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74 <br /> <br /> <br /> <br /> (√) <br />If Present Potential Hazard Potential Harm <br /> Source And Location Of Hazard <br />(identify hazard) <br /> <br /> EMPLOYEE EMERGENCY RESPONSE DUTIES <br /> Designated employees have a duty to <br />provide first aid/CPR <br />May be exposed to HIV or HBV. May result in <br />illness and death. <br /> Designated employees have a duty to <br />extinguish fires <br />May result in thermal burns and/or the <br />inhalation of hot/toxic smoke. May result in <br />injury or death. <br /> <br /> Designated employees have a duty to <br />respond to hazardous chemical spills <br />May be exposed to flammable, reactive, toxic, <br />or corrosive chemicals. May result in illness, <br />injury, or death. <br /> <br /> Designated employees have a duty to <br />perform rescues <br />May be exposed to an atmospheric, <br />entrapment, engulfment, fire, fall, electrical, <br />and/or moving equipment hazards. May result <br />in injury or death. <br /> <br /> <br /> <br /> OTHER HAZARDS <br /> <br /> <br /> <br /> <br /> <br /> <br />This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place. <br /> <br /> <br />