Minger Construction_SAFETY MANUAL and APPENDIX_2022

SECTION 36: HYDROGEN SULFIDE (H2S) AWARENESS GENERAL 1. Hydrogen Sulfide (H2S) is a colorless, flammable, and extremely hazardous gas that occurs naturally in crude petroleum and natural gas and can also be produced by the breakdown of organic matter and human/animal waste (sewage). It is heavier than air and can collect in low-lying and enclosed, poorly ventilated areas such as basements, manholes, sewer lines, and other below grade areas. This gas is highly toxic and can cause loss of consciousness or death. H2S typically has a strong odor of rotten eggs. Sense of smell become rapidly fatigued by H2S and cannot be relied upon to warn of the continuous presence of H2S. 2. Minger construction realizes that even thought the policy is to avoid all contact with this toxin, the employee could still come into accidental contact with H2S due to other activities on or near the site. Potential exposure could exist when employees work on or near a site that contains any of the following: Drilling operations, Recycled Drilling Mud, water from sour crude wells, Blowouts, crude oil production tanks, pipelines, and refining operations. HEALTH EFFECTS 1. Hydrogen Sulfide can affect your health if it is inhaled, contacts the eyes, or contacts the skin. 2. Low concentration overexposure may cause irritation of eyes, nose, throat, or respiratory system. Effects can be delayed. 3. Effects of moderate concentrations ma be more severe eye and respiratory effects, headache, dizziness, nausea, coughing, vomiting, and difficulty breathing. 4. High concentrations may cause shock, convulsions, unable to breathe, coma, and death. Effects can be extremely rapid (within a few breaths). TOXICITY/EXPOSURE LIMITS 1. The maximum permissible exposure limit (PEL) for H2S is 20 PPM (parts per million) with a 10-minute maximum peak of 50 ppm. 2. H2S is flammable with an explosive range from 4% to 44% by volume. CONTROLS 1. The Host Company (Owner) is responsible for identifying areas where Hydrogen Sulfide may exist and for informing the contractor of these locations. This area is usually demarcated by the use of specific-worded signs or colored barricade tape. Minger Construction will inform its employees and subcontractors of the location of potential H2S exposures. These areas will be regulated. Access to these sites will be limited to authorized personnel who have been provided with appropriate levels of personal protective equipment and training. 251

2. The host company must make the contractor aware of any existing site-specific contingency plans, so it may inform its employees of the plan and implement it into this program. 3. Use detection equipment when working in an area where there is a possibility of hydrogen sulfide gas, especially in enclosed or below grade areas. Determination of employee exposure will be made from personal and rea monitors that will alarm when concentrations exceed the PEL of 20 PPM for 1910 or 10 PPM for 1926. 4. Do not enter a hydrogen sulfide area without proper training (including CPR) and Authorization. Always follow the permit required confined space program when working with confined spaces. 5. In atmospheres immediately dangerous to life or health (IDLH level of 100 PPM or greater), a standby person(s) with suitable self-contained breathing apparatus must be available for the purpose of rescue. Never attempt to rescue a hydrogen sulfide victim without the proper respiratory protection. 6. If a monitor alarm sounds, cavate the area immediately and do not re-enter without the proper respiratory protection. PERSONAL PROTECTIVE EQUIPMENT 1. Respiratory Protection: whenever the engineering and work practice controls are deemed ineffective at reducing exposure potentials, then respiratory protection will be provided in accordance with the Respirator Protection Program found in this safety manual. These requirements will meet or exceed the recommendations set forth by NIOSH regarding Hydrogen Sulfide. A self-contained breathing apparatus (SCBA) with a full face-piece will be the minimum level of Respiratory Protection. 2. PPE will be worn where appropriate to prevent inhalation, eye contact, and dermal (skin) exposure to Hydrogen Sulfide. Affected employees will refer to the PPE Program found in this manual for proper PPE requirements. These requirements will meet or exceed the recommendations set for by NIOSH for respiratory protective regarding H2S. Employees will also comply with any host facilities’ PPE rules and regulations. This equipment will be provided to employees at no cost. 3. Eyes: safety eyewear complying with an approved standard will be used. 4. Skin: Personal protective equipment for the body should be selected based on the task being performed and the risks involved and should be approved by a specialist before handling H2S. A chemical resistant full body suite may be required. 5. Hands: Chemical-resistant, impervious gloves complying with an approved standard should be worn at all times when handling chemical products. 252

APPENDIX FORMS SECTION 5 HAZARD COMMUNICATION & RIGHT TO KNOW PROGRAM SECTION 6  Global Harmonized system – Hazard Communication – Right to Know SECTION 7 Acknowledgement Form.……………………………………………...255 SECTION 8 SECTION 9  Site Inventory of Hazardous Chemicals…………….............................256 SECTION 10 GENERAL SAFETY RULES SECTION 14  General User Quick Start Guide to Using MSDSOnline……………...257  Safety Data Sheets OSHA Standard 29 CRF 1910.1200(g)…………..265  Project Safety Guide…………………………………………………..273  Weekly Hazard Review (JSA)………………………………………...274  Daily Crew Safety Briefing/Pre-Shift Safety Review…………………277 VIOLATION & DISCIPLINARY ACTION  Employee and supervisor Conference Form…………………………..281 INCIDENT REPORTING AND INVESTIGATION PLAN  Accident/Incident/Damage Report…………………………………….283 RETURN-TO-WORK PROGRAM  Return-to-Work Program Guide……………………………………….285  Employment Offer Letter – Return-to-Work…………………………..289  Light Duty Job Description Example…………………………………..290  Preferred Medical Provider…………………………………………….291 COMPLIANCE INSPECTIONS BY REGULATORY AGENCIES  Compliance Inspection Report………………………………………...292 CONFINED SPACE ENTRY PROGRAM  Confined Space Entry Permit………………………………………….294  Confined Space Pre-Entry Checklist and Certification………………..296  Permit Required Confined Space Rescue Services Evaluation………..297 253

SECTION 15 HOT WORK, WELDING & CUTTING PROGRAM  Hot Work Permit……………………………...………………………..298 SECTION 16 HEAVY EQUIPMENT PROGRAM  Heavy Equipment Daily Inspection Checklist…………………………299  Mobile Heavy Equipment Hand Signals……………………………….300 SECTION 17 POWERED INDUSTRIAL TRUCKS PROGRAM  Powered Industrial Trucks Forklift Practical…………………………..301  Heavy Equipment Daily Inspection Checklist…………………………302  Forklift Hand Signals…………………………………………………..303 SECTION 25 PERSONAL PROTECTIVE EQUIPMENT  Safety Equipment Checklist……………………………………...……304 SECTION 26 MOBILE CRANE PROGRAM  Crane Lift and Rigging Plan………………………...………..………..305  Each Shift Crane Inspection Report……………………………………310  Hand Signals for Crane Operation……………………………………..312 SECTION 28 FALL PROTECTION PROGRAM  OSHA Fall Protection Requirements…………………………………..314 SECTION 31 RESPIRATORY PROTECTION PROGRAM  OSHA Questionnaire and Annual Fit Test Record………………….…315  Respirator Types OSHA Specifications 1910.120 & PPE……………..323  Manufacturer Recommendation……………………………………….324  Respirator Protection Acknowledgement……………………………...325 SECTION 32 SILICA DUST HAZARDS  Silica Exposure Control Plan…………………………………………..326 254

Employee Acknowledgement Form Global Harmonized system – Hazard Communication – Right to Know Employee Name: ___________________________________________________ Training Completion Date: _____/_____/_____ I have been instructed in and understand the Globally Harmonized System (GHS) of Hazard Communication and the GHS HazCom Program currently in place for Minger Construction, Co., Inc. I have also received a copy of Minger Construction, Co., Inc.’s GHS HazCom program for my own use and reference. I have a clear understanding of GHS regulation labeling and Safety Data Sheet (SDS) forms and if I have any questions or concerns regarding hazardous materials, chemicals, or substance, I will ask my supervisor/foreman before attempting to handle it myself. Employee Signature: ________________________________________________ Safety Supervisor: _______________________ Date: _____/_____/_____ 255

SITE INVENTORY OF HAZARDOUS CHEMICALS Hazardous Common Product Manufacturer MSDS has Chemicals Name Name Name been received? 256

General User Quick Start Guide to Using MSDSonline MSDS online is where we store all of our Safety Data Sheets electronically in the eBinder. There are two ways you can access the eBinder, either through the internet, or by downloading the app. Either option requires the company link highlighted below. Access Option 1: Internet Browser Go to your Company Link: https://chemmanagement.ehs.com/9/8f8d36e0-de8b-4fff-af30- dde4467873c9. Copy and paste the link below into your browser. This will bring you to the eBinder main page where you will be able to see the SDS’ for the materials we have on hand at Minger. 257

Option 2: Download the App Find the SDS/Chemical Management app for iPhone or Android. Once downloaded follow the steps below to access the eBinder. Log in with Username (Minger email) and Password (Minger=2020), or if you do not have one, select “don’t have username and password” and type in the company link to access the binder https://chemmanagement.ehs.com/9/8f8d36e0-de8b-4fff-af30- dde4467873c9. 258

Training Video: (ctl + click the link below) Click on the following link for General Site User Training. (Required) file:///C:/Users/whitney/Downloads/General%20User%20Help%20Center% 20Video%20English.mp4 A written how-to is below, but we recommend you watch the video first, to see the site in action. 259

Accessing the eBinder If your account does not default to your eBinder, click on the Menu button in the upper left corner of the screen and then click on the eBinder button. Searching for an (M)SDS within your eBinder 1. Type the product information into the single search field and click Search. Hint: After you type at least three characters of your search term into the Search Bar, you will see suggested search results and categories. You can either click on one of these options, click the Search button, or press Enter on your keyboard. 260

2. You can also use the Categories menu drop down to pre-filter your search results. By default, the eBinder will search by “All Categories”. If you want to search in only one specific category, click on the Categories menu drop down and select the category. After that has been selected, you can then proceed to type your search term into the Search Bar and click the Search button. 261

3. If searching your eBinder produces no results, you will have the options to either “Search MSDSonline” or “Request an SDS”. 4. Search MSDSonline 262

5. Put a check mark next to the GHS you want and then in the upper right-hand corner, select Add to eBinder. This will add the item to the administrator Queue for approval. Once the item is approved it will appear in the eBinder. Viewing and Printing Safety Data Sheets 1. View the (M)SDS by clicking the Document icon to the left of the Product Name. Once open you will see options in the top right corner to rotate the document clockwise, download, or print the (M)SDS. 263

2. Clicking on the Product Name will take you to the Product Summary. From here you will see the Product Details and any indexed data. 264

SAFETY DATA SHEETS The Hazard Communication Standard (HCS) (29 CFR 1910.1200(g)), revised in 2012, requires that the chemical manufacturer, distributor, or importer provide Safety Data Sheets (SDSs) (formerly MSDSs or Material Safety Data Sheets) for each hazardous chemical to downstream users to communicate information on these hazards. The information contained in the SDS is largely the same as the MSDS, except now the SDSs are required to be presented in a consistent user-friendly, 16-section format. 1. The SDS includes information such as the properties of each chemical; a. The physical, health, and environmental health hazards; b. Protective measures; and safety precautions for handling, storing, and transporting the chemical. c. The information contained in the SDS must be in English (although it may be in other languages as well). d. In addition, OSHA requires that SDS preparers provide specific minimum information as detailed in Appendix D of 29 CFR 1910.1200. e. The SDS preparers may also include additional information in various section(s). 2. Sections 1 through 8 contain general information about the; a. chemical, b. identification, c. hazards, d. composition, e. safe handling practices, f. emergency control measures (e.g., fire- fighting). 3. Additionally, the information needed to generate the label for a product can be found in Sections 1 and 2. Sections 9 through 11 and 16 contain other technical and scientific information, such as physical and chemical properties, stability and reactivity information, toxicological information, exposure control information, and other information including the date of preparation or last revision. 4. The SDS must also state that no applicable information was found when the preparer does not find relevant information for any required element. 5. The SDS must also contain Sections 12 through 15, to be consistent with the UN Globally Harmonized System of Classification and Labeling of Chemicals (GHS), but OSHA will not enforce the content of these sections because they concern matters handled by other agencies. 6. A description of all 16 sections of the SDS, along with their contents, is presented below: SECTION 1: IDENTIFICATION This section identifies the chemical on the SDS as well as the recommended uses. It also provides the essential contact information of the supplier. The required information consists of: a. Product identifier used on the label and any other common names or synonyms by which the substance is known. b. Name, address, phone number of the manufacturer, importer, or other responsible party, and emergency phone number. 265

c. Recommended use of the chemical (e.g., a brief description of what it actually does, such as flame retardant) and any restrictions on use (including recommendations given by the supplier). SECTION 2: HAZARD(S) IDENTIFICATION This section identifies the hazards of the chemical presented on the SDS and the appropriate warning information associated with those hazards. The required information consists of: a. The hazard classification of the chemical (e.g., flammable liquid, category1) b. Signal word. c. Hazard statement(s). d. Pictograms (the pictograms or hazard symbols may be presented as graphical reproductions of the symbols in black and white or be a description of the name of the symbol (e.g., skull and crossbones, flame). e. Precautionary statement(s). f. Description of any hazards not otherwise classified. g. For a mixture that contains an ingredient(s) with unknown toxicity, a statement describing how much (percentage) of the mixture consists of ingredient(s) with unknown acute toxicity. Please note that this is a total percentage of the mixture and not tied to the individual ingredient(s) SECTION 3: COMPOSITION/INFORMATION ON INGREDIENTS This section identifies the ingredient(s) contained in the product indicated on the SDS, including impurities and stabilizing additives. This section includes information on substances, mixtures, and all chemicals where a trade secret is claimed. The required information consists of: a. Substances 1. Chemical name. 2. Common name and synonyms. 3. Chemical Abstracts Service (CAS) number and other unique identifiers. 4. Impurities and stabilizing additives, which are themselves classified and which contribute to the classification of the chemical. b. Mixtures 1. Same information required for substances. 2. The chemical name and concentration (i.e., exact percentage) of all ingredients which are classified as health hazards and are: 3. Present above their cut-off/concentration limits or 4. Present a health risk below the cut-off/concentration limits. 5. The concentration (exact percentages) of each ingredient must be specified except concentration ranges may be used in the following situations: 6. A trade secret claim is made, 7. There is batch-to-batch variation, or 8. The SDS is used for a group of substantially similar mixtures. 266

c. Chemicals where a trade secret is claimed: a statement that the specific chemical identity and/or exact percentage (concentration) of composition has been withheld as a trade secret is required. SECTION 4: FIRST-AID MEASURES This section describes the initial care that should be given by untrained responders to an individual who has been exposed to the chemical. The required information consists of: a. Necessary first-aid instructions by relevant routes of exposure (inhalation, skin and eye contact, and ingestion). b. Description of the most important symptoms or effects, and any symptoms that are acute or delayed. c. Recommendations for immediate medical care and special treatment needed, when necessary. SECTION 5: FIRE-FIGHTING MEASURES This section provides recommendations for fighting a fire caused by the chemical. The required information consists of: a. Recommendations of suitable extinguishing equipment, and information about extinguishing equipment that is not appropriate for a particular situation. b. Advice on specific hazards that develop from the chemical during the fire, such as any hazardous combustion products created when the chemical burns. c. Recommendations on special protective equipment or precautions for firefighters. SECTION 6: ACCIDENTAL RELEASE MEASURES This section provides recommendations on the appropriate response to spills, leaks, or releases, including containment and cleanup practices to prevent or minimize exposure to people, properties, or the environment. It may also include recommendations distinguishing between responses for large and small spills where the spill volume has a significant impact on the hazard. The required information may consist of recommendations for: a. Use of personal precautions (such as removal of ignition sources or providing sufficient ventilation) and protective equipment to prevent the contamination of skin, eyes, and clothing. b. Emergency procedures, including instructions for evacuations, consulting experts when needed, and appropriate protective clothing. c. Methods and materials used for containment (e.g., covering the drains and capping procedures). d. Cleanup procedures (e.g., appropriate techniques for neutralization, decontamination, cleaning or vacuuming; adsorbent materials; and/or equipment required for containment/clean up). SECTION 7: HANDLING AND STORAGE 267

This section provides guidance on the safe handling practices and conditions for safe storage of chemicals. The required information consists of: a. Precautions for safe handling, including recommendations for handling incompatible chemicals, minimizing the release of the chemical into the environment, and providing advice on general hygiene practices (e.g., eating, drinking, and smoking in work areas is prohibited). b. Recommendations on the conditions for safe storage, including any incompatibilities. Provide advice on specific storage requirements (e.g., ventilation requirements). SECTION 8: EXPOSURE CONTROLS/PERSONAL PROTECTION This section indicates the exposure limits, engineering controls, and personal protective measures that can be used to minimize worker exposure. The required information consists of: a. OSHA Permissible Exposure Limits (PELs), American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values (TLVs), and any other exposure limit used or recommended by the chemical manufacturer, importer, or employer preparing the safety data sheet, where available. b. Appropriate engineering controls (e.g., use local exhaust ventilation, or use only in an enclosed system). c. Recommendations for personal protective measures to prevent illness or injury from exposure to chemicals, such as personal protective equipment (PPE) (e.g., appropriate types of eye, face, skin or respiratory protection needed based on hazards and potential exposure). d. Any special requirements for PPE, protective clothing or respirators (e.g., type of glove material, such as PVC or nitrile rubber gloves; and breakthrough time of the glove material). 268

SECTION 9: PHYSICAL AND CHEMICAL PROPERTIES This section identifies physical and chemical properties associated with the substance or mixture. The minimum required information consists of: a. Appearance, physical state, color, etc.) b. Upper flammability/explosive limits c. Lower flammability/explosive limits; d. Odor; e. Vapor pressure; f. Odor threshold; g. pH; h. Relative density; i. Melting point/freezing point; j. Solubility(ies); k. Initial boiling point and boiling range; l. Flash point; m. Evaporation rate; n. Flammability (solid, gas); o. Vapor pressure; p. Vapor density; q. Relative density; r. Solubility(ies); s. Partition coefficient: n- octanol/water; t. Auto-ignition temperature; u. Decomposition temperature; and v. Viscosity 269

The SDS may not contain every item on the above list because information may not be relevant or is not available. When this occurs, a notation to that effect must be made for that chemical property. Manufacturers may also add other relevant properties, such as the dust deflagration index (Kst) for combustible dust, used to evaluate a dust’s explosive potential. SECTION 10: STABILITY AND REACTIVITY This section describes the reactivity hazards of the chemical and the chemical stability information. This section is broken into three parts: reactivity, chemical stability, and other. The required information consists of: a. REATIVITIY: Description of the specific test data for the chemical(s). This data can be for a class or family of the chemical if such data adequately represent the anticipated hazard of the chemical(s), where available. b. CHEMICAL STABILITY: 1. Indication of whether the chemical is stable or unstable under normal ambient temperature and conditions while in storage and being handled. 2. Description of any stabilizers that may be needed to maintain chemical stability. 3. Indication of any safety issues that may arise should the product change in physical appearance. c. OTHER: 1. Indication of the possibility of hazardous reactions, including a statement whether the chemical will react or polymerize, which could release excess pressure or heat, or create other hazardous conditions. Also, a description of the conditions under which hazardous reactions may occur. 2. List of all conditions that should be avoided (e.g., static discharge, shock, vibrations, or environmental conditions that may lead to hazardous conditions). 3. List of all classes of incompatible materials (e.g., classes of chemicals or specific substances) with which the chemical could react to produce a hazardous situation. 4. List of any known or anticipated hazardous decomposition products that could be produced because of use, storage, or heating. (Hazardous combustion products should also be included in Section 5 (Fire-Fighting Measures) of the SDS.) SECTION 11: TOXICOLOGICAL INFORAMTION This section identifies toxicological and health effects information or indicates that such data are not available. The required information consists of: a. Information on the likely routes of exposure (inhalation, ingestion, skin and eye contact). The SDS should indicate if the information is unknown. b. Description of the delayed, immediate, or chronic effects from short- and long-term exposure. c. The numerical measures of toxicity (e.g., acute toxicity estimates such as the LD50 (median lethal dose) - the estimated amount [of a substance] expected to kill 50% of test animals in a single dose. 270

d. Description of the symptoms. This description includes the symptoms associated with exposure to the chemical including symptoms from the lowest to the most severe exposure. e. Indication of whether the chemical is listed in the National Toxicology Program (NTP) Report on Carcinogens (latest edition) or has been found to be a potential carcinogen in the International Agency for Research on Cancer (IARC) Monographs (latest editions) or found to be a potential carcinogen by OSHA. SECTION 12: ECOLOGICIAL INFORMATION (NON-MANDATORY) This section provides information to evaluate the environmental impact of the chemical(s) if it were released to the environment. The information may include: a. Data from toxicity tests performed on aquatic and/or terrestrial organisms, where available (e.g., acute or chronic aquatic toxicity data for fish, algae, crustaceans, and other plants; toxicity data on birds, bees, plants). b. Whether there is a potential for the chemical to persist and degrade in the environment either through biodegradation or other processes, such as oxidation or hydrolysis. c. Results of tests of bioaccumulation potential, making reference to the octanol-water partition coefficient (Kow) and the bio- concentration factor (BCF), where available. d. The potential for a substance to move from the soil to the groundwater (indicate results from adsorption studies or leaching studies) e. Other adverse effects (e.g., environmental fate, ozone layer depletion potential, photochemical ozone creation potential, endocrine disrupting potential, and/or global warming potential). 271

SECTION 13: DISPOSAL CONSIDERATIONS (NON-MANDATORY) This section provides guidance on proper disposal practices, recycling or reclamation of the chemical(s) or its container, and safe handling practices. To minimize exposure, this section should also refer the reader to Section 8 (Exposure Controls/Personal Protection) of the SDS. The information may include: a. Description of appropriate disposal containers to use. b. Recommendations of appropriate disposal methods to employ. c. Description of the physical and chemical properties that may affect disposal activities. d. Language discouraging sewage disposal. e. Any special precautions for landfills or incineration activities SECTION 14: TRANSPORT INFORMATION (NON-MANDATORY) This section provides guidance on classification information for shipping and transporting of hazardous chemical(s) by road, air, rail, or sea. The information may include: a. UN number (i.e., four-figure identification number of the substance)1. b. UN proper shipping name1. c. Transport hazard class(es)1 d. Packing group number, if applicable, based on the degree of hazards. e. Environmental hazards (e.g., identify if it is a marine pollutant according to the International Maritime Dangerous Goods Code (IMDG Code)). f. Guidance on transport in bulk (according to Annex II of MARPOL 73/783 and the International Code for the Construction and Equipment of Ships Carrying Dangerous Chemicals in Bulk (International Bulk Chemical Code (IBC Code)). g. Any special precautions which an employee should be aware of or needs to comply with, in connection with transport or conveyance either within or outside their premises (indicate when information is not available). SECTION 15: REGULATORY INFORMATION (NON-MANDATORY) This section identifies the safety, health, and environmental regulations specific for the product that is not indicated anywhere else on the SDS. The information may include: a. Any national and/or regional regulatory information of the chemical or mixtures b. Including any OSHA, Department of Transportation, Environmental Protection Agency, or Consumer Product Safety Commission regulations SECTION 16: OTHER INFORMATION This section indicates when the SDS was prepared or when the last known revision was made. The SDS may also state where the changes have been made to the previous version. You may wish to contact the supplier for an explanation of the changes. Other useful information also may be included here. 272

PROJECT SAFETY GUIDE Daily Weekly Monthly Perform a Safety Check upon Monday – Fire Extinguisher Check Arrival to Jobsite SWPPP Check 1st week of the month check all Fire Take a look around. Are there Ensure barriers are in place and are extinguishers on the job and mounted hazards that need immediate adequate. in vehicles and equipment. attention? Electrical Hazard Check Develop a Pre-Task Plan/JHA Tuesday – Toolbox Talks Check all electrical drop cords, tool As work conditions change, so should cords and GFCI in the 2nd week of the plan. Review with workers, and have them month. Document the check on sign. JSA/Audit/Tailgate Talk. Stretch and Bends Wednesday – Send Copies of Safety Audits into Complete a Safety Audit Safety Department at end of month or Completed daily before workers begin fill out on Procore. assigned duties. Use Safety Audit Sheet on Procore. Maintain Audits on site for entire job. Review Pre-Task/JHA with all Personnel Answer any/all questions they may have. Utilize and encourage crew participation. Check for proper PPE: Hard Hat, Safety Glasses, High Visibility Class 2 & 3 Vests & Steel/Safety Toe Boots as a minimum. Inspect PPE for serviceability. Ensure Daily Checks have been Completed: Equipment, GFCI, Fall protection harnesses, gas detectors, rigging, respirators, etc. Be Professional when conducting Minger Construction, Co., Inc. Business. You are Minger Construction’s best salesperson. 273

620 Corporate Drive Jordan, Minnesota 55352 P: (952)-368-9200 F: 952-368-9311 Weekly Hazard Review (JSA) Meeting Date: ___________________________________ Meeting Time: _____:_____ Meeting Location: _______________________________ Competent Person Onsite: _________________________________ Foreman: __________________________________________ First Aid Person: __________________________________________ Emergency Muster Point: __________________________________ Nearest Hospital: __________________________________________ Overview Utilize this tool to help your crew focus on the relationship between the worker, the task, the tools, and the work environment. Attendees 4. _________________________________ 1. _________________________________ 5. _________________________________ 2. _________________________________ 6. _________________________________ 3. _________________________________ 1. Injuries, Incidents or Near Misses No. Did any injuries occur yesterday? If yes, be sure the report is complete and the Safety Coordinator is notified. 11.1 Injury Types: strains, sprains, breaks, lacerations, contusions, overuse injuries (pain, swelling & bruising). Describe Below: No. Did any incidents occur yesterday? If yes, be sure the report is complete and the Safety Coordinator is notified. 11.2 An incident is defined as an unplanned event that does not result in personal injury but may result in property damage or is worthy of recording. Describe Below: 274

No. Did any Near Misses occur yesterday? If yes, be sure the report is complete and the Safety Coordinator is notified. A near miss is an incident in which no property was damaged and no personal injury was sustained, but where, given a slight shift in time or position, damage or injury easily could have occurred. 1.3 Describe Below: No. Additional Information 1.4 If applicable. 2. Lessons Learned No. Performance Lesson learned to improve safety performance and/or work performance. 2.1 Describe Below: 3. Training Topics No. Description People gravitate to what they like and are more engaged if they are involved. Rather than selecting the training topics, ask your crew what they need and what they want to learn. If you have a large crew, consider appointing a small subgroup to bring forward ideas. 3.1 Describe Below: 4. Today's Task No. Description Go through the expectations of what your crew will accomplish today. 4.1 Describe Below: 275

5. Hazard Identification No. Description Identify potential hazards associated with today's work. After uncontrolled hazards are identified, take action to eliminate them or reduce risk. 5.1 Describe Below: 6. Abatements No. Description Go over safe practices that may be used to control hazards. 6.1 Describe Below: Completed by: _____________________________________ Sign Name _________________________________________ Print Name 276

Date And Time Of Meeting: Daily Crew Safety Supervisors: Briefing Project Number: Weekly Toolbox Topic Reviewed And Discussed: Did any injuries, incidents, or near misses occur yesterday? If yes, complete the next four sections: Yes No Was there an Injury Report Completed and was the Safety Coordinator Notified: Yes No Was the Safety Coordinator Notified: Yes No Explanation Of What Occurred: Lessons Learned To Improve Safety Performance: 277

Suggested Training Topics: Today's Job Description Or Tasks: List Potential Hazards Associated With Today's Work: List Safe Practices to be Used to Control Hazards: 278

Pre-Shift Safety Review Please review the following items with the crew(s). Mark any deficiencies found and correct the hazards identified. ACCESS WALKWAYS - clear, clean, non-slip Yes No N/A COMPETENT PERSONS ON SITE - excavations, fall protection, etc. Yes No N/A CONFINED SPACE WORK - reviewed confined space policy and Yes No N/A procedure CREW FIT FOR DUTY Yes No N/A ELECTRICAL CORDS - good condition, GFCI/assured grounding Yes No N/A EQUIPMENT/MACHINERY - right equipment for task, completed Yes No N/A daily inspections, seat belt used, 3-point contact EQUIPMENT OPERATORS - qualified and properly trained Yes No N/A EMERGENCY - have all emergency plans been established and Yes No N/A communicated EXCAVATION - completed daily inspections, underground Yes No N/A utilities located FALL PROTECTION - anything 6' or greater protected by guard Yes No N/A rail or other approved fall restraint FIRE PREVENTION - extinguishers available within 25' of fire Yes No N/A hazards & inspected HAND AND POWER TOOLS - inspections performed, good Yes No N/A condition, guards in place, defective equipment pulled from HAZCOM - SDS accessible, containers labeled, spill response Yes No N/A plan reviewed with everyone on site HOUSEKEEPING - Materials secured, trash and debris cleaned Yes No N/A up LADDERS - inspected prior to use, correct lengths, free of Yes No N/A defects, 3' above protection system or grou2n79d, tied off, pitched at 4:1 ratio

LOCKOUT/TAGOUT PLAN - procedure reviewed, sufficient Yes No N/A supplies Yes No N/A NIGHT WORK - light plants, flashlights, beacons Yes No N/A PPE - all required PPE used and supplies on hand for task Yes No N/A specific requirements, such as chaps and faceshields Yes No N/A Yes No N/A RESPIRATORY PROTECTION - everyone trained and fit tested, Yes No N/A respirators in good condtion and inspected prior to use Yes No N/A Yes No N/A ON SITE ROADWAYS - well graded, proper signage, speed monitored Yes No N/A SUBCONTRACTORS - monitored for safety compliance TRAFFIC CONTROL - set up properly and maintained, crews protected TRAINING - ALL CREW MEMBERS are trained with the tasks being performed WEATHER CONDITIONS - monitored for severe weather and a plan in place for severe weather or heat and cold exposures UTILITIES - overhead and undergound utilities located and marked clearly Please Briefly Describe Any Corrections Made To Deficiencies Found: 280

Employee and Supervisor Conference Form Date: Time: Employee: Employee Position: Supervisor: Supervisor Position: Other Employees/Supervisors Involved: Details of Concerns: Time: Date: Job Number: Description of Concerns: (Reason for Conference) Employee Explanation: Witness Explanation: 281

Has the Employee been Properly Trained for Operations being Performed in Regards to the Concerns? (Mark with X) Yes: No: Frequency of Offense: (Mark with X) First Offense: Second Offense: Third Offense: Action to be Taken: (Mark with X) Counseling/ Written Employee Verbal Suspended Other Training Warning Terminated Warning Corrective Action Required of Employee: (State what is required of employee to do and further disciplinary action that will result if employee does not meet the supervisor expectations.) By signing this document, you acknowledge that you have ready and understood the information contained herein. Employee Signature: Witness Signature: (if applicable) Supervisor Signature: 282

Accident/Incident/Damage Report Project: Date & Time: Damage Address: Supervisor: Employee: Were any injuries reported? If there were injuries, was an injury report completed? Yes No Yes No n/a Was a utility damaged? If a utility was damaged, was a utility damage report completed? Yes No Yes No n/a Equipment Involved: Witnesses of accident/incident/damages: Accident/incident/damage description (please be as specific as possible): Any injuries (please complete an injury report as well): 283

How could this accident/incident/damage have been prevented? Notes/comments: 284

RETURN-TO-WORK PROGRAM GUIDE Every employee should be entered into the Return-to-Work Program upon medical certification that the employee may return to some type of work duty. Written return to work authorization must be obtained from the preferred medical provider. Every attempt should be made to modify the employee’s current job to meet restrictions. Injured employees should usually be under the direct supervision of the Supervisor in the area in which he/she is working. However, Supervisors should understand their responsibility and be willing to work with employees not normally under their control. The Safety Department and the treating physician shall make the final decision, with input from the injured employee’s Supervisor and Authorized Minger Representative, as to when an employee returns to work in either his/her original position, a transitional work assignment, a permanently modified job or a reassigned position. RETURN-TO-WORK PROCESS When an employee has been injured on the job and it is a non-emergency injury the following steps must be taken in order for the Return-to-Work Process to be the most effective and efficient: STEP 1. Injured employee immediately reports any and all injuries to their Supervisors. STEP 2. The Supervisor and employee notify the Safety Department of the injury and complete an injury report when feasible. STEP 3. The employee and Supervisor will call the Work Partners Triage Hotline Service and consult with a physician. If the employee needs further medical attention, he or she will be brought to one of the established preferred medical providers listed in Appendix A. STEP 4. The employee provides the following information to the medical provider: • Minger’s Workers Compensation Information • Workability Form • Job Description • Letter to Treating Physician STEP 5. The employee provides the Safety Department with information from the treating physician. STEP 6. The Safety Department reviews the information from the treating physician and determines if the employee will be able to continue working in their current position with respect to their restrictions given by the treating physician. If the employee is unable to 285

perform their normal work duties a transitional work assignment, alternate work duty or permanent job modification/new position will be offered depending on the medical restrictions. STEP 7. The Safety Department will send a return-to-work employment offer (Appendix C) with respect to the restrictions set forth by the treating physician if the employee is unable to perform regular work duties. STEP 8. The injured employee accepts or declines the employment offer provided by the Safety Department. If the offer is declined, lost time wages will no longer be covered by the insurance company through indemnity payments. STEP 9. If the injured employee accepts the offer, he/she will keep weekly communication with the Safety Department and will immediately provide updates if any changes occur regarding medical restrictions upon any visits to the treating physician. STEP 10. The employee receives clearance from the treating physician for all restrictions and the employee returns to performing normal work duties with no restrictions. The Safety Department informs the insurance company that the employee is no longer working under restrictions and is back to normal work duties. When an employee, who has been injured on the job and placed on workers’ compensation leaves and/or has been released to return to work by the treating physician, the possible return to work options are as follows: OPTION 1: An employee has reached maximum medical improvement and has been released to return to work by the treating physician. The employee is then returned to the original position he/she held prior to workers’ compensation leave. OPTION 2: An employee has not reached maximum medical improvement and is ready to return to a transitional work assignment (limited, light or modified work duty) with approval of the treating physician, but retains some disability which prevents successful performance in the original position. The company will provide work reassignment suitable to the employee’s capacity which is both meaningful, productive and advantageous to the employee and the company. OPTION 3: An employee has reached maximum medical improvement and has been released to return to work by the treating physician, but has received a disability which prohibits employment in his/her previous position. The company will attempt to place the employee in a permanently modified job or another position suitable to the employee’s capacity which is both meaningful, productive and advantageous to the employee and the company. This work placement may be a 286

permanent assignment or either a part-time or temporary assignment until a permanent assignment is found. If a position is not available for work placement, Management will appoint the employee to the first suitable vacancy which occurs. In some cases, the extent of disability may be that vocational rehabilitations will be necessary. If so, Management will make the necessary arrangements for such training to assist the employee in obtaining suitable employment. MATCHING EMPLOYEES TO ALTERNATE DUTY STEP 1. The Safety Department will list all restrictions provided by the physician. STEP 2. The Safety Department and Controller will list all alternate duty jobs, including regular jobs with modifications available. STEP 3. The doctor’s restrictions are then being matched to the best possible alternate duty. In the case where there may be a unique restriction from the physician, a check of the alternate duty job chosen will be made to ensure it meets with the restrictions or can be modified to meet the restriction. STEP 4. If the physician’s restrictions interfere with more than one job as appropriate, the best alternate duty position should be chosen to best meet company needs. STEP 5. The Safety Department meets with the injured employee and physicians as needed to explain the alternate duty position. FINANCIAL RESPONSIBILITIES Minger shall pay the full current salary and benefits of an employee enrolled in the Return-to- Work Program. It is at Minger’s discretion whether or not to offer overtime to employees enrolled in the Return-to-Work Program and may vary from case to case. Should an employee be unable to work due to medically verifiable restrictions, Minger shall pay all related expenses for the injury/illness including Workers’ Compensation benefits whenever possible. An employee’s refusal to participate in the Return-to-Work Program effectively terminates all of Minger’s financial responsibility including, but not limited to, salary, any benefits received and Worker’s Compensation. 287

TRAINING Supervisors must accurately understand their key role in this program. Therefore, Supervisors shall receive training that includes specific details on the Return-to-Work process and their responsibilities under this program. Employees must understand the Return-to-Work process in order for it to be effective and efficient. All employees will be trained on the return-to-work program at initial hire and periodically throughout their employment at Minger Construction. PROGRAM COMMUNICATION The Return-to-Work Program must be effectively communicated to injured employees, affected Supervisors, and preferred providers. Program communication will be achieved by the training of Supervisors, safety orientation training for employees and the distribution of toolbox talks and other means of program literature. Injured employees and affected Supervisors – The Safety Department will provide an employee information package on Workers’ Compensation and Return-to-Work information that provides specific details on injured employees and affected Supervisor’s responsibilities and required actions. Preferred medical providers – They will receive verbal communication from the Safety Department for each case of employee injury. If the Safety Department is unable to accompany the injured employee at the preferred medical facility, this policy and procedures manual along with the additional forms will be provided to the medical provider by the injured employee. 288

EMPLOYMENT OFFER LETTER – RETURN-TO-WORK RETURN-TO-WORK EMPLOYMENT OFFER DATE XX, XXXX FIRST LAST Hand Deliver XX/XX/XXXX ADDRESS 1 CITY, STATE ZIP Dear FIRST LAST: I am pleased to hear of your ongoing recovery from your work-related injury. Minger Construction Co., Inc. looks forward to your successful return to work. I would like to offer you this transitional employment position that meets the medical restrictions outlined by your physician in the enclosed medical report. The shop laborer position is a full-time position. You will be working Monday through Thursday, from 7 a.m. to 5 p.m. You will be compensated at $34.30/hour and will continue to be eligible for MN Laborers Union Fringe Benefits. A copy of the job description further outlining the duties of the position is enclosed. Please contact me with your acceptance or denial of this offer by Monday, April 16, 2018 or earlier if possible. Your first day of work in this position is available immediately and you may begin Monday, April 16, 2018. Please contact me if you have questions about this job offer. I look forward to hearing from you. Sincerely, Mike Nelson Safety Coordinator Minger Construction Co., Inc. 952-368-9200 [email protected] Enclosures: Job Description and Physician’s Work Restrictions cc: Bill Traxler 289

Light-duty Job Description Employee: EMPLOYEE Claim number: XXXXXX, XXXXXX Job title: Shop Laborer Wage: $34.30/hour Work hours: 7 a.m. to 5 p.m. Work days: Mon, Tues, Wed, Thurs Location of job: Minger’s Shop (620 Corporate Drive, Jordan, MN 55352) Duration of job: Temporary Permanent This job is a: Pre-injury job Modified pre-injury job New job The job meets current medical restrictions: Yes No 1. Job duties include: Repairing of slide shoring systems, grinding and metal fabrication, general housekeeping and organizing items throughout the shop and equipment or vehicles, possibility of picking up parts for mechanics. 2. Physical requirements of the job: Working from a sitting and or standing position while grinding and performing metal fabrication work, carrying or moving lightweight items around the shop and or yard not to exceed 20 pounds. Work will be limited as much as possible to below the shoulder work to keep from exacerbating the hernia injuries. Kneeling and squatting will be limited to keep from exacerbating the knee injury. 3. Other job requirements (education, etc.): None. 4. Other comments: Other tasks may be assigned throughout the course of your light duty work, if and only if they are in correspondence to the restrictions set by your doctor. Employee signature: Date: Employer representative: Date: 290

PREFERRED MEDICAL PROVIDER MINNESOTA OCCUPATIONAL HEALTH: OrthoQUICK Woodbury ST. PAUL Woodbury Clinic (Woodlake Center) 1661 St. Anthony Ave 2090 Woodwinds Drive 2nd Floor Woodbury, MN 55125 Phone: 651-968-5806 St. Paul, MN 55104 Hours: Closed – Saturday & Sunday M-F – Open 7:30AM – 4:00PM BLAINE OrthoQUICK Vadnais Heights 10230 Baltimore St. Summit Orthopedics Suite 300 3580 Arcade Street Blaine, MN 55449 Vadnais Heights, MN 55127 Hours: Phone: 651-968-5806 Closed – Saturday & Sunday M-F – Open 7:30AM – 4:00PM EAGAN OrthoQUICK Eagan 1400 Corporate Center Curve Summit Orthopedics Suite 200 2620 Eagan Woods Drive Eagan, MN 55121 Eagan, MN 55121 Hours: Phone: 651-968-5806 Closed – Saturday & Sunday M-F – Open 7:30AM – 4:00PM SHAKOPEE OrthoQUICK Hours – All Locations 4360 12th Ave E • Sunday: 8 AM – 8 PM Shakopee, MN 55379 • Monday: 8 AM – 8 PM Hours: • Tuesday: 8 AM – 8:00 PM Closed – Saturday & Sunday • Wednesday: 8 AM – 8 PM M-F – Open 7:30AM – 4:00PM • Thursday: 8 AM – 8 PM INJURY CARE AFTER HOURS: • Friday: 8 AM – 8 PM Visit urgent care. • Saturday: 8 AM – 8 PM 291

Compliance Inspection Report State: Date: Time: Location Address: Competent Person or Foreman Onsite: COMPLIANCE AGENCY INFORMATION Badge Number: Name of Agency Performing the Inspection: Fax Number: Compliance Officer’s Name: Phone Number: Compliance Agency Address: RECORD OF EVENTS YES ____ NO ____ If yes, what was specifically stated? OPENING Conference Held? Did the Compliance Officer Wait for any Representation Before Beginning the Inspection? NO _____ YES ____ How Long? _______hrs. Name of Rep? Did the Compliance Officer Indicate Any Non-Compliance Issues? YES ____ NO ____ If yes, what indications or observations were made? Did the Compliance Officer Make Any Observations of the Jobsite Before Announcing His/Her Presence? YES ____ NO ____ If yes, what observations were made? Did the Compliance Officer Specifically Ask to See Anything Onsite? YES ____ NO ____ If yes, describe what he/she asked to see? Did the Compliance Officer VIDEO TAPE any Events Onsite? YES ____ NO ____ If yes, describe what was videotaped? 292

Did the Compliance Officer take PHOTOGRAPHS, MEASUREMENTS or SAMPLES? NO ____ YES ____ If yes, please describe. CLOSING Conference Held? YES ____ NO ____ If yes, what was specifically stated? Who attended the closing conference? List the Names of All Employees Onsite: Job Title: Job Title: Name: Job Title: Name: Job Title: Name: Job Title: Name: Name: What Specific Questions were Asked by OSHA and What Specific Answers Were Offered? Question Asked? Answer Given: Question Asked? Answer Given: Question Asked? Answer Given: Question Asked? Answer Given: Name of Person Filling Out This Report: Signature: Date: Phone Number: 293

Project: City: Date: Confined Space Entry Permit Is a permit required for the space to be entered? Yes No If no, complete only 1, 2, 3, 7, 9, 11 and cancel permit. , SEC# , JOB# 1. Permit Space To Be Entered MH#: 2. Purpose of Entry Authorized Duration of Entry Permit 3. Date of Entry 4. Authorized Entrant(s) 5. Attendant (s) 6. Name of Current Entry Supervisor(s) 1. Time Entry Supervisor who Originally Authorized Entry 2. Time Signature or Initials 7. Record hazards of the permit space to be entered. 8. Check off List the measures used to isolate the permit space and to eliminate N/A or control permit space hazards before entry. Hazard Yes No A. Purge-Flush and Vent A. Lack of Oxygen B. Ventilation B. Combustible Gases C. Lockout/Tag Out C. Combustible Vapors D. Inerting D. Combustible Dusts E. Blanking, Blocking, Bleeding E. Toxic Gases F. External Barricades F. Toxic Vapors G. Confined Space Identification/Signs G. Chemical Contact H. Electrical Hazards I. Mechanical Exposure J. Tmperature K. Engulfment L. Entrapment M. Others 294

9. Acceptable Entry Conditions 10. Test(s) To Be Taken Permissible Test 1 Test 2 Test 3 Test 4 Entry Levels A. Oxygen (O2) Name B. Combustible (LEL) 19.5% - 23.5% Telephone C. Hydrogen Sulfide (H2S) <10% LEL D. Carbon Monoxide (CO) <10 PPM E. <25 PPM F. G. H. I. Initials of Tester Test Times 11. Rescue and Emergency Services Available Name Telephone 12. Communication procedures to be used by authorized entrants and attendants. 13. Equipment supplied to the employee. Equipment Description Yes No N/A (i) Gas Test and Monitoring Name Model/Type AM PM Serial/Unit No. Hard Hats Eye Date (ii) Ventilating Ear Face (iii) Communications Safety Harness With Life Hand (iv) Personal Protective Equipment Lines Foot Clothing Respiratory Other (v) Lighting Pedestrian Vehicle (vi) Barriers/Shields Ladders Hoists Resuscitators (vii) Safe Ingress/Egress Lifelines Inhalator (viii) Rescue and Emergency (ix) Other Safety Equipment 14. Other information for this particular confined space to ensure employee safety. 15. Additional Permits Required THIS CONFINED SPACE ENTRY PERMIT HAS BEEN CANCELLED: By: Time Entry Permit Supervisor 295

Confined Space Pre-Entry Checklist and Certification This form is intended to determine if a confined space is a permit-required, alternative procedure required confined space, or non-permit confined space. This evaluation must be performed by the Entry Supervisor who is knowledgeable about safe entry into confined spaces. Work Location: ___________________________ Date: _______ Time: ______ Purpose of Entry ________________________________________________________ Atmosphere tested with (identify gas monitor) _________________________________ Data: Oxygen: _________% Flammable __________%LEL H2S __________PPM CO _________PPM Other: ____________________PPM 1. Identify any physical hazards: ___ i. Chemical ___ a. Electrical b. Mechanical ___ j. Pipelines ___ c. Hydraulic d. Pneumatic ___ k. Welding/cutting ___ e. Radiation f. Temperature extremes ___ l. Falls ___ g. Engulfment h. Noise ___ m. Obstructions ___ ___ n. Converging surfaces ___ ___ o. Other: ________________ ___ ___ p. Other: ________________ ___ 2. Have all physical hazards been eliminated, isolated, YES NO or locked or blocked out? ___ ___ 3. Are there any existing or potential atmospheric hazards? ___ ___ 4. If #3 is YES, will forced-air ventilation control the hazard? ___ ___ 5. Has the weather been checked for possible flash flooding? ___ ___ Atmosphere tested after isolation and ventilation Data: Oxygen: _________% Flammable __________%LEL H2S __________PPM CO _________PPM Other: ____________________PPM For the purpose of this entry this confined space is: Select one: Permit-required -- the full permitting process must be implemented. _____ Alternate-procedure – continuous ventilation and gas monitoring must be used, and all physical hazards must be eliminated or isolated. _____ Non-permit – does not meet the requirements for permit-required. _____ Entry Supervisor: Print name: ________________________Signature: ___________________________ 296

Permit Required Confined Space Rescue Services Evaluation Facility Location: Evaluator: Date of Evaluation: Rescue Service Evaluated: Rescue Service Contact: Rescue Service Phone #: Availability and Response Time Yes No Is the rescue service willing/able to respond to confined space rescues at the above facility? If the rescue service is notified we are performing a confined space entry, will they guarantee their availability or notify us if their confined space rescue services become unavailable? When available, is the rescue service able to provide confined space rescue services at the facility within 3-4 minutes of being notified (for IDLH environments, rescuers must be on standby outside the confined space and available/equipped for immediate action)? Is the rescue service available 24 hrs/day, 365 days/year? If no, enter the times/dates they are unavailable Yes No (entries may not occur during these times): Equipment and Skills Are rescue service crews trained on the hazards of confined space entry and to recognize the signs, symptoms, and consequences of exposure to hazardous atmospheres that exist at this facility? Are rescue service crews trained and equipped for: • IDLH Environments (e.g. SCBA’s, atmospheric monitoring, etc.); • Vertical (> 5’) Tank Entry (e.g. fall protection, technical rope/rigging knowledge, tripod, etc.); • Horizontal Tank Entry; • Limited size openings (less than 24 inches in diameter); and • Limited internal space or internal obstacles. Are crews trained on hazard communication and able to read/understand MSDS information? Do rescue service crews practice confined space rescues at least once every 12 months using confined spaces that are similar to those that may be encountered at this facility? Are crews equipped and trained to provide emergency medical assistance? If “yes” to what level of training? Has the rescue service been informed of the hazards that exist in on-site permit spaces and provided access to the permit spaces for evaluation and training purposes? Notification Procedures How will the rescue service be notified that this facility will be performing a PRCS entry? How will the rescue service be notified in the event of an emergency involving a PRCS entry? If the Agency/Company becomes unavailable while an entry is underway, what is the procedure for notifying this facility so the attendant can instruct the entrants to abort the entry immediately? Final Determination Yes No This rescue service meets all requirements (e.g. all above boxes are checked yes) for a confined space rescue service? If “no” explain: Evaluator’s Signature: 297

IS HOT WORK NECESSARY? IS THERE A SAFER WAY? CAN HOT WORK BE AVOIDED? Hot Work Permit This Hot Work Permit is required for any temporary operation or activity that creates heat, flame, sparks, or smoke. This includes, but is not limited to: welding (gas or arc), cutting, brazing, grinding, soldering, thawing pipe, open flame heaters in buildings and hot asphalt applied roofing. This permit should be prominently displayed at the worksite. Project Name: JOBSITE INSPECTION AND COMMUNICATION Permit Expires: Project Supervisor Name: Job Number: Subcontractor: Date: Hot Work Performed by: Start Time: Employee: Name of person(s) doing hot work: Hot Work Description: Location(s): Primary Ignition Sources: Fire Watch Needed (Print Name): Yes: No: A fire watch should be posted when: Combustible materials within 35' radius of hot work cannot be removed. Wall or floor openings within a 35' radius of hot work expose combustible materials in adjacent areas, including concealed spaces in walls or floors. Combustible materials are adjacent to the opposite side of partitions, walls, ceilings or roofs and are likely to be ignited. It is deemed necessary by the permit authorizing individual. Training Verified: Yes No HOT WORK PRE-TASK PLAN CHECKLIST Are available sprinklers, hose and extinguishers operable? Hot work equipment I good condition? Have combustible materials been Are spark and flash screens in place? Inspected? removed or protected by fire? Is ventilation adequate? Is flammable or combustible resting required? Has the work area been isolated and roped off? Is spark or flames controlled-protected from reaching lower level? Are fire watch personnel needed on multiple Have remote alarms been disabled? floors? Other FIRE WATCH/HOT WORK AREA MONITORING Fire watch will be provided by the contractor during and for a minimum of Fire watch provided with suitable extinguishing 30 minutes after work or as deemed necessary, including during coffee and equipment. lunch breaks. Fire watch shall report any and all incidents to the project supervisor. Fire watch signoff: I have monitored the work area for Fire watch shall not have any other duties that could impact their ability to do their job. 30 minutes and have determined the area to be fire safe. PERMIT CLOSEOUT The information on this permit has been evaluated, the site has been examined and all Date: Time: Person conducting Hot Work Sign off: safety measures are in place. Supervisor Sign Off: Fire Watch Sign off: 298

Heavy Equipment Daily Inspection Checklist Heavy equipment should be inspected daily to prevent costly maintenance or accidents. Use this checklist to verify that your equipment is evaluated daily. As you warm up your equipment to proper running temperature, inspect these important factors. Tip: You also can use this checklist to prep equipment for long-term storage, if needed. Inspection Date: / / Time: a.m./p.m. Unit #: Location: Inspector's Signature: Equipment Type: Hours/Mileage: Inspector's Name: Inspection Working Condition Needs Repair N/A Cab, mirrors, seat belt, and glass Horn and gauges Lights Turn signals Backup lights and alarm Fire extinguisher condition Windshield wipers and fluid Fuel levels Battery Engine oil level Engine oil added? Y or N Transmission fluid Antifreeze Oil leak Brake condition (service, park) Tires or tracks Hydraulic oil Hose condition Coupling devices and connectors Exhaust system Blade/boom/ripper condition Grease Points Cutting Edges Notes/Attachments: 299

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