Minger Construction_SAFETY MANUAL and APPENDIX_2022

Powered Industrial Trucks/Forklift Practical Evaluation Employee Name: Equipment: Evaluated by: Evaluation Date: Forklift Demonstration Steps Demonstrated Unable to Demonstrate 1. Pre-operational inspection of the forklift 2. Safety equipment (seat belts, etc.) 3. Drive and maneuver forklift 4. Drive forklift in reverse 5. Line up and load pallet 6. Lift pallet to drive position 7. Set down pallet at ground level 8. Stack pallet safely on shelf 301

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: 302

FORKLIFT HAND SIGNALS Emergency Stop Stop Stop Engine Pause Everything Raise Load Lower Load Raise Load Slowly Lower Load Slowly This Far To Go Tilt Forks Up Tilt Forks Down The operator must only respond to signals from the designated signaller. The only exception is if anyone gives the emergency stop signal, the operator must follow it. 303

SAFETY EQUIPMENT CHECKLIST I understand that the following personal protective equipment is required on all jobs: Hard Hat Safety toe boots Shirts and long pants ______Class 2 & 3 Retroreflective Safety Vest ANZI Z87.1 rated Safety Glasses and other eye protection Other equipment as required: Work gloves Welding leathers Coveralls Rain gear Respiratory equipment Hearing Protection Gas Detector This list is not intended to be complete. It is the responsibility of the employee to inquire and obtain a detailed hazard assessment to ensure proper PPE for the job is determined. I, acknowledge: (Print your name here) • That I have been instructed as to the hazards and safety regulations on the job as indicated above. • My obligation to abide by all safety requirements of Minger Construction, Co., Inc., and the Project Owner as a condition of my employment and to report all unsafe conditions I discover to my immediate supervisor or other company competent person representative. • I have relayed to Minger Construction, Co., Inc. in writing any conditions that I may require to reasonably accommodate my ability to complete the duties of my position. Employee Signature: ___________________________________ Date: _____/_____/_____ 304

Crane Lift and Rigging Plan General Information Company Name: _______________________ Project Name & #: ____________________________________ Lift Date: _______________ Point of Contact: ________________________ Contact #: _______________ Crane Operator Information Name: _____________________________ License #: _________________________ Exp. Date: ___________ License Type: NCCO/TLL (Swing cab) NCCCO/TSS (fixed cab) Other: __________________ Crane Information Owner: ____________________ Make: _________________ Model: ____________ Gross: ____________ ton Inspection/Certification Date: _____________ Decal on Crane (required) Periodic Report (required) Crane Configuration: On Main Boom On Jib On Outriggers/Stabilizers Load Rating Chart Supplied: Main Boom on Outriggers/Stabilizers Jib Hoist Line Class: Standard Rot Res Breaking Strength: __________ lbs. SWL: _________lbs. Winch: Main Aux Parts of Line Used: __________ Total Line Capacity: __________lbs. Assembly/Disassembly Director (fulfills role as Lift Director & Site Supervisor per ASME) Name: ________________________ Employer: ___________________ Phone #: ______________________ Competent Person: Yes No Qualified Person: Yes No Set Up Procedures Implemented: Crane Manufacturer’s Company Specific (attach copy to this plan) Qualified Rigger Name: ____________________________ Employer: ________________________ Rigger Card Type: Employer (provide documentation) 3rd Party National Certification Card Expiration Date: _____________________ Qualified Person for Rigging Tasks: Yes No Qualified Signal Person Name: ____________________________ Employer: ________________________ Signal Card Type: Employer (provide documentation) 3rd Party National Certification Card Expiration Date: _____________________ Qualified Person for Signal Tasks: Yes No 305

Instructions for Page 1 Contact Information: Use this section to gather all contact information necessary. Make sure you have every section filled with all appropriate phone and cell phone numbers. Crane Operator: Take information directly off the crane operator’s Certification ID card. We recognize NCCCO, CIC NCCER and OECP Certifications. If the operator provides another type of operator qualification cared (internal company, US Military or other), take a copy of the card and consult with CSM as soon as possible. Operators must produce a current medical physical certification. Your state may also require seizures and mental capacity that will not be on a DOT physical. Crane Information: Name and owner of the crane could be a subcontractor and /or a rental company. • Monthly inspections require a competent person to perform them and records (includes 14 items) be provided of the most current prior month’s inspection. Annual inspection require inspections by a qualified person which include issuing the annual inspection sticker and providing a copy of the annual inspection (21 items) per 1926.1412. • Note the configuration the crane will be in during the lifts and secure a copy of the appropriate rating chart from the crane. Note the diameter and class of the wire rope along with the Breaking Strength. Divide breaking strength by 3.5 for standard cable for 5 for rotation resistant cable to arrive at the SWL. • Note the stamped capacity of the load hook and check to see if te hook used has an installed safety latch (larger hooks will not have or require one). Assembly/Disassembly Director (AD) (fulfills role as Lift Director and Site Supervisor per ASME): • Get the name of the certified rigger, his 3rd party Certification Card and Issuer. This certification card should be in the riggers name only with no company on it. -Or- • Get the name of the qualified rigger, his 3rd party or Company Qualification Card and Issuer. This qualification card is company specific and is not portable from one company to another. Qualified Signalperson Onsite • Only Required when (1) The point of operation is not in full view of operator or (2) the operator’s view is obstructed in the direction the equipment is traveling. • Get the name of the qualified signalperson, his 3rd party or Company Qualification Card and Issuer. This qualification card is company specific, is not portable and documenting must be on site. • They have been verified that they understand types, modes and meanings of the signals, crane dynamics, effects of signals on the crane, hazards associated with craning and signaling, the new regulations for working around energized power lines. They have passed a written and/or oral exam and demonstrated knowledge via practical evaluation. 306

Project Site Conditions Overhead Hazards: No Yes (If yes, identify controls): _________________________________________ Underground Hazards: No Yes (If yes, identify controls): ___________________________________ Ground Conditions: Level/Firm/Supportive Poor (explain): ___________________________________ Cribbing: Yes (must be implemented) (cribbing size recommended): ______________________________ Power Line Hazard (<350kV line) (for >350kV, use 50 ft barrier boundary) Overhead Power Lines: No Yes (voltage and document): ___________________________ Demarcation Boundary 20 ft: N/A 360 degLimited area (explain): _______________________ 20 ft Clearance Distance: Can’t reach w/crane Could reach w/crane Will encroach w/crane Proximity Decisions: Maintain 20 ft clearanceDe-energize & ground Use table “A” clearance Table Clearances: Voltage (utility)Warning lines w/proximity alarm Warning lines w/spotter Lift and Rigging Plan Load Description: ____________________________________________ Load Weight: ________________lbs. Projected Measurements: Radius: _____ ft Boom Angle: ______ deg Boom Length: _________ ft Chart Used: Main Boom Jib On Outriggers Load Rating Chart x 0.75 ________________ lbs. Spreader Bar: N/A Mfg. Site Made (PE approval) Shackles: size _________ Rating _______ tons Winch: Main Aux Parts of Line Used: _______________ Total Line Capacity: _________ lbs. Slings: Type: _________________ Size: _____________ In-line Rating: ____________ Length _________ Horizontal Angle _______________ Additional Stress __________ % Hitch Configuration ________________ Lift & Rigging Sketch Reviewed By (Signature): PSO/s Superintendent: _______________________________________ Date: _____________________ SSR: _____________________________________________ Date: ____________________________ 307

Instructions for Page 3 Site Conditions: • Ensure the underground search has been conducted. • Document any overhead encumbrances or hazards. • Ground must be evaluated for crane and load support. • If action is required, indicate who is going to take the appropriate action. • All cranes on Centennial/JV jobsites need to be cribbed. Cribbing should be double the size of the float pad. Power Line Hazard (<350kV line= 20ft) (for greater >350kV line use 50ft barrier boundary) • You must identify the max radius utilized with as a limited use area or 360 degrees via a demarcation line. • If no part of the crane, line, rigging, load or accessories can reach to within 20 feet of an energized power line, then clearly mark the 20 foot barrier and no signal person is required. • If the crane can come within 20 feet of the power line (in any direction), the lines must be de-energized and grounded -Or- • Clearly mark the 20 foot boundary, utilize a qualified signal person/spotter and o not encroach inside the minimum safe distances outlined in the OSHA “A” Table. Lift and Rigging Plan • Known load wight and load configuration for appropriate rigging. • #1 task is to rig for load stability and be level in rigging. • Get projected set down measurements from the dry run with the crane. • Identify all rigging hardware and spreader bars utilized and verify ratings are appropriate. • Verify all rigging components are labeled or tagged with capacity ratings. • Identify and verify all slings utilized capacity ratings are sufficient for the load wight and additional sling angle stress imposed on them. • If any questions arise, consult the qualified rigger and CSM prior to elevating the load. Lift or Rigging Sketch Take time to draw out the position of the crane, height and radius in relation to set down area, distances from the load, buildings, distances from hazards, lines of demarcation and 20 foot power line barrier zone. You should also sketch the shape of the load, load weight, rigging hitches, lengths and types of slings and any other configurations utilized. Required Documentation Checklist Copy of Operator’s License Copy of Crane Load Rating Chart Copy of Operator’s Medical Cert. Sketch of Site Layout and Rigging Copy of Riggers Card or Cert. Copy of Company Crane Setup Copy of Annual Crane Insp. Cert. Utility Owner Voltage Information Copy of Monthly Crane Insp. Cert. PE spreader bar or custom rigging 308

360 Degree Rating – Loads in lb. x 1000 RADIUS MAIN BOOM with TRACKS FULLY EXTENDED RADIUS (ft) 35,000 lb. COUNTERWEIGHT (ft) 10 10 12 MAIN BOOM LENGTH (ft) 12 15 15 20 42.0 51.6 61.1 70.7 85.0 99.3 113.7 128.0 20 200.0 140.0 120.0 96.0 25 172.0 132.0 109.0 86.0 70.0 25 155.0 120.0 95.0 75.0 64.0 50.0 30 129.0 100.0 78.0 61.0 53.0 47.0 45.0 40.0 30 35 35 112.2 90.0 70.0 55.0 46.0 44.0 42.0 37.5 40 40 45 79.6 78.9 62.0 49.0 43.0 41.5 38.0 35.0 45 65.2 64.5 54.0 42.0 37.5 35.5 33.5 32.5 50 50 55 47.0 46.5 37.0 35.0 34.2 30.0 29.0 55 38.0 37.6 35.0 33.0 30.6 27.5 26.9 60 60 65 30.8 30.4 31.0 27.0 25.0 24.0 65 70 25.3 25.1 25.9 24.8 23.0 21.8 70 75 20.8 22.2 22.8 21.0 19.5 75 80 17.7 19.3 20.8 19.0 17.8 80 85 85 17.2 18.3 17.2 16.0 90 90 95 15.1 16.2 16.0 14.8 95 100 13.0 14.1 14.6 13.9 100 105 105 110 12.3 13.1 12.7 110 115 115 120 10.8 11.5 11.8 120 10.3 10.7 9.0 9.4 7.9 8.4 7.5 6.6 5.9 309

Each Shift Crane Inspection Report Operator _______________________________________________________________ Date ______________ Shift _____________ Unit Inspected ___________________________________ Serial Number _______________________________ Instructions: Each crane must be inspected by a competent person prior to each shift it will be used, and completed before or during that shift. The inspection consists of observations for apparent deficiencies. For wire rope, the inspection must consist of observation of wire ropes (running and standing), that are likely to be in use during the shift, for apparent deficiencies. Untwisting (opening) of wire rope or booming down is not required as part of this inspection. Each lift made with Type 2 or Type 3 rotation resistant wire rope must be inspected by a qualified person and recorded. See 19 and 20 below. Indicate “S” for satisfactory, “U” for unsatisfactory, “N/A” for not applicable. Mechanical S U N/A Critical review items S U N/A 21. Rotation resistant wire rope in use 1. Control Mechanisms are operating properly 2. Control and drive mechanisms show or 22. Wire rope used for boom hoists and luffing hoists, excessive wear or contamination particularly at revers bends 3. Air, hydraulic, and other pressurized lines 23. Wire rope at flange, crossover, and repetitive are free of leaks or deterioration pickup points on drums 4. Hydraulic system has proper fluid level 24. Wire rope at or near terminal ends 5. Hooks and latches are free of deformation, 25. Wire rope in contact with saddles, equalizer cracks, excessive wear, or damage sheaves, or other sheaves where rope travel is limited Wire Rope Other Required Inspections 6. Wire rope reeving complies with the manufacturer’s specifications 26. Electrical apparatus has no excessive deterioration, dirt, or moisture accumulation. Category I inspection criteria 7. Wire rope is free of significant distortion (i.e. 27. Tires properly inflated and in good condition 28. Ground conditions provide proper support (See note 3) kinking, crushing, unstranding, etc.) 8. Wire rope is free of significant corrosion 29. Equipment is level within specified tolerances (See 9. Wire rope has no electric arc or heat damage note 4) (from sources other than power lines) 30. Operator cab windows are free of significant 10. Wire rope end connections are properly applied cracks, breaks, or other deficiencies. 11. Wire rope end connections are free of significant 31. Rails, rail stops, rail clamps, and supporting corrosion, cracks, bends or wear surfaces in proper condition An Other Required Inspection item(s) is A Category Item(s) is unsatisfactory and unsatisfactory and deemed a safety hazard. deemed a safety hazard. The equipment or The equipment must be taken out of service hoist has been tagged-out and one of the until corrected. following actions were taken: Safety Devices (See note 5) Followed manufacturer’s criteria for removal 32. Crane level indicator – equipped with and Entire wire rope was replaced operating properly Damaged portion was removed (no splicing) (See note 1) 33. Bloom stops operating properly Category 2 inspection criteria (See note 2) 34. Jib stops operating properly 12. Running wire ropes have acceptable number of visible broken wires 35. Foot pedal brakes equipped with locks 13. Rotation resistant ropes have acceptable number 36. Hydraulic outrigger and stabilizer jacks have of visible broken wires 14. Pendants or standing wire ropes have acceptable integral holding device/check valve number of visible broken wires 37. Equipment on rails have rail clamps and rail stops 15. Wire rope diameter reduction of no more than 5 percent 38. Horn – equipped with and operating properly A Safety Device(s) is unsatisfactory. The equipment has been tagged and taken out-of-service until device is working properly 310

A Category 2 item(s) is unsatisfactory. The Operational Aids equipment or hoist has been tagged-out and one of the following actions were taken: Category 1 inspection criteria 39. Boom hoist limiting device – equipped with and Entire wire rope was replaced Damaged portion was removed (no operating properly splicing) (See note 1) 40. Luffing jib limiting device – equipped with and Category 3 inspection criteria operating properly 16. Rotation resistant wire rope has no core failure 41. Anti-two-blocking device – equipped with and (core protrusions, other distortion) operating properly 17. Wire rope has no apparent electrical contact with A Category 1 items(s) is unsatisfactory. The a power line temporary alternative measures (See note 6) were implemented 18. Wire rope has no broken strand A Category 3 item(s) is unsatisfactory. The Category 2 inspection criteria equipment or hoist has been tagged-out and 42. Boom angle or radius indicator readable from one of the following actions were taken: Entire wire rope replaced. operator’s station Damaged portion was removed (no splicing) (See note 1) 43. Jib angle indicator operating properly 44. Telescopic boom equipped with boom length Note: Repair of power line damaged rope is prohibited. indicator 19. Number of lifts made by Type 2 rotation resistant 45. Load weighing device, load moment indicator, or rope ________ load moment limiter – equipped with and 20. Number of lifts made by Type 3 rotation resistant operating properly rope A Category 2 item(s) is unsatisfactory. The temporary alternative measures (See note 7) were implemented For equipment manufactured after November 8, 2011, see notes for additional inspection items. Remarks: _________________________________________________________________________________________________ ________________________________________________________________________________________________________________ Name of person conduction inspection: ________________________________________________________________________________ Signature of person conducting inspection: _________________________________________ Date of inspection:_____________________ 311

48174 Hand Signals for Crane Operation Federal Register / Vol. 75, No. 152 / Monday, August 9, 2010 / Rules and Regulations emcdonald on DSK2BSOYB1PROD with RULES2 ER09AU10.003</GPH> 312 VerDate Mar<15>2010 17:33 Aug 06, 2010 Jkt 220001 PO 00000 Frm 00270 Fmt 4701 Sfmt 4700 E:\\FR\\FM\\09AUR2.SGM 09AUR2

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OSHA Construction Fall Protection Requirements 314

OSHA Respirator Medical Evaluation Questionnaire (Mandatory) To the employer: Answers to questions in Section 1, and to question 9 in Section 2 of Part A, do not require a medical examination. To the employee: Your employer must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you. To maintain your confidentiality, your employer or supervisor must not look at or review your answers, and your employer must tell you how to deliver or send this questionnaire to the health care professional who will review it. Part A - Section 1. (Mandatory) The following information must be provided by every employee who has been selected to use any type of respirator (please print). 1. Today's date: 2. Your name: 3. Your age (to nearest year): 4. Sex (circle one): Male / Female 5. Your height: __________ ft. __________ in. 6. Your weight: ____________ lbs. 7. Your job title: 8. A phone number where you can be reached by the health care professional who reviews this questionnaire (include the Area Code): 9. The best time to phone you at this number: 10. Has your employer told you how to contact the health care professional who will review this questionnaire (circle one): Yes/No 11. Check the type of respirator you will use (you can check more than one category): N - R, or P disposable respirator (filter-mask, non - cartridge type only). Other type (for example, half or full-face piece type, powered-air purifying, supplied- air, SCBA) 12. Have you worn a respirator (circle one): Yes / No If \"yes,\" what type(s) 315

Part A Section 2 (Mandatory) Questions 1 through 9 below must be answered by every employee who has been selected to use any type of respirator (circle \"yes\" or \"no\") 1. Do you currently smoke tobacco, or have you smoked tobacco in the last month: Yes/No 2. Have you ever had any of the following conditions? a. Seizures (fits): Yes/No b. Diabetes (sugar disease): Yes/No c. Allergic reactions that interfere with your breathing: Yes/No d. Claustrophobia (fear of closed-in places): Yes/No e. Trouble smelling odors: Yes/No 3. Have you ever had any of the following pulmonary or lung problems? a. Asbestosis: Yes / No b. Asthma: Yes / No c. Chronic bronchitis: Yes / No d. Emphysema: Yes / No e. Pneumonia: Yes / No f. Tuberculosis: Yes / No g. Silicosis: Yes / No h. Pneumothorax (collapsed lung): Yes / No i. Lung cancer: Yes / No j. Broken ribs: Yes / No k. Any chest injuries or surgeries: Yes/ No l. Any other lung problem that you've been told about: Yes / No 4. Do you currently have any of the following symptoms of pulmonary or lung illness? a. Shortness of breath: Yes/No b. Shortness of breath when walking fast on level ground or walking up a slight hill or incline: Yes/No c. Shortness of breath when walking with other people at an ordinary pace on level ground: Yes/No d. Have to stop for breath when walking at your own pace on level ground: Yes/No e. Shortness of breath when washing or dressing yourself: Yes/No f. Shortness of breath that interferes with your job: Yes/No g. Coughing that produces phlegm (thick sputum): Yes/No h. Coughing that wakes you early in the morning: Yes/No i. Coughing that occurs mostly when you are lying down: Yes/No j. Coughing up blood in the last month: Yes/No k. Wheezing: Yes/No 316

l. Wheezing that interferes with your job: Yes/No m. Chest pain when you breathe deeply: Yes/No n. Any other symptoms that you think may be related to lung problems: Yes/No 5. Have you ever had any of the following cardiovascular or heart problems? a. Heart attack: Yes / No b. Stroke: Yes / No c. Angina: Yes / No d. Heart failure: Yes / No e. Swelling in your legs or feet (not caused by walking): Yes / No f. Heart arrhythmia (heart beating irregularly): Yes / No g. High blood pressure: Yes / No h. Any other heart problem that you've been told about: Yes / No 6. Have you ever had any of the following cardiovascular or heart symptoms? a. Frequent pain or tightness in your chest: Yes / No b. Pain or tightness in your chest during physical activity: Yes / No c. Pain or tightness in your chest that interferes with your job: Yes / No d. In the past two years, have you noticed your heart skipping or missing a beat: Yes / No e. Heartburn or indigestion that is not related to eating: Yes / No f. Any other symptoms that you think may be related to heart or circulation problems: Yes / No 7. Do you currently take medication for any of the following problems? a. Breathing or lung problems: Yes / No b. Heart trouble: Yes / No c. Blood pressure: Yes / No d. Seizures (fits): Yes / No 8. If you've used a respirator, have you ever had any of the following problems? (If you've never used a respirator, check the following space and go to question 9:) a. Eye irritation: Yes/No b. Skin allergies or rashes: Yes/No c. Anxiety: Yes/No d. General weakness or fatigue: Yes/No e. Any other problem that interferes with your use of a respirator: Yes/No 317

Would you like to talk to the health care professional who will review this questionnaire about your answers to this questionnaire: Yes/No Questions 10 to 15 below must be answered by every employee who has been selected to use either a full-face piece respirator or a self-contained breathing apparatus (SCBA). For employees who have been selected to use other types of respirators, answering these questions is voluntary. 10. Have you ever lost vision in either eye (temporarily or permanently): Yes/No 11. Do you currently have any of the following vision problems? a. Wear contact lenses: Yes/No b. Wear glasses: Yes/No c. Color blind: Yes/No d. Any other eye or vision problem: Yes/No 12. Have you ever had an injury to your ears, including a broken ear drum: Yes/No 13. Do you currently have any of the following hearing problems? a. Difficulty hearing: Yes/No b. Wear a hearing aid: Yes/No c. Any other hearing or ear problem: Yes/No 14. Have you ever had a back injury: Yes/No 15. Do you currently have any of the following musculoskeletal problems? a. Weakness in any of your arms, hands, legs, or feet: Yes/No b. Back pain: Yes/No c. Difficulty fully moving your arms and legs: Yes/No d. Pain or stiffness when you lean forward or backward at the waist: Yes/No e. Difficulty fully moving your head up or down: Yes/No f. Difficulty fully moving your head side to side: Yes/No g. Difficulty bending at your knees: Yes/No h. Difficulty squatting to the ground: Yes/No i. Climbing a flight of stairs or a ladder carrying more than 25 lbs: Yes/No j. Any other muscle or skeletal problem that interferes with using a respirator: Yes/No 318

Part B Any of the following questions, and other questions not listed, may be added to the questionnaire at the discretion of the health care professional who will review the questionnaire. 1. In your present job, are you working at high altitudes (over 5,000 feet) or in a place that has lower than normal amounts of oxygen: Yes/No If \"yes,\" do you have feelings of dizziness, shortness of breath, pounding in your chest, or other symptoms when you're working under these conditions: Yes/No 2. At work or at home, have you ever been exposed to hazardous solvents, hazardous airborne chemicals (e.g., gases, fumes, or dust), or have you come into skin contact with hazardous chemicals: Yes/No If \"yes,\" name the chemicals if you know them: 3. Have you ever worked with any of the materials, or under any of the conditions, listed below: a. Asbestos: Yes/No b. Silica (e.g., in sandblasting): Yes/No c. Tungsten/cobalt (e.g., grinding or welding this material): Yes/No d. Beryllium: Yes/No e. Aluminum: Yes/No f. Coal (for example, mining): Yes/No g. Iron: Yes/No h. Tin: Yes/No i. Dusty environments: Yes/No j. Any other hazardous exposures: Yes/No If \"yes,\" describe these exposures: 4. List any second jobs or side businesses you have 5. List your previous occupations: 6. List your current and previous hobbies: 7. Have you been in the military services? Yes/No If \"yes,\" were you exposed to biological or chemical agents (either in training or combat): Yes/No 8. Have you ever worked on a HAZMAT team? Yes/No 9. Other than medications for breathing and lung problems, heart trouble, blood pressure, and seizures mentioned earlier in this questionnaire, are you taking any other medications for any reason (including over-the-counter medications): Yes/No 319

If \"yes,\" name the medications if you know them: 10. Will you be using any of the following items with your respirator(s)? a. HEPA Filters: Yes/No b. Canisters (for example, gas masks): Yes/No c. Cartridges: Yes/No 11. How often are you expected to use the respirator(s) (circle \"yes\" or \"no\" for all answers that apply to you)? a. Escape only (no rescue): Yes/No b. Emergency rescue only: Yes/No c. Less than 5 hours per week: Yes/No d. Less than 2 hours per day: Yes/No e. 2 to 4 hours per day: Yes/No f. Over 4 hours per day: Yes/No 1. Will you be wearing protective clothing and/or equipment (other than the respirator) when you're using your respirator: Yes/No If \"yes,\" describe this protective clothing and/or equipment 2. Will you be working under hot conditions (temperature exceeding 77 deg. F): Yes/No 3. Will you be working under humid conditions: Yes/No 4. Describe the work you'll be doing while you're using your respirator(s):_______________________________________________________________ _________________________________________________________________________ 5. Describe any special or hazardous conditions you might encounter when you're using your respirator(s) (for example, confined spaces, life-threatening gases): _________________________________________________________________________ _________________________________________________________________________ 6. Provide the following information, if you know it, for each toxic substance that you'll be exposed to when you're using your respirator(s): Name of the first toxic substance: Estimated maximum exposure level per shift: Duration of exposure per shift Name of the second toxic substance: 320

Estimated maximum exposure level per shift: Duration of exposure per shift: ___________________________________________________ Name of the third toxic substance: _________________________________________________ Estimated maximum exposure level per shift: Duration of exposure per shift: ___________________________________________________ The name of any other toxic substances that you'll be exposed to while using your respirator: ____________________________________________________________________________ Describe any special responsibilities you'll have while using your respirator(s) that may affect the safety and well-being of others (for example, rescue, security):______________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 321

Annual Respirator Fit Test Record Annual Respirator Fit Test Record Date: Employee Data Employee Name: Job Title: Date Respiratory Protection Assigned: Respirator Data Model Manufacturer Assigned Protection Factor Type/Face Piece NIOSH/MSHA Approval No._________________ Size Fit Test Results Test Code Positive/Negative Fit* Factor Pass/Fail Test Date (See below) Pressure Fit Check Test Code Table Qualitative Quantitative QL1 - Isoamyl QN1 - Oil Mist Acetate QL2 - Irritant Smoke QN2 - Sodium Chloride QL3 - Saccharin Mist QN3 - Ambient Aerosol QL4 - Other QN4 - Other (Describe) (Describe) * For quantitative tests only, enter the measured fit factor. Attach test equipment documentation. 322

Respirator types OSHA Specifications 1910.120 & PPE LEVEL A LEVEL A To be selected when the greatest level of respiratory Positive pressure (pressure demand), self-contained protection is required: Positive pressure, full face piece breathing apparatus (MSHA/NIOSH approved) self-contained breathing apparatus (SCBA), or positive pressure supplied air respirator with escape SCBA, • Fully encapsulating chemical resistant suit approved by the National Institute for Occupational • Gloves, inner, chemical resistant Safety and Health (NIOSH). • Gloves, outer, chemical resistant Note: In 29CFR§1910.120 (g) (3) (iii), OSHA requires that Level A Boots, chemical resistant, steel toe and shank (worn over or respiratory protection be used \"when chemical exposure levels present under suit boot) will create a substantial possibility of immediate death, immediate serious illness or injury, or impair the ability to escape.\" • Underwear, cotton, long-john type* LEVEL B • Coveralls (under suit)* To be selected when the highest level of respiratory • Hard hat (under suit)* protection is necessary, but a lesser level of skin protection is needed: Positive pressure, full face piece • Two-way radio communications (intrinsically safe) self-contained breathing apparatus (SCBA), or positive pressure supplied air respirator with escape SCBA LEVEL B (NIOSH approved). Self-contained breathing apparatus Note: Level B respiratory protection specified by OSHA is identical to Level A respiratory protection. The hazards involve \"atmospheres that Chemical resistant clothing (overalls and long sleeved present severe inhalation hazards and that do not represent a severe jacket, chemical resistant coveralls) skin hazard; or that do not meet the criteria for use of air-purifying respirators.\" Coveralls (under splash suit)* Gloves, outer, inner; chemical resistant Boots, outer, chemical resistant, steel toe and shank • Boots, outer, chemical resistant* • Two-way radios (intrinsically safe) • Hard hat LEVEL C LEVEL C To be selected when the concentration(s) and type(s) of Full-face, air purifying respirator (MSHA/NIOSH approved) airborne substance(s) is known and the criteria for using Chemical resistant clothing (one piece coverall, hooded two air purifying respirators are met: piece chemical splash suit, chemical resistant hood and 1. Full-face or half-mask air purifying respirators apron, disposable chemical resistant coveralls) (NIOSH approved). • Gloves, outer, chemical resistant 2. Escape mask (optional). • Gloves, inner, chemical resistant* Note: In 29CFR§1910.120 (g) (iii) (vi) OSHA requires that respirators • Boots, steel toe and shank, chemical resistant be selected and used in accordance with 29CFR§1910.134. Cloth coveralls (inside chemical protective clothing)* Respirators (NIOSH approved) other than those described in Levels Two-way radio communications (intrinsically safe)* A,B,C, and D may be more appropriate and may be used to provide Hard hat*, Escape mask* the proper level of protection. Thus, where Level A or B respiratory protection is not required (eg. In a non-IDLH atmosphere), but air- purifying respirators are inadequate because of the presence of excessive concentration levels of gases or vapors having poor warning properties, suitable airline respirators may be used. LEVEL D LEVEL D No respirator is required. However, OSHA does specify Primarily a work uniform and should not be worn on any an \"escape mask\" as optional equipment to insure a site where respiratory or skin hazards exist. safe escape should an inhalation hazard unexpectedly and suddenly appear. 323

Manufacturer Recommendation Using the Manufacturer's Recommendation to determine a cartridge's service life Chemical and respirator manufacturers may be able to provide an estimate based upon their own expertise and testing data. Steps Example 1. Obtain the following information: Steve is the owner of an auto body shop, where the workers are exposed to paint vapors. The airborne • names of airborne contaminants chemical is Xylene. Steve determined through • concentrations of those sampling that the amount of Xylene in the air doesn’t exceed 400 ppm. The local weather conditions contaminants (in parts per million) suggest an expected maximum of 55% relative • humidity in work area humidity. Steve figures his painters and other helpers • work rate have a moderate breathing rate — their work is not as vigorous as shoveling snow. 2. Contact the manufacturer of the Steve went to the Advisor page called \"List of Manufacturers\" where he located the address, fax respirators you plan to use number, and phone number of SafetyFirst, the makers of BreathEZ respirators. He phoned SafetyFirst and 3. Provide the manufacturer with the was directed to the Research Coordinator. following information: Steve explained to the coordinator that he had just • name of the respirator model purchased 5 new BreathEZ 450 Half Mask • information from step 1 Respirators. He explained the situation and gave the necessary data. The coordinator said he would get back with Steve shortly. 4. Request the cartridge service life as When the coordinator called back with an estimated cartridge life recommendation of 190 minutes, Steve well as the exact objective information asked him to fax a report indicating the exact they relied upon to project that service procedures and objective data that were used to derive life. the service life. 5. Create a written change schedule for Steve applied a safety factor to the manufacturer's suggested cartridge service life and had his employees the cartridges change their cartridges every two hours. He included the report from SafetyFirst and his safety factor modification in his written respiratory protection program. . Minger Construction Co., Inc. will always follow the manufacturer’s recommendations for respirator cartridge scheduled change. 324

RESPIRATORY PROTECTION 29 CFR 1910.134 (Mandatory) Information for Employees Using Respirators When Not Required Under the Standard Respirators are an effective method of protection against designated hazards when properly selected and worn. Respirator use is encouraged, even when exposures are below the exposure limit, to provide an additional level of comfort and protection for workers. However, if a respirator is used improperly or not kept clean, the respirator itself can become a hazard to the worker. Sometimes, workers may wear respirators to avoid exposures to hazards, even if the amount of hazardous substance does not exceed the limits set by OSHA standards. If your employer provides respirators for your voluntary use, of if you provide your own respirator, you need to take certain precautions to be sure that the respirator itself does not present a hazard. You should do the following: 1. Read and heed all instructions provided by the manufacturer on use, maintenance, cleaning and care, and warnings regarding the respirator’s limitations. 2. Choose respirators certified for use to protect against the contaminant of concern. NIOSH, the National Institute for Occupational Safety and Health of the U.S. Department of Health and Human Services, certifies respirators. A label or statement of certification should appear on the respirator or respirator packaging. It will tell you what the respirator is designed for and how much it will protect you. 3. Do not wear your respirator into atmospheres containing contaminants for which your respirator is not designed to protect against. For example, a respirator designed to filter dust particles will not protect you against gases, vapors, or very small solid particles of fumes or smoke. 4. Keep track of your respirator so that you do not mistakenly use someone else's respirator. Acknowledgment of Minger Construction Co., Inc.’s Written Respiratory Protection Program I the unsigned have read, or have had read to me, the Written Respiratory Protection Program. I understand it is my responsibility to follow these respiratory safety guidelines / requirements at all times. I have received and read, or have read to me a copy of Appendix D to sec. 1910.134 (Mandatory) Information for Employees Using Respirators When Not Required Under the Standard. I understand that if I do not know or understand any part of this written respiratory protection program, I am supposed to ask my supervisor or the company designated program administer. Employee Name Employee Signature Date 325

Job Name: Silica Exposure Control Plan General Site Information Competent Person: Job Number: Date: Address: Description of Work: Part 1 Will you generate dust containing Silica on the job? The materials listed below contain silica. Select all of the materials you plan to encounter. Asphalt Gunite/Shotcrete Sand Brick Mortrar Soil (fill dirt, top soil, soil Cement w/fly ash added) Concrete Block Paints Containing Silica Stone (granite, limestone, quart Plaster sandstone, shale, slate, cultured, etc.) Stucco/EIFS Drywall Refractory Mortar/Castables Terrazzo Fiber Cement Products Tile (clay and ceramic) Grout Rock Material Other Roof Tile (concrete) Part 2 Which Activities will be Performed? Abrasive Blasting Grinding Sanding Bushhammering Jackhammering Scabbling Cutting/Sawing Milling Scarifying Demolishing/Disturbing Mixing/Pouring Scarping Drilling/Coring Polishing Sweeping/Clean Up Earthmoving Sacking/Patching Other Part 3 Indicate the engineering and work practice controls from Table 1. See Attached. Operate equipment from within an Other ____________________________ enclosed cab when conditions dictate. Apply water and/or dust suppressants as Other ____________________________ necessary to minimize dust emissions. Other ____________________________ Tools equipped with integrated water delivery system. Respiratory protection when all Tools with commercial dust collection system. engineering and administrative controls are exhausted. 326

Part 4 Exposure assessment and Controls Please describe the procedures to restrict access to work areas, when necessary, to minimize the number of employees exposed to respirable crystalline silica and their level of exposure, including exposures generated by other employers or sole proprietors. Required by 29 CFR 1926.1153(g)(1)(iv) Check all that apply Signage Berms Caution Tape Verbal Communication Please use the space below to describe the training that will be provided to workers engaged in dust producing tasks and those working nearby. Employees annual silica training and site-specific training for work potentially exposing employees to Respirable Silica. Please use the space below to describe the housekeeping measures that will be used on the project to limit employee exposure to respirable crystalline silica. Required by 29 CFR 1926.1153 (g)(1)(iii) Please use the space below to describe medical surveillance that will be provided to workers exposed to silica dust. Please use the space below to describe medical surveillance that will be provided to workers exposed to silica dust. **Medical Surveillance is not expected, as it is not anticipated employees will be required to wear respirators for over 30 days per year.** Please use the space below to describe other things that need to be taken into consideration when controlling dust on this project. In the event Table 1 Controls will not alleviate the Silica Hazard Please contact Safety Department for additional plan development. 327