EP 1110-1-18
24 Apr 00
H-2. Hazard/Risk Analysis.
a. Tasks to be performed:
Task #: ___________
Task #: ___________
Task #: ___________
Task
HAZARDS:
ACTION LEVELS:
#
Safety, Chemical, Physical, Radiological, Biological, OE
(**See Below)
(*See Below)
Notes to Hazard/Risk Analysis:
*HAZARDS:
Safety:
Structural: (e.g. sagging roof or floor, broken or missing stairs, railings, floor boards, leaning or deteriorated
load bearing walls/support beams, etc.)
Falling: (e.g. open pits; manholes; silos; wells; shafts; rocks; steep inclines; wet surfaces; etc.)
Climbing: (e.g. falls from structures > 4 feet; deteriorated ladders or missing rungs; etc.)
Walking or Debris: (e.g. Uneven terrain; animal burrows; surface indentations; exposed nails; broken timbers;
sharp protruding objects; broken glass; etc.)
Confined Space (e.g. excavations > 4 feet deep; surface/underground utility vaults; vats/silos/grain bins; open
surface tanks/cisterns/septic tanks; cellars/crawl spaces; tunnels; wells; boilers; underground/above ground
storage tanks; etc.)(NO ENTRY)
Eye Hazards: (e.g. Thicket branches; airborne dust/windy conditions; contaminated liquid splashes; etc.)
OE/Other: (e.g. explosives; combustible or flammable materials; oxygen deficiency; etc.)
Chemical:
Evaluate the chemical hazards that may be encountered during site activities for each task. For activities
utilizing this plan, encounters with chemicals above the PEL, TLV or the IDLH are not expected. THIS PLAN
SHALL NOT BE USED IF OVEREXPOSURES OR IDLH CONDITIONS ARE EXPECTED. (List the
chemical TLV/PEL/REL; OSHA/NIOSH IDLH; odor threshold/warning levels; warning signs/symptoms of
overexposure; concentrations expected on site.)
Physical:
Evaluate the potential for injury from physical agents such as noise, electricity, moving parts/machinery, heat
and cold stress that may be present (e.g. loud machinery; overhead or underground power lines; personal
protective clothing, etc.)
H-3
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