Applies Applies Description Description YES NO YES NO 4. RADIOLOGICAL HAZARDS a. b. Radioactive materials Radioactive contamination c. d. HCA, HRA, ARA Radiation-generating devices e. f. Nuclear criticality Biological transport vectors g. h. Contact dose rates higher than 5 mrem Other: (specify) Notes: 5. INDUSTRIAL HYGIENE HAZARDS Lead/lead containing materials, cadmium, or a. b. Asbestos/asbestos containing materials other heavy metals c. d. Flammable Organic solvent e. f. Pesticide Oxygen deficient atmosphere g. h. Unknown chemical High noise (>85 dba) Airborne dust/particulates i. j. Incompatibility or reactivity of materials Fumes, gas, mist, vapor (Non-Rad) k. l. Beryllium PCB Intrusive activities or excavation in Accessing components of electrical m. n. unassessed facility or area distribution equipment o. p. Heat stress Other: (specify) Notes: 6. BIOLOGICAL HAZARDS a. b. Fungi/mold Infectious waste, sewage, septic Notes:
Description Applies Description Applies YES NO YES NO 4. RADIOLOGICAL HAZARDS a. Radioactive materials b. Radioactive contamination c. HCA, HRA, ARA d. Radiation-generating devices e. Nuclear criticality f. Biological transport vectors g. Contact dose rates higher than 5 mrem h. Other: (specify) Notes: 5. INDUSTRIAL HYGIENE HAZARDS a. Asbestos/asbestos containing materials b. Lead/lead containing materials, cadmium, or other heavy metals c. Flammable d. Organic solvent e. Pesticide f. Oxygen deficient atmosphere g. Unknown chemical h. High noise (>85 dba) i. Airborne dust/particulates Fumes, gas, mist, vapor (Non-Rad) j. Incompatibility or reactivity of materials k. Beryllium l. PCB m. Intrusive activities or excavation in unassessed facility or area n. Accessing components of electrical distribution equipment o. Heat stress p. Other: (specify) Notes: 6. BIOLOGICAL HAZARDS a. Fungi/mold b. Infectious waste, sewage, septic Notes:
EPC-FS-231_JHIW_DRAFT.docx