Title of Job/Operation: Petroleum Site Inspections and Contractor Oversight

Date:
Log Number:

Employee Name and Job Title:

Analyst/ Date:

Job Safety Analysis Worksheet

Division/Bureau/Section: DWM/Petroleum Restoration Program

Approved By/ Date:

September 2013
Personal Protective Equipment Recommended or Required: hard hat, protective eyewear, steel-toed;/shank construction boots, steeltoed/shank chemical resistant boots, ear plugs, protective outerwear, heavy duty gloves and nitrile or latex gloves, dust mask
Sequence of Basic Job Steps
Prepare for site visit. Identify
site/activity PPE needs; Check
contents of PPE equipment bag
for complete inventory

Potential Accidents or Hazards

N/A

Proceed to vehicle/Travel to and

from site

(SB) Moving vehicles on road or in parking

areas

Initial site arrivalAssess site conditions

Visual
inspection
of
layout/Walk about site

Beware of site security

site

Recommended Safe Job Procedures

Obtain and review site HASP from contractor;
familiarize self w/site prior to visit; know
contaminants of concern and properties,
locations of suspected contaminant areas. Have
proper training completed, and identify
appropriate PPE needs. Provide itinerary to
supervisor, or periodically check in w/office.
MAP
LOCATION
OF
NEAREST
EMERGENCY
MEDICAL
FACILITY
EQUIPPED TO HANDLE CHEMICAL
EXPOSURES!
Be attentive when crossing traffic and walking
within parking areas. Map route to site; have
area map available; follow defensive driving
practices.

(SB) Traffic hazards

If using State vehicle: Perform quick inspection

for obvious items such as tire inflation, wind
shield wipers, sufficient gas to get to destination,
observe State guidelines for use of a State
vehicle: make certain procedures regarding
accidents, injuries, vehicular break downs or
roadside emergencies are available in vehicle

(E) Weather conditions

Heat- know signs of heat stroke, have fluids

available at site
Sun- keep body protected; wear sunscreen when
not sampling; wear wide brimmed hat or hard
hat.
Inclement conditions- seek covered, secure
shelter.
Extreme cold- layered clothing, gloves, hat, etc.

(SB) Traffic

Be alert; attempt to secure area from through

traffic.

Irritated site owner

Dangerous surroundings

Be courteous and diplomatic

Do not enter site unless accompanied by another
inspector or site personnel.

(BIO) Animals(dogs),
insects

snakes,

(CW) Chemical release areas

stinging

Identify areas where biohazards may lurk, plan

escape route in advance.
Wear site/activity appropriate PPE. Be familiar
w/site plan, ID areas of contamination. Survey
site for areas of discoloration, puddles, dead or
stressed vegetation; Stay reasonably clear of
such areas.

Oversight during drilling

construction operations

or

(E) Vapors
(SB) Heavy equipment operation, drilling
rigs(augers, piping, drill bits, chains)

Identify escape route, position self-upwind, and

evacuate immediately if/when strong odors or
irritation noted.
Maintain safe distance from equipment, wear
site/activity appropriate PPE. Understand basic
operation of drill rig.
Wear protective clothing and sit/activity
appropriate PPE, may require dust mask.

Oversight
during
Soil
Excavation/Tank Pull Operations

Oversight
during
Remedial
System Construction/Operation
and Maintenance

(SB) Heavy equipment operation-front end

loader, backhoe, dump trucks, etc.

(CW) Dirt, dust, debris

Wear protective clothing and site/activity

appropriate PPE, may require dust mask.

(E) Vapors, liquids

Identify escape route, position self-upwind,

evacuate immediately if/when strong odors or
irritation noted; do not enter excavated hole.
Maintain safe distance from equipment. Wear
site/activity appropriate. Do not assist contractor
during onsite operations

(SB) Heavy equipment operation-front end

loader, backhoe, dump trucks, etc.

(CW) Dirt, dust, debris

Wear protective clothing and site/activity

appropriate PPE, may require dust mask.

(E) Vapors, liquids

Identify escape route, position self-upwind,

evacuate immediately if/when strong odors or
irritation noted; do not enter excavated hole.
Identify escape route, position self-upwind, and
evacuate immediately if/when strong odors or
irritation noted.
Wear appropriate site/activity PPE.

Sampling Oversight

(CW) Vapors, liquids

IDW pickup oversight

(CW) Liquids
(CBT) Drums; crushed fingers and toes

Site exit

(CW) Contaminated vehicle

Return to office/home

(SB) Traffic hazards

*Codes for Potential Hazards:

Struck By (SB)
Struck Against (SA)
Contacted By (CB)
Contact With (CW)

Identify escape route, position self up wind, and

evacuate immediately if/when strong odors or
irritation noted.
Maintain safe distance from equipment. Wear
site/activity appropriate. Do not assist contractor
during onsite operations

Caught On (CO)
Caught In (CI)
Caught Between (CBT)
Fall - Same Level (FS)

Do not handle drums, keep safe distance form

contractor operations.
Booties, tyvek, latex gloves should be disposed
on-site. Remove boots and soiled clothing for
secure storage in trunk; decontaminate as soon
as possible. Wash hands promptly. Update
exposure log.
FOLLOW
TRAVEL
TO
SITE
PROCEDURES.

Fall To Below (FB)

Overexertion
Exposure (E)