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68 <br /> <br /> (√) <br />If Present Potential Hazard Potential Harm <br /> Source And Location Of Hazard <br />(identify hazard) <br /> <br /> HAZARDOUS MATERIALS <br /> Toxic substances May cause illness, injury, or death. <br /> Flammable substances May cause fire/explosion and/or illness, injury, <br />or death. <br /> Reactive substances May react violently with other substances <br />and/or cause illness, injury, or death. <br /> Corrosive substances May corrode metal, react violently with other <br />substances, and/or cause illness, injury, or <br />death <br /> <br /> Compressed gasses Cylinder may rupture and/or become a missile. <br />Gas may be toxic, flammable, reactive, toxic <br />and/or corrosive. May cause illness, injury, or <br />death. <br /> <br /> Infectious materials or disease <br />causing agents/organisms <br />May cause disease. May cause illness or <br />death. <br /> Radioactive materials May cause radiation burns and radiation <br />sickness. <br /> Asbestos containing materials Asbestos is known to cause asbestosis, lung <br />cancer, and mesothelioma. <br /> Lead containing materials Lead is known to cause acute or chronic lead <br />poisoning and/or injury to reproductive system. <br />Know to cause birth defects. <br /> <br /> Known carcinogens Cancer. May result in illness, deformations, <br />genetic changes, or death. <br /> Hot or molten materials May cause thermal burns. May produce harmful <br />fumes. <br /> Cryogenic liquids May cause frostbite. High expansion ratio (liquid <br />to gas). Gas may be toxic, flammable, reactive, <br />and/or corrosive. <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 />