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Field Level Hazard Assessment  Form

Field Level Hazard Assessment Form

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Injuries? Yes No Yes No (If Yes, explain) No If Yes, explain: Identify and Prioritize the tasks and hazards below, then identify the plans to eliminate/control the hazards. Please print and sign below (All members of the crew) prior to commencing work, and initial when task is completed or at the end of the shift. Worker’s Name (Print) Signature Initial Worker’s Name (Print) Signature Initial Supervisor’s Name and Signature (Sign upon reviewing completed card):...
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