A02. Appendix E - Accident Prevention.doc

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Attached to
Solid Waste Removal Contract at Lake Shelbyville, Illnois
Solicitation number
W912P921R002
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ACCIDENT PREVENTION PROGRAM

JOB HAZARD ANALYSIS

1. Contract No. N/A
2. Project: Lake Shelbyville
3. Facility:
4. Date:
5. Location:
6. Estimated Start Date:

7. Item:

8. Phase of Work:

9. Safety Hazard:
10. Precautionary Action Taken:

11. Contractor/Volunteer:

(Signature and Date)

12. Report discussed with Contractor/Superintendent on:

Area/Resident Engineer (Signature and Date)

13. Contracting Officer or Contracting Officer Representative:

(Signature and Date)

APPENDIX H

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