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Water Checklist #4 <br />A. <br />Date Cr o _ Location Crew Lead <br />S 3az,�a�lu_ ll � <br />Flaggers Names <br />Briefed by <br />Flagger Briefing: <br />Job Tasks: Flagger Responsibilities, Emergency Signals, Flagger Radios, Specific work zone hazards, <br />PPE, Night Lighting, Planned Equipment Movement, Emergency Escape Plans. <br />C. Vehicle Inspection Checklist: <br />Driver's Name <br />Equipment # <br />Location <br />Inspection <br />Completed? <br />Comments <br />D. Checklist #4 - Routine Part 1 <br />YES <br />NO <br />1. Make site visit before starting work <br />2. Define activity, scope, and limits <br />3. Review Part 1 BMPs <br />• Permit needed <br />• Equipment maintenance <br />• Disturbed soil <br />• Waste material removed <br />• Spill kit -- <br />• Part 2 BMPs needed <br />• Use checklist #3 and routine <br />checklist <br />4. Is environmental staff required? <br />NO - continue maintenance <br />YES - contact environmental staff for <br />review <br />S:\/Common\dtria4SlAliE13\:uoraan,l \ChmiLsL, _ WaRr d: <br />YES <br />NO <br />5. In water work <br />• Stop work <br />• Contact environmental staff for <br />review <br />• Evaluate using detailed checklist <br />1, 2, and/or 3 and routine <br />checklist <br />6. Location <br />1 <br />2 <br />3 <br />4 <br />5 <br />516 <br />