Muskogee Public Schools
Hazard Assessment Form
Job Description: Transportation Mechanic
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
X
BURN
CHEMICAL SPLASH
X
ELECTRICAL SHOCK
X
IMPACT
X
OTHER
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
NO
PPE Provided
X
CHEMICALS
DUST
X
HEAT
Safety Glasses
X
IMPACT
LIGHT/RADIATION
Safety Glasses
X
X
Welding Helmet
OTHER
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Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
BURNS
YES
X
CHEMICAL EXPOSURE
X
CUTS/ABRASION
X
PUNCTURE
OTHER
NO
PPE Provided
Leather Gloves
Rubber Gloves
Leather Gloves
X
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
CHEMICAL EXPOSURE
NO
X
PPE Provided
Rubber Boots
COMPRESSION
X
IMPACT
X
PUNCTURE
OTHER
X
Other Hazards:
Ear plugs for noise protection
Body fluid cleanup kits on all buses for driver protection. Kit includes
plastic gloves and mask for body fluid spills.
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Muskogee Public Schools
Hazard Assessment Form
Job Description: Maintenance Department Employees
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
X
Welders helmets
BURN
CHEMICAL SPLASH
x
ELECTRICAL SHOCK
x
IMPACT
x
OTHER
x
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
NO
PPE Provided
Safety Glasses
x
CHEMICALS
DUST
x
HEAT
x
Safety shields and glasses
Welders Helmets
IMPACT
x
LIGHT/RADIATION
x
OTHER
Welders Helmets
x
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Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
BURNS
YES
x
CHEMICAL EXPOSURE
x
CUTS/ABRASION
x
PUNCTURE
OTHER
x
NO
PPE Provided
Appropriate gloves for task
Appropriate gloves for task
Appropriate gloves for task
Appropriate gloves for task
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
CHEMICAL EXPOSURE
NO
PPE Provided
X
COMPRESSION
x
IMPACT
x
PUNCTURE
OTHER
Enclosed shoe required
x
x
Other Hazards:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_____________________________________________
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Muskogee Public Schools
Hazard Assessment Form
Job Description: Warehouse/Delivery personnel
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
x
BURN
CHEMICAL SPLASH
x
ELECTRICAL SHOCK
x
IMPACT
x
OTHER
x
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
CHEMICALS
DUST
NO
x
x
HEAT
x
IMPACT
x
LIGHT/RADIATION
x
OTHER
PPE Provided
x
Page
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Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
YES
NO
BURNS
x
CHEMICAL EXPOSURE
x
CUTS/ABRASION
x
PUNCTURE
OTHER
PPE Provided
x
x
Leather gloves provided to protect hands
In below zero conditions (warehouse
freezer)
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
NO
CHEMICAL EXPOSURE
x
COMPRESSION
x
IMPACT
x
PUNCTURE
OTHER
PPE Provided
Leather, steel toed, non skid shoes provided
x
x
Other Hazards: ______sub zero overalls and coats provided while employee is
working in freezer
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_______________________________________
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Muskogee Public Schools
Hazard Assessment Form
Job Description: Child Nutrition Technician
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
x
BURN
CHEMICAL SPLASH
x
ELECTRICAL SHOCK
x
IMPACT
x
OTHER
x
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
NO
PPE Provided
x
Safety glasses
CHEMICALS
DUST
x
HEAT
x
IMPACT
x
LIGHT/RADIATION
x
OTHER
x
Page
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Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
BURNS
YES
x
CHEMICAL EXPOSURE
x
CUTS/ABRASION
x
PUNCTURE
OTHER
NO
PPE Provided
Hot pads and mitts
Rubber gloves
Mesh gloves
x
x
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
CHEMICAL EXPOSURE
NO
x
PPE Provided
Leather, non skid shoes
COMPRESSION
x
IMPACT
x
PUNCTURE
OTHER
x
x
Other Hazards:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_____________________________________________
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Muskogee Public Schools
Hazard Assessment Form
Job Description: Transportation Drivers
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
X
BURN
CHEMICAL SPLASH
X
ELECTRICAL SHOCK
X
IMPACT
X
OTHER
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
NO
PPE Provided
X
CHEMICALS
DUST
X
HEAT
Safety Glasses
X
IMPACT
LIGHT/RADIATION
Safety Glasses
X
X
Welding Helmet
OTHER
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Muskogee Public Schools
Hazard Assessment Form
Job Description: Custodians
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
x
BURN
CHEMICAL SPLASH
x
ELECTRICAL SHOCK
x
IMPACT
x
OTHER
x
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
NO
PPE Provided
Safety Glasses
x
CHEMICALS
DUST
x
Safety shields and glasses
HEAT
x
IMPACT
x
LIGHT/RADIATION
x
OTHER
x
Page
1 of 2
Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
YES
BURNS
CHEMICAL EXPOSURE
x
CUTS/ABRASION
x
PUNCTURE
OTHER
x
NO
PPE Provided
x
Appropriate gloves for task
Appropriate gloves for task
Appropriate gloves for task
Appropriate gloves for task
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
NO
CHEMICAL EXPOSURE
X
COMPRESSION
x
IMPACT
x
PUNCTURE
OTHER
PPE Provided
Enclosed shoe required
x
x
Other Hazards: _Bloodborne Pathogen clean up kit available in all site with PPE
required depending on body fluid spill.
Page 2 of 2
Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
BURNS
YES
X
CHEMICAL EXPOSURE
X
CUTS/ABRASION
X
PUNCTURE
OTHER
NO
PPE Provided
Leather Gloves
Rubber Gloves
Leather Gloves
X
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
CHEMICAL EXPOSURE
NO
X
Rubber Boots
COMPRESSION
X
IMPACT
X
PUNCTURE
OTHER
X
Other Hazards:
Ear plugs for noise protection
Page 2 of 2
PPE Provided
Muskogee Public Schools
Hazard Assessment Form
Job Description: Campus Police
HEAD HAZARDS - Tasks that can cause head hazards include: Working below other workers who
are using tools and materials which could fall, working on energized electrical equipment, working
with chemicals, and working under machinery or processes which might cause materials or objects
to fall.
YES
NO
PPE Provided
x
BURN
CHEMICAL SPLASH
x
ELECTRICAL SHOCK
x
IMPACT
x
OTHER
x
EYE HAZARDS - Tasks that can cause eye hazards include: Working with acids and chemicals,
chipping, grinding, furnace operations, sanding, welding and woodworking.
YES
CHEMICALS
DUST
NO
x
x
HEAT
x
IMPACT
x
LIGHT/RADIATION
x
OTHER
PPE Provided
x
Page
1 of 2
Muskogee Public Schools
Hazard Assessment Form
HAND HAZARDS - Tasks that can cause hand hazards include: Cutting materials, working with
chemicals and working with hot objects.
YES
BURNS
NO
PPE Provided
x
CHEMICAL EXPOSURE
x
CUTS/ABRASION
x
Puncture and cut proof Gloves
PUNCTURE
OTHER
x
Puncture and cut proof gloves
x
FOOT HAZARDS - Tasks that can cause foot hazards include: Carrying or handling materials
that could be dropped, performing manual material handling, walking on sharp surfaces and
working with chemicals.
YES
NO
CHEMICAL EXPOSURE
x
COMPRESSION
x
IMPACT
x
PUNCTURE
OTHER
PPE Provided
x
x
Static free Boots 5 -11 Tact
Other Hazards: _
Ballistic Vest Bullet and Knife, Level 3,
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
__________________________________________
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