7t intergration of exposure

7/29/2019 7t Intergration of Exposure

1/13

ERHMS
http://www.osha.gov/oilspills/gulf-operations-ppe-matrix.pdfhttp://nrt.org/production/NRT/NRTWeb.nsf/AllAttachmentsByTitle/SA-1049TADFinal/$File/TADfinal.pdf?OpenElementhttp://nrt.org/production/NRT/NRTWeb.nsf/AllAttachmentsByTitle/SA-1049TADFinal/$File/TADfinal.pdf?OpenElementhttp://nrt.org/production/NRT/NRTWeb.nsf/AllAttachmentsByTitle/SA-1049TADFinal/$File/TADfinal.pdf?OpenElementhttp://nrt.org/production/NRT/NRTWeb.nsf/AllAttachmentsByTitle/SA-1049TADFinal/$File/TADfinal.pdf?OpenElementhttp://www.osha.gov/oilspills/gulf-operations-ppe-matrix.pdf


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ERHMS


3/13

ERHMS

Staging Area Information Check List

Staging Location:

(Insert County/Parish,

State)

Date:

NIOSH Personnel:

Number of Workers:

Type of Workers:

VOO, On-shore, Off-shore

Number of collected

surveys:

Describe Work Tasks:

Workshift time/duration:

Module Training required

Personal ProtectiveEquipment Required

Safety Concerns observed:

Top Safety Concerns

observed by Safety Officer

(Identify Safety Officers)

Decon in Use

Describe Medical Support

Heat Stress Coordinator


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ERHMS


Heat Stress Program

Details

(Shade provided, time

on/off)

Hot Zones

Hot Zone Markings

Safety Briefings ( yes/no

when

Specific Messages during

briefing

Hygiene Logistics

(hand washing stations,

etc)

Consumables provided to

workforce at staging

area?

(food, water, Gatorade,

etc.)

Workforce Organization

(buddy system, etc.)

Pre-employee medical

screening


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ERHMS


Description of Site

Issues Observed: :


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ERHMS

General InformatIonName: Job title:

Process description: Length of process:

Dept: Line: Location:

Potential exposures:

Sampling conducted: Heat stress Dermal/surface Other:

Worker

observation

Form

HETA #

Date:

Sequence #

Page

1

(See

Back)

respIratory protectIon

Mnf: Model:

Respirator use:Mandatory Voluntary

Is employee in a written respiratory protection program?

Yes No

Correct type of respirator forexposures?

Yes No Worn correctly? Yes No

Respirator condition

Frequency of use: Changeout frequency

Employees judgment ofeffectiveness:

Company name:

Completed by:

Air SAmpling informAtion

Sample #

Sampling media

Pump #

Type

Start time

Stop time


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ERHMS

protective clothing / gloveSType (gloves,

coveralls, etc)

Mnf

Model

Material

Available but not

worn

Changeout freq.

Condition Good Fair Poor Good Fair Poor Good Fair Poor

Description

Other PPE

Uncovered skin

(Check all thatapply)

Arms

Hands

Wrist

Neck

Face Legs Other:

notes

Page

2

Worker

observation

Form

enGIneerInG controls

Task/Process

Type (LEV,enclosure,etc)

Mnf

Model

Description

Judgment ofeffectiveness

Effective Ineffective Effective Ineffective Effective Ineffective

If ineffective,why?

Furtherevaluationneeded?

Yes No Yes No Yes No

HearInG protectIon

Type: Plugs Muffs Available but not worn

Mnf: Model: NRR:

Use:

Mandatory

Voluntary Worn correctly?

Yes

NoIs employee in a written hearing conservation program? Yes No Dont know


8/13

ERHMS

Chemical form

solid

liquid/pourliquid/spray

Other

inhalation

potential

himed

low

Dermal

Potential

hiMed

lo

duration

(hrs/day)

if indoors,

ventilation:

nonegeneral

local exhaust

Comments

Oil

Dispersant

Cleaner

other

(Specify)


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ERHMS

PPE Type In use? Replacement

Frequency

Type Other Info Provided by Use is

Safety

glasses No

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Goggles No

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Gloves No

Yes

As nec Daily

Task Other

Short Long Employer

Employee

Required

Voluntary

Respirator No

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Safety

shoesNo

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Hard hat No

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

HearingProtection

NoYes

As nec Daily Task Other

EmployerEmployee

Required Voluntary

Face

ShieldNo

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Tyvek or

TychemNo

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Rubber

BootsNo

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Slicker

Suit (rain)No

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Other No

Yes

As nec Daily

Task Other

Employer

Employee

Required

Voluntary

Clothing No Yes Type

Shirt No Yes Long sleeve Short sleeve

Pants No Yes Long Short

Head covering No Yes

Protective sleeves No Yes

Apron No Yes

Waders No Yes


10/13

ERHMS

Item No Yes Comments

Shower facilities on site

Handwash facil ities onsi te

Emergency eyewash onsite

Adequate sanitary facilit ies

Access t o air condition area for breaks

Shaded work area

Shaded break area

Do workers eat, drink, or smoke in work area?

Adequate water provided?

MSDS readily availablenon-English, as needed

Unlabelled chemical containers?

Facilities for first aid?

Procedures for medical emergencies?

Decon of clothing

Decon of tools?

What is the average number of hours worked per day?

What is the maximum number of hours worked per day?

Is there a work/rest regimen? No Yes minutes on minutes off

Check if any evidence of the following.

snakes wild animals mosquitoes ticks all igators


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ERHMS

1. Incident Name 2. Date Prepared 3. Time Prepared

4. Unit Name/Designators 5. Unit Leader (Name and Position) 6. Operational Period (Date/Time)

7. Personnel Roster Assigned

NAME ICS POSITION HOME BASE

8. ACTIVITY LOG (CONTINUE ON REVERSE)

TIME MAJOR EVENTS

9. Prepared By:


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ERHMS

ICS 204 8/96

3. Incident Name 4. Operational Period (Date/Time)

1. Branch 2. Division/Group

5. Operations Personnel

6. Resources Assigned This Period

Strike Team/Task Force/Resource

IdentifierLeader Phone

# of

Pers.

Drop Off

Point/Time

Pick Up

Point/Time

7. Assignments

8. Special Instructions/Safety Message

11. Approved By: (Planning Section Chief) Date/Time ApprovedPrepared By

Div./Group/Unit

Tactical

Command

Local

Repeat

Function Freq. System Chan.

Support

Local

Repeat

Function Freq. System Chan.

Ground-To-Air


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ERHMS

ICS 208 HM Page 1 3/98

SITE SAFETY ANDCONTROL PLAN

ICS 208 HM

1. Incident Name: 2. Date Prepared: 3. Operational Period:Time:

Section I. Site Information

4. Incident Location:

Section II. Organization

5. Incident Commander: 6. HM Group Supervisor: 7. Tech. Specialist - HM Reference:

8. Safety Officer: 9. Entry Leader: 10. Site Access Control Leader:

11. Asst. Safety Officer - HM: 12. Decontamination Leader: 13. Safe Refuge Area Mgr:

14. Environmental Health: 15. 16.

17. Entry Team: (Buddy System)

Name: PPE Level

18. Decontamination Element:

Name: PPE Level

Entry 1 Decon 1

Entry 2 Decon 2

Entry 3 Decon 3

Entry 4 Decon 4

Section III. Hazard/Risk Analysis

19. Material: Container

type

Qty. Phys.

State

pH IDLH F.P. I.T. V.P. V.D. S.G. LEL UEL

Comment:

Section IV. Hazard Monitoring

20. LEL Instrument(s): 21. O2 Instrument(s):

22. Toxicity/PPM Instrument(s): 23. Radiological Instrument(s):

Comment:

Section V. Decontamination Procedures

24. Standard Decontamination Procedures: YES: NO:

Comment:

Section VI. Site Communications

25. Command Frequency: 26. Tactical Frequency: 27. Entry Frequency:

Section VII. Medical Assistance

28. Medical Monitoring: YES: NO: 29. Medical Treatment and Transport In-place: YES: NO:

Comment:

7t intergration of exposure

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