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70 <br /> <br />FORM SP-4 HAZARD EVALUATION AND ELIMINATION/CONTROL WORKSHEET <br /> <br />This checklist provides general guidance for the evaluation and elimination/control of workplace safety and health hazards. It is not all inclusive. The employer must customize the form for the specific <br />work place. <br /> <br />Use this worksheet to identify how hazards identified in the workplace hazard survey will be eliminated or controlled. (The worksheet may also be used to analyze specific operations or areas). Identify the <br />source and location of each hazard in column 1. Identify the cause and severity of the hazard in column 2. Identify the means/methods of hazard elimination/control in column 3. <br /> Facility: Area/Operation: <br /> <br />Affected Positions: Compiled By: Date: <br /> <br /> Hazard Source/Location Hazard Evaluation <br />Identify cause and severity of hazard. <br />Include results of personal monitoring, <br /> if applicable. <br /> Methods/Means Of Hazard Elimination/Control <br />Identify means and methods that will be used to eliminate or control the hazard. <br />Consider hazard elimination, engineering controls, administrative controls, procedures, <br /> work practices, employee training, and personal protective equipment. <br /> <br /> <br /> <br /> <br />