print/sign/date) Other (print/sign/date) (print/sign/date)

Other (print/sign/date) Other (print/sign/date) Other (print/sign/date) Activity/Task Hazard Analysis Yes No Method* Method* 1. Chemical Use Emergency shower identified and IH Sample Plan #: If Yes, IH concurrence required available Eye wash station Respiratory Protection Form List Non-GHA Chemicals MSDS/SDS# used. (identified/available) (Site Form A-6005-593) Portable eyewash w/drench hose

(Number of units required for work Dermal PPE activity): Chemical Boots Ventilation Chemical Gloves Chemical Goggles Additional/Other Controls: Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* Emergency shower identified and Pipe / Vessel purged, drained, 2. Potential Contact with Tank Waste available flushed Portable eyewash w/drench hose Pipe / Vessel breach point If yes, IH concurrence required. (Number of units required for work containment activity): Pipe / Vessel depressurized Chemical Gloves Pipe / Vessel isolated Dermal PPE Additional/Other Controls: Task:

Yes No Method* Method* Emergency shower identified and Pipe / Vessel breach point 3. Potential Contact with Process Chemicals available containment Eye wash station Respiratory Protection Form

If yes, IH concurrence required. (identified/available) (Site Form A-6005-593) Portable eyewash w/drench hose Pipe / Vessel purged, drained, (Number of units required for work flushed activity): Chemical Boots Pipe / Vessel depressurized Chemical Gloves Pipe / Vessel isolated Chemical Goggles Ventilation IH Sample Plan #: Dermal PPE Additional/Other Controls:

JHA completion instructions located on the JHA website. *Method: 1-Precaution/Limitation/Prerequisite. 2-WARNING/CAUTION. 3-Work/Procedure Instruction. 4-Permit/Plan/Evaluation **Method of implementation not applicable for Standing JHAs – Standing JHAs are used as supporting work documents. Page 1 A-6004-101 (REV 23) WRPS JOB HAZARD ANALYSIS CHECKLIST (Continued)

Work Package: Procedure No.: Standing JHA No.:

Task: See GHA for Skill Based Hazard Controls Yes No RAD Risk Screening and development of appropriate controls are performed in accordance with: 4. Radiological TFC-OPS-MAINT-C-01 and TFC-ESHQ-RP-RWP-C-03 Yes No Method* Method* 5. Tank Farm Vapors Tank Vapors Information Sheet Respiratory Protection Form

If yes, IH concurrence required. (TVIS) # (Site Form A-6005-593) IH Sample Plan# Similar Exposure Group Additional/Other Controls: Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* 6. Beryllium(BCA/BRA) Beryllium Work Permit IH Sample Plan # If yes, IH concurrence required. (Site Form A-6006-202) Additional/Other Controls: Task:

Yes No Method* Method* 7. Asbestos Asbestos Work Permit IH Sample Plan # If yes, IH concurrence required. (Site Form A-6003-870) Additional/Other Controls: Task:

Yes No Method* Method* 8. Lead Lead Compliance Plan IH Sample Plan # If yes, IH concurrence required. Additional/Other Controls: Task:

Yes No Method* 9. Electrical EEWP EHE

Additional/Other Controls: See GHA for Skill Based Hazard Controls Task:

Yes No Method* Method* Confined Space Hazard 10. Confined Space Hazard Non-Permit Confined Space Identification If yes, IH concurrence required. Controls: (Site Form A-6005-724) Confined Space Entry Permit IH Sample Plan # (Site Form A-6005-717) Additional/Other Controls: Task:

Yes No Method* 11. Rotating/Moving Block parts against motion Equipment or Pinch Additional/Other Controls: Points Task:

See GHA for Skill Based Hazard Controls Yes No Method* Method* 12. Noise >85 dBA Noise Barrier Hearing Protection Boundary If yes, IH concurrence required. Hearing Protection Specify: IH Sample Plan #

Additional/Other Controls: Task:

Yes No Method* Method*

JHA completion instructions located on the JHA website. *Method: 1-Precaution/Limitation/Prerequisite. 2-WARNING/CAUTION. 3-Work/Procedure Instruction. 4-Permit/Plan/Evaluation **Method of implementation not applicable for Standing JHAs – Standing JHAs are used as supporting work documents. Page 2 A-6004-101 (REV 23) WRPS JOB HAZARD ANALYSIS CHECKLIST (Continued)

Work Package: Procedure No.: Standing JHA No.:

13. Crane or Other Lifting Special Lift Critical Lift Equipment Lifting and Utilities Notification EU notification Rigging Objects Additional/Other Controls:

Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* 14. Vehicular Traffic, Lane Closure Equipment and/or Forklift Additional/Other Controls:

Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* 15. Elevating Work Platforms Lane Closure Cones Fall Protection Work Permit Signs (Site Form A-6004-286) Traffic Barricades Additional/Other Controls: Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* 16. Overhead Utilities De-energizing req. Insulation blankets req. Wire watch req. Req. clearance distance Safe work zone marked Electrical Utilities Notification Additional/Other Controls: Task:

Yes No Method* Method* Fall Protection Work Permit (Site 17. Falls/Roof Work Engineering Evaluation Form A-6004-286) Fall Protection Equipment

Pre-Use Inspection Additional/Other Controls: Task:

Yes No Method* Method* 18. Scaffolding Fall Protection Work Permit

(Site Form A-6004-286) Additional/Other Controls: Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* Barricade around potential fall 19. Moving/Falling Objects Warning Signs from Height area Additional/Other Controls: See GHA for Skill Based Task: Hazard Controls Yes No Method* Method* Site Excavation Permit 20. Excavations, Trenching, Ground Scans Shoring, and Soil (Site Form A-7400-373) Contamination Barricades Additional/Other Controls: Task:

Yes No Method* Method* 21. Underground Utilities Ground Scan Voltage rated gloves (Line Locating) Insulated hand tools Maintain clearance distance Safe work zone marked Site Excavation Permit

Underground Electrical Utilities (Site Form A-7400-373) Additional/Other Controls:

JHA completion instructions located on the JHA website. *Method: 1-Precaution/Limitation/Prerequisite. 2-WARNING/CAUTION. 3-Work/Procedure Instruction. 4-Permit/Plan/Evaluation **Method of implementation not applicable for Standing JHAs – Standing JHAs are used as supporting work documents. Page 3 A-6004-101 (REV 23) WRPS JOB HAZARD ANALYSIS CHECKLIST (Continued)

Work Package: Procedure No.: Standing JHA No.:

Task:

Yes No Method* Method* 22. Fire Hazard Weld, Burn, Respiratory Protection Hot Work Permit Grind, Solder. Fire Blanket Welding Screen If Yes, FPE and IH IH Sample Plan # Fire Marshall Permit # concurrence required. Additional/Other Controls: Task:

Yes No Method* Method* 23. Hazardous Energy (Air/ Depressurize Sleeving Steam/Fluid/Pressurized) Cool down systems

Additional/Other Controls:

Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* 24. Stored Energy Barricade Work Area Remove Energy Additional/Other Controls: Task:

Yes No Method* Method* 25. Eye, Foot, Head, Hand Face Shield Goggles Hazards Cut Resistant Gloves Heat Resistant Gloves Additional/Other Controls: Task: See GHA for Skill Based Hazard Controls Yes No Method* Method* Area Scan where penetration will 26. Wall Ceiling Blind Penetration take place Additional/Other Controls: Task:

Yes No Method* Method* Ignition Source Control Screening 27. Tank Vapor Flammable/ Explosive Hazards (Site form A-6003-774) Additional/Other Controls: Task:

Yes No Method* Method* 28. Laboratory Hazards (e.g., Chemical Segregation Volume Limitations Chemical Splashes, Fume Hoods Special Labeling or Postings Chemical Compatibility, IH Sample Plan # Lab Coat Reactive, Time Sensitive) Additional/Other Controls: If Yes, IH concurrence Task: required.

Yes No Method* Method* 29. Heat Stress due to Heat Stress Mitigation Checklist localized heat source or

special PPE use Additional/Other Controls: Task:

Yes No Method* Method* 30. Removal of Abandoned/ Air Gaps Containment Deactivated Equipment Flushing Drain/Depressurize Hot Tap Remove Stored Energy Additional/Other Controls: Task:

Yes No Method* JHA completion instructions located on the JHA website. *Method: 1-Precaution/Limitation/Prerequisite. 2-WARNING/CAUTION. 3-Work/Procedure Instruction. 4-Permit/Plan/Evaluation **Method of implementation not applicable for Standing JHAs – Standing JHAs are used as supporting work documents. Page 4 A-6004-101 (REV 23) WRPS JOB HAZARD ANALYSIS CHECKLIST (Continued)

Work Package: Procedure No.: Standing JHA No.:

31. Other Describe: Controls:

Task:

Yes No Method* 32. Other Describe: Controls:

Task:

Comments:

JHA completion instructions located on the JHA website. *Method: 1-Precaution/Limitation/Prerequisite. 2-WARNING/CAUTION. 3-Work/Procedure Instruction. 4-Permit/Plan/Evaluation **Method of implementation not applicable for Standing JHAs – Standing JHAs are used as supporting work documents. Page 5 A-6004-101 (REV 23) WRPS JOB HAZARD ANALYSIS CHECKLIST (Continued)

Work Package: Procedure No.: Standing JHA No.:

Walk Down Conducted: YES If YES, Date Performed: NO If NO, Level 2 Manager Approval: Justification: N/A N/A, if Level 2 PM work package

Walk Down or Tabletop/JHA Participants Print First and Last Name Signature Discipline/Responsibility Date