List the safety requirements for this task (include personal protective equipment)

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HAZARD ASSESSMENTS FOR JOB TASKS Organization Name: Job Title: Job Task: Date: Basic Description of Duties: Steps of job Lifting, and material handling Material handling Slips/trips/falls Exposure to falling materials- foot and head injuries Exposure to flying material- eye injury Exposure to high noise environments or tasks Exposure to respiratory irritants Forklift operation Working with sharp items Working with chemicals (specify) Working with non-ionizing sources Working with ionizing radiation sources Desk work Machine/tool operation (specify) Machine/tool maintenance work Machine/tool blade or tooling changes Machine/tool unjamming work Working with the public Driving (specify) Compressed air use Hoist or crane use Welding, torch cutting, brazing, grinding Confined space work Elevated work Step ladder use Extension ladder use Exposure to electrical sources (specify) Exposure to traffic Traffic control Handling hot items Work in, exposure to trenches Pallet jack use Dolly or hand truck use Abrasive blasting Concrete work Computer/VDT workstation use Resident handling Personnel lift use Other (specify): List the safety requirements for this task (include personal protective equipment)

Hazard Assessment for PPE Use with WAC 296-800-160 Personal Protective Equipment (PPE) This tool can help you do a hazard assessment to see if your employees need to use personal protective equipment (PPE) by identifying activities that may create hazards for your employees. The activities are grouped according to what part of the body might need PPE. You can make copies, modify and customize it to fit the specific needs of your particular work place, or develop your own form that is appropriate to your work environment. This tool can also serve as written certification that you have done a hazard assessment as required by WAC 296-800-16010. Document your hazard assessment for PPE. Make sure that the blank fields at the beginning of the checklist (indicated by *) are filled out (see below, Instructions #4). Instructions: 1. Do a walk through survey of each work area and job/task. Read through the list of work activities in the first column, putting a check next to the activities performed in that work area or job. 2. Read through the list of hazards in the second column, putting a check next to the hazards to which employees may be exposed while performing the work activities or while present in the work area. (for e.g., work activity: chopping wood; work-related exposure: flying particles). 3. Decide how you are going to control the hazards. Try considering engineering, work place, and/or administrative controls to eliminate or reduce the hazards before resorting to using PPE. If the hazard cannot be eliminated without using PPE, indicate which type(s) of PPE will be required to protect your employee from the hazard. 4. Make sure that you complete the following fields on the form (indicated by *) to certify that a hazard assessment was done: Name of your work place Address of the work place where you are doing the hazard assessment Name of person certifying that a workplace hazard assessment was done Date the hazard assessment was done P: 206.329.1120 F: 206.328.0131 www.archbright.com Archbright. All Rights Reserved

PPE Hazard Assessment Certification Form *Name of work place: *Assessment conducted by: *Work place address: *Date of assessment: Work area(s): Job/Task(s): *Required for certifying the hazard assessment. Use a separate sheet for each job/task or work area EYES abrasive blasting chopping cutting drilling welding punch press operations sanding grinding hammering airborne dust flying particles blood splashes hazardous liquid chemicals intense light Safety glasses Side shields Safety goggles Dust-tight Shading/Filter (# ) goggles Welding shield FACE cleaning cooking siphoning painting dip tank operations other foundry work welding mixing pouring molten metal hazardous liquid chemicals extreme heat/cold potential irritants: Face shield Shading/Filter (# ) Welding shield HEAD building maintenance confined space operations construction electrical wiring walking/working under catwalks walking/working under conveyor belts walking/working under crane loads utility work beams pipes exposed electrical wiring or components falling objects machine parts Protective Helmet Type A (low voltage) Type B (high voltage) Type C Bump cap (not ANSI-approved) Hair net or soft cap

HANDS/ARMS baking cooking grinding welding working with glass using computers using knives dental and health care services material handling sanding hammering blood irritating chemicals tools or materials that could scrape, bruise, or cut extreme heat/cold Gloves Chemical resistance Liquid/leak resistance Temperature resistance Abrasion/cut resistance Slip resistance Protective sleeves FEET/LEGS building maintenance construction demolition food processing foundry work logging plumbing trenching use of highly flammable materials welding explosive atmospheres explosives exposed electrical wiring or components heavy equipment slippery surfaces tools Safety shoes or boots Toe protection Electrical protection Puncture resistance Anti-slip soles Leggings or chaps Foot-Leg guards Metatarsal protection Heat/cold protection Chemical resistance BODY/SKIN Work activities such as: baking or frying battery charging dip tank operations fiberglass installation irritating chemicals chemical splashes extreme heat/cold sharp or rough edges Vest, Jacket Coveralls, Body suit Raingear Apron Welding leathers Abrasion/cut resistance

BODY/WHOLE 1 Work activities such as: building maintenance construction logging utility work working from heights of 10 feet or more working near water Fall Arrest/Restraint: Type: PFD: Type: *(See Footnote 1) LUNGS/RESPIRATORY 1 Work activities such as: cleaning pouring mixing painting fiberglass installation compressed air or gas operations irritating dust or particulate irritating or toxic gas/vapor *(See Footnote 1) EARS/HEARING 1 Work activities such as: generator ventilation fans motors sanding pneumatic equipment punch or brake presses use of conveyors grinding machining routers loud noises loud work environment noisy machines/tools punch or brake presses *(See Footnote 1) (1) NOTE: There are other hazards requiring PPE (such as respiratory, noise, fall, etc. hazards), that are not included in this volume of the PPE Guide but will be covered in future volumes (see WAC 296-62 for respiratory and hearing protection and WAC 296-155 for fall protection for further assessment). However, you should consider all hazards when you conduct your hazard assessment. See a list of other WISHA rules (in How to use this guide p. 4) for information regarding PPE for specific work places.

Hazard Recognition & Awareness Activities: Tour your location with employees, pointing out unsafe conditions. Ask employees to explain some of the unsafe acts that can lead to injuries (use open ended questions). Background A single training session or safety meeting won't create a safety mind-set. But regular and consistant reinforcement can encourage workers to apply their safety knowledge continually so hazard identification and correction become second nature. The key to hazard recognition and injury prevention is simple: Before you start any task, think about what could go wrong. Then take action to avoid that problem. Encourage workers to apply that rule every hour of every day on the job to substances, equipment, procedures, situations. It's particularly important for new workers or new tasks. That's where most injuries tend to happen. These are some of the questions workers should be asking themselves before they start any job: "Could something in the area make the chemical I'm about to use catch fire or explode?" "Does this chemical produce vapors that could be toxic?" "Could something in the work area make a person slip, trip, or fall?" "Is an emergency exit or aisle blocked?" "Is a tool or machine not working right?" "Is another worker performing an unsafe act?" The list could go on and on. The point is to look ahead at what you're going to do or where you're going to go; think about what could go wrong; and prevent the worst from happening. Many hazards are obvious to those who open their eyes and minds to see them. Typical injuries-waiting-to-happen include: Materials or cords on the floor Open drawers or cabinets or tools hanging off a work surface Loose flooring or carpet or wet, slick or waxed floors Overloaded electrical circuits Open containers of chemicals or flammable scrap Live electrical wires or energized equipment Lack of ventilation in a confined space or an area containing flammable substances.

Identifying Unsafe Acts Hazard recognition has to extend to unsafe acts as well as unsafe conditions. Workers must be aware of the hazard potential in everything they do, and be willing to ask other workers who are not following safety procedures to shape up, too. Failure to check and follow company procedures or instructions on a container label or MSDS is a hazard. So is failure to inspect and use protective clothing and equipment. Other common unsafe acts include improper lifting or material handling, horseplay, running instead of walking, skipping job steps or procedures, drinking or drug use on the job, and inattention to tasks. Correct the Identified Hazard Hazard recognition is only valuable if it's followed by corrective action. In most cases, workers have the knowledge and ability to prevent injuries by removing obstructions from aisles, covering a chemical container, etc. Even if someone else caused the hazard, the worker who notices it can and should put away a sharp tool, point out an overloaded circuit, or refuse to play "catch" with a tool. If the worker cannot correct a problem for instance, loose floor tiles the proper response is to report it to you so you can get the right people to correct it. Encourage workers to always ask if they're not sure about a hazard or corrective action. Too often, people are embarrassed to admit that they're human and there's something they don't know. Supervisory Reinforcement Supervisors have many opportunities to stimulate ongoing hazard recognition and build workers' safety consciousness. For example: Set an example. Tune in to potential hazards, point them out, and make sure they're corrected. Emphasize that hazards put workers' personal health and safety at risk. Understanding the "why" of safety is a strong motivator. Set clear standards for workplace behavior and enforce them. Praise workers who identify and correct hazards on the job. Constantly underline the importance of hazard identification and correction until it becomes a natural part of workers' jobs and lives. Other Resources WAC and OSHA Regulatory codes and resources Archbright consultation

Hazard Recognition Checklist Housekeeping Keep the work area clean, with everything in its place when not in use. Close drawers when not in use. Clean tools before putting them away never leave sharp edges unprotected Remove trip, slip, or fall hazards from floor; report loose flooring or carpet. Clean up small spills immediately; report larger ones. Dispose of trash promptly and properly. Smoke only where permitted, and use deep ashtrays. Chemicals Review company SOPs before starting job. Read label and review SDS when working with unfamiliar chemicals. Keep incompatible substances away from each other. Use proper protective clothing and equipment and hygiene practices. Check that ventilation is adequate. Keep containers closed when not in use. Electrical Circuits and Equipment Stay away from live wires. Obey lockout/tagout procedures. Be sure cords are untangled and have good insulation. Don't overload circuits or outlets. Tools and Machinery Select the right equipment or tool for the job. Be familiar with equipment hazards and safe procedures. Be sure machine guards are in place. Use protective equipment to prevent shock, burns, and injuries. Turn off equipment when not in use.

Worker Activities Follow all safety procedures; don't get overconfident, skip steps, or take shortcuts. Lift properly so legs, not back, do the work. Make use of mechanical lifting aids whenever possible. Don't carry a load you can't see over. Stand on a ladder, not boxes or furniture, to reach high places. Walk, don't run, in hallways and on stairs. Check protective equipment for defects before use. Turn in any protective equipment that's damaged. Attitudes Focus on what you're doing no fooling around or showing off. Think about the job your performing instead of what you may be doing this weekend. Pay attention to safety training. Always ask questions about anything you don't understand. Know what to do in case of emergency. Don't use drugs or drink on the job. Treat safety as an important part of your job. Don't let personal feelings or problems interfere with working safely. Keep asking "what could go wrong here" before it goes wrong.