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Document 600 – Site-Specific Health and Safety PlanInstructions and Template for Plan PreparationPlease go to the EWB-USA website to make sure that you are using the most current version of this document.The following document has been annotated to help your team to develop a site-specific health and safety plan (HASP) for your project. The goal of the HASP is to organize and consolidate the health, safety, and security information in a single place that can be carried on site in the event of an emergency, and to inform the members of the project team of the potential hazards associated with the project. EWB-USA requires a HASP be submitted at the same time as all pre-trip reports (521 - Pre-Assessment Report, 525 – Pre-Implementation Report, 525B – Pre-Implementation Short Form, and 530 - Pre-Monitoring Report) and that a printed copy of this document be carried on site to serve as reference in the event of an emergency. The ideal place for it is in the First Aid Kit.This particular document is based on HASPs previously submitted by chapters with some elements added, generated or changed to illustrate an example of the minimum acceptable level of detail for your team’s HASP. This template is also based on the organizational health and safety requirements, which are outlined in the EWB-USA Health and Safety Policy available on the Health and Safety Program page of the EWB-USA website. Your team is expected to review the policy before completing your team’s HASP.Section Comments and TipsThe annotations in the document provide general instructions or comments about the material to be presented in each section. The document itself is an example of what would be considered the minimum level of acceptable detail for your team’s approval to travel. The task hazards shown in this document are specific to the example project and your HASP will include different information. The instructions and comments should be deleted prior to the initial HASP submittal to EWB-USA.FormattingThe formatting in this document can be modified by the project team and is not intended to be a required format. EWB-USA is more concerned with the content of the plan and that the team prepares a comprehensive project-specific HASP.Emergency Contact Page (Form 606)The 606 - Emergency Contact Page is Page 2 of the HASP but must be submitted as a separate document for review, along with the HASP. This page is the document referenced if the EWB-USA office needs to contact the chapter during the trip or for an emergency situation.Attachment I: Task HazardsAttachment I contains EWB-USA’s standard task hazards that must be followed on all projects. All task hazard pages shall be included in the printed copy of the HASP in the event an unexpected hazard arises during a project. A pdf file of each task hazard management strategy is available on the Health and Safety Program page of the EWB-USA website.If the team would like to modify items in this section, the proposed modifications must be brought to EWB-USA’s attention.Revision HistoryJanuary 2008 - Original version September 2010 – Second RevisionSeptember 2011 – Third RevisionMarch 2013 – Fourth Revision – Current VersionTHE HASP TEMPLATE STARTS ON THE FOLLOWING PAGE. PLEASE DELETE THIS INSTRUCTIONAL TEXT BEFORE SUBMITTING YOUR HASP FOR REVIEW.Document 600SITE SPECIFIC HEALTH AND SAFETY PLANCHAPTER: CHAPTER NAMECOUNTRY: COUNTRY NAMECOMMUNITY: COMMUNITY NAMEPROJECT: PROJECT NAMETRIP TYPE: ASSESSMENT/IMPLEMENTATON/MONITORINGTRAVEL DATES: DATES120713550800INSTRUCTIONS – COVER SHEETFill in blue text with appropriate information.00INSTRUCTIONS – COVER SHEETFill in blue text with appropriate information. PREPARED BYNames of report authorsSubmittal DateENGINEERS WITHOUT BORDERS-USAewb-EMERGENCY CONTACT PAGE/PROTOCOLS (Form 606)708660599440INSTRUCTIONS – EMERGENCY CONTACT PAGE (Form 606)1) Download the 606 – Emergency Contact Page from the Sourcebook Downloads page of the EWB-USA website.2) The completed 606 document must be submitted separately as an Excel spreadsheet, along with the HASP.3) The completed 606 document should be printed on a bold color paper (yellow, orange, or green is standard) and laminated for waterproofing. 4) Place the laminated 606 document here as the first page of the HASP before entering into the field. 5) Make small copies of the 606 document for individual team members and the U.S. Check-In Contact to carry around with them for the duration of the trip.6) The team does not need to insert a copy of the 606 in the electronic version of the HASP.00INSTRUCTIONS – EMERGENCY CONTACT PAGE (Form 606)1) Download the 606 – Emergency Contact Page from the Sourcebook Downloads page of the EWB-USA website.2) The completed 606 document must be submitted separately as an Excel spreadsheet, along with the HASP.3) The completed 606 document should be printed on a bold color paper (yellow, orange, or green is standard) and laminated for waterproofing. 4) Place the laminated 606 document here as the first page of the HASP before entering into the field. 5) Make small copies of the 606 document for individual team members and the U.S. Check-In Contact to carry around with them for the duration of the trip.6) The team does not need to insert a copy of the 606 in the electronic version of the HASP.Place holder for completed and printed 606 documentDIRECTIONS & MAP TO MEDICAL FACILITYRoute 213 SOUTH/EAST from Les Anglais to Les Cayes-37465025404349752238375INSTRUCTIONS –MAP TO MEDICAL TREATMENT FACILITYThis map should be tabbed in the printed copy for rapid reference. Driving directions should be included.00INSTRUCTIONS –MAP TO MEDICAL TREATMENT FACILITYThis map should be tabbed in the printed copy for rapid reference. Driving directions should be included.1581150132715001985010267970004724400349250033045402647950043954706032500375412011493500To Les Cayes Airport (80Km / 50Mi)Turn Right on Route 214 NORTH center6477016903702292350020586701955800019132558763000To Hospital Immaculee Conception (70Km / 44Mi)Right on Avenue CartagenaRight on 1ere Grand RueLocated South of Rue Duvivier Hall and North of Rue Toussaint L’Ouverturecenter234955778501295400014782803219450024777702698750033451802679700037750753340100040640006858000SIGNATURE PAGEEngineers Without Borders - USA Site-Specific Health and Safety PlanProject InformationName:Location:Chapter:Travel DatesStart Date:End Date: -74930452120INSTRUCTIONS – SIGNATURE PAGEThe Project Lead, HSOs, U.S. Check-In Contact, and Professional Mentor (student projects) must sign this page prior to submittal to EWB-USA for review. The entire project team is not required to sign this page. However, all travel team members must acknowledge that they understand, and will comply with the protocols described in this document in the Volunteer Waiver Agreement (Form 605). The HSOs should go through this document with the team prior to travel to make sure that the travel team understands the key content. 00INSTRUCTIONS – SIGNATURE PAGEThe Project Lead, HSOs, U.S. Check-In Contact, and Professional Mentor (student projects) must sign this page prior to submittal to EWB-USA for review. The entire project team is not required to sign this page. However, all travel team members must acknowledge that they understand, and will comply with the protocols described in this document in the Volunteer Waiver Agreement (Form 605). The HSOs should go through this document with the team prior to travel to make sure that the travel team understands the key content. Project Team H&S Representative SignaturesThe undersigned confirm that they have read the EWB-USA Health and Safety Policy, that they will make sure that each traveler submits their Personal Health Checklist (Form 603) to the health and safety officers, that all the information contained in this document is current and correct, and that all travel team members. will be briefed on the contents. prior to travel.Health & Safety Officer #1:Date:Health & Safety Officer #2:Date:Project Lead:Date:U.S. Check-In Contact:Date:Professional Mentor:Date:TABLE OF CONTENTS TOC \o "1-3" \h \z \u 1.0 INTRODUCTION PAGEREF _Toc350497128 \h 1Table 1.1 – Document History PAGEREF _Toc350497129 \h 12.0 ORGANIZATION AND COORDINATION PAGEREF _Toc350497130 \h 22.1 Key Project Personnel PAGEREF _Toc350497131 \h 2Table 2.1 – Key Project Personnel PAGEREF _Toc350497132 \h 22.2 Team Member Responsibilities PAGEREF _Toc350497133 \h 2Table 2.3 – Team Member Responsibilities PAGEREF _Toc350497134 \h 23.0 TASK DESCRIPTIONS PAGEREF _Toc350497135 \h 43.1 Specific Scope of Work PAGEREF _Toc350497136 \h 43.2 Point-to Point Travel Details PAGEREF _Toc350497137 \h 5Table 3.2: Point To Point Travel Details PAGEREF _Toc350497138 \h 53.3 Project Schedule PAGEREF _Toc350497139 \h 7Table 3.3 – Schedule PAGEREF _Toc350497140 \h 74.0 TASK SAFETY AND HEALTH RISK ANALYSES PAGEREF _Toc350497141 \h 84.1 Preliminary Evaluation PAGEREF _Toc350497142 \h 8Table 4.1 – Task Health & Safety Risk Analysis PAGEREF _Toc350497143 \h 84.2 Security PAGEREF _Toc350497144 \h 94.3 Chemical Hazards PAGEREF _Toc350497145 \h 104.4 Biological Hazards PAGEREF _Toc350497146 \h 104.5 Physical Hazards PAGEREF _Toc350497147 \h 115.0 COMMUNICATIONS PAGEREF _Toc350497148 \h 135.1.1 Cell Phones PAGEREF _Toc350497149 \h 135.1.2 Radios PAGEREF _Toc350497150 \h 135.1.3 Hand Signals PAGEREF _Toc350497151 \h 135.1.4 Emergency Signals PAGEREF _Toc350497152 \h 135.1.5 Translator Names PAGEREF _Toc350497153 \h 145.1.6 International SOS PAGEREF _Toc350497154 \h 145.1.7 Email PAGEREF _Toc350497155 \h 145.1.8 Local Medical Clinic / Nearest Medical Professional PAGEREF _Toc350497156 \h 145.1.9 Fire Response PAGEREF _Toc350497157 \h 155.1.10 Police Response PAGEREF _Toc350497158 \h 155.2 U.S. Check-In Contact PAGEREF _Toc350497159 \h 156.0 PROTOCOLS PAGEREF _Toc350497160 \h 156.1 Task By Task Health & Safety Protocols PAGEREF _Toc350497161 \h 1501 Noise And Hearing Conservation PAGEREF _Toc350497162 \h 1502 ?Inclement?Weather PAGEREF _Toc350497163 \h 1503 ?Heat?Stress PAGEREF _Toc350497164 \h 1604 Cold Stress PAGEREF _Toc350497165 \h 1605 Footcare PAGEREF _Toc350497166 \h 1606 Confined Space PAGEREF _Toc350497167 \h 1607 Hot Work PAGEREF _Toc350497168 \h 1608 Manual Lifting PAGEREF _Toc350497169 \h 1609 Rough Terrain PAGEREF _Toc350497170 \h 1610 Housekeeping PAGEREF _Toc350497171 \h 1611 Structural Hazards PAGEREF _Toc350497172 \h 1712 Remote Areas PAGEREF _Toc350497173 \h 1713 Working Over/Near Water PAGEREF _Toc350497174 \h 1714 Traffic PAGEREF _Toc350497175 \h 1715 Heavy Equipment Operations PAGEREF _Toc350497176 \h 1716 Fall Protection PAGEREF _Toc350497177 \h 1817 Ladders PAGEREF _Toc350497178 \h 1818 Shoring and Trenching PAGEREF _Toc350497179 \h 1819 Hazardous Materials Use and Storage PAGEREF _Toc350497180 \h 1820 Demolition PAGEREF _Toc350497181 \h 1821 Active and Abandoned Utilities and Landmines PAGEREF _Toc350497182 \h 1822 Electrical Safety PAGEREF _Toc350497183 \h 1823 Hand and Power Tools PAGEREF _Toc350497184 \h 1824 Hand and Emergency Signals PAGEREF _Toc350497185 \h 1925 Lock Out Tag Out PAGEREF _Toc350497186 \h 1926 Biological Hazards PAGEREF _Toc350497187 \h 1927 Hazardous Materials PAGEREF _Toc350497188 \h 1928 Clearing, Grubbing, and Logging PAGEREF _Toc350497189 \h 1929 Falling Objects, Punctures, Abrasions, Dust, and Noise PAGEREF _Toc350497190 \h 1930 Silica PAGEREF _Toc350497191 \h 196.2 Emergency Response Plans PAGEREF _Toc350497192 \h 207.0 TRAINING PAGEREF _Toc350497197 \h 217.1 Pre Mobilization Training PAGEREF _Toc350497198 \h 217.2 On Site Training PAGEREF _Toc350497199 \h 218.0 PERSONAL PROTECTIVE EQUIPMENT (PPE) PAGEREF _Toc350497200 \h 228.1 Rationale For Use PAGEREF _Toc350497201 \h 228.2 Criteria For Selection PAGEREF _Toc350497202 \h 228.3 Listing By Task PAGEREF _Toc350497203 \h 229.0 SITE CONTROL MEASURES PAGEREF _Toc350497204 \h 239.1 Exclusion Zones PAGEREF _Toc350497205 \h 239.2 Site Hygiene PAGEREF _Toc350497206 \h 2310.0 MEDICAL CONSIDERATIONS PAGEREF _Toc350497207 \h 2410.1 Medications and Vaccinations PAGEREF _Toc350497208 \h 2410.2 Location of and person responsible for First Aid Kit(s) PAGEREF _Toc350497209 \h 2410.3 Exposure/Injury/Medical Support (on site and off) PAGEREF _Toc350497210 \h 2410.4 Medical Treatment Facilities (Location & Transportation) PAGEREF _Toc350497211 \h 2410.5 Incident Report PAGEREF _Toc350497212 \h 2411.0 POST MOBILIZATION REPORTING PAGEREF _Toc350497213 \h 2511.1 System To Capture And Report Project Related Injury And Illness PAGEREF _Toc350497214 \h 2511.2 Participant Signatures PAGEREF _Toc350497215 \h 25ATTACHMENT A: AREA MAP PAGEREF _Toc350497216 \h 1Table A-1: Area Site Coordinates PAGEREF _Toc350497217 \h 1Picture A-1: Area Map PAGEREF _Toc350497218 \h 1ATTACHMENT B: PROJECT SITE MAP PAGEREF _Toc350497219 \h 1Table B-1: Site Coordinates PAGEREF _Toc350497220 \h 1Picture B-1: Project Site Coordinates PAGEREF _Toc350497221 \h 1ATTACHMENT C: TASK HAZARD ANALYSES PAGEREF _Toc350497222 \h 1Table C-1 – Site Specific Task Hazard Analysis PAGEREF _Toc350497223 \h 1ATTACHMENT D: PERSONAL PROTECTIVE EQUIPMENT ANALYSES PAGEREF _Toc350497226 \h 1Table D-1 – Site Assessment & Investigation PPE Analysis PAGEREF _Toc350497227 \h 1ATTACHMENT E: MATERIAL SAFETY DATA SHEETS (MSDS) PAGEREF _Toc350497228 \h 1ATTACHMENT F: POTENTIAL VENOMOUS SNAKES & SPIDERS PAGEREF _Toc350497229 \h 1ATTACHMENT G: TRAINING COPY CERTIFICATES PAGEREF _Toc350497230 \h 1ATTACHMENT H: REQUIRED MEDICAL KIT CONTENTS PAGEREF _Toc350497231 \h 1ATTACHMENT I: TASK HAZARD MANAGEMENT STRATEGIES PAGEREF _Toc350497232 \h 1ATTACHMENT J: INCIDENT REPORT (Form 612) & ROOT CAUSE ANALYSIS (Form 613) PAGEREF _Toc350497233 \h 1ATTACHMENT K: EMERGENCY RESPONSE PLAN (FORM 614) PAGEREF _Toc350497234 \h 1ATTACHMENT L: ADDENDUM FOR TRAVEL TO A HIGH RISK COUNTRY/AREA OR TO A COUNTRY WITH A U.S. DEPARTMENT OF STATE TRAVEL WARNING PAGEREF _Toc350497235 \h 1ATTACHMENT M: ADDENDUM FOR SMALL TRAVEL TEAMS/EXTENDED STAYS PAGEREF _Toc350497236 \h 11.0 INTRODUCTION 636270289560INSTRUCTIONS – SECTION 1: INTRODUCTION Please provide the following in this section: Chapter name, community name, project name, trip type, travel dates, and very brief description of the project. For additional background information refer the reader to the pre-trip report that the team will be submitted along with this HASP. In addition, please include a summary of the approval record of the previous versions of the HASP for trips to this same community. This information will help focus the reviewer’s effort.00INSTRUCTIONS – SECTION 1: INTRODUCTION Please provide the following in this section: Chapter name, community name, project name, trip type, travel dates, and very brief description of the project. For additional background information refer the reader to the pre-trip report that the team will be submitted along with this HASP. In addition, please include a summary of the approval record of the previous versions of the HASP for trips to this same community. This information will help focus the reviewer’s effort.This site-specific Health and Safety Plan (HASP) is for the implementation trip that the San Francisco Professional Chapter plans to take to San Juan de Dios, El Salvador from September 1st through October 30th, 2010. The project involves the expansion and rehabilitation of the community’s pumped water supply system. For additional background on the program, project, and community please see the 525-Pre-Implementation Report that was submitted at the same time as this HASP.This HASP is the second HASP that has been submitted for work in this community under the water supply project. Two HASPs were previously submitted under the sanitation project in this community. The table below summarizes the approval record of all previous versions of the HASP for work conducted in San Juan de Dios, El Salvador. Table 1.1 – Document HistoryDateVersion of HASPH&S Reviewer Who Approved DocumentFebruary 2009521 Pre-Assessment Trip Report for sanitation projectKelly LathamAugust 2009525 Pre-Implementation Trip Report for sanitation project in San Juan de DiosAnnMarie SpexetFebruary 2010521 – Pre-Assessment Trip Report for water supply projectKelly Latham2.0 ORGANIZATION AND COORDINATION 2.1 Key Project Personnel The key project personnel are identified in Table 2.1.Table 2.1 – Key Project Personnel-125981261148INSTRUCTIONS – SECTION 2.1 Key Project Personnel Identify the project lead(s), chapter president, faculty advisor, mentor(s), health and safety officers, U.S. check-in contact etc. You can copy and paste this table from your pre-trip report (521, 525, or 530) but make sure you add the U.S. Check-In contact.00INSTRUCTIONS – SECTION 2.1 Key Project Personnel Identify the project lead(s), chapter president, faculty advisor, mentor(s), health and safety officers, U.S. check-in contact etc. You can copy and paste this table from your pre-trip report (521, 525, or 530) but make sure you add the U.S. Check-In contact.Project TitleNameEmailPhoneChapter Name or Organization NameProject LeadsPresidentMentor #1Mentor #2Faculty Advisor (if applicable)Health and Safety OfficerAssistant Health and Safety OfficerEducation Lead NGO/Community ContactU.S. Check-In Contact2.2 Team Member Responsibilities 58229574295INSTRUCTIONS – SECTION 2.3 Team Member ResponsibilitiesIdentify other team members and their associated tasks. If contractors or other parties will be directly involved in carrying out some of the trip activities, a separate table should be added that identifies these people and their role. 00INSTRUCTIONS – SECTION 2.3 Team Member ResponsibilitiesIdentify other team members and their associated tasks. If contractors or other parties will be directly involved in carrying out some of the trip activities, a separate table should be added that identifies these people and their role. The team member responsibilities are identified in Table 2.3 “Team Member Responsibilities”.Table 2.3 – Team Member ResponsibilitiesTEAM MEMBERROLERuchir XxxxxxxxImplementationCody XxxxxxxxImplementationJim XxxxxxxxImplementationJennifer XxxxxxxxEducationSnigdha XxxxxxxxImplementationHeath XxxxxxxxImplementationBert XxxxxxxxImplementationAlondra XxxxxxxxEducation3.0 TASK DESCRIPTIONS 3.1 Specific Scope of WorkThe implementation trip will involve the following specific work tasks:735596262890INSTRUCTIONS – SECTION 3.1 Specific Scope of WorkDiscuss only the on-site activities for this project and trip. Do not include tasks for activities that will not take place on this trip.00INSTRUCTIONS – SECTION 3.1 Specific Scope of WorkDiscuss only the on-site activities for this project and trip. Do not include tasks for activities that will not take place on this trip.Pump & Pipe Calculations: EWB-XYZ has completed calculations to determine the proper pump sizing and the pipe diameter required based on field measurements taken during previous assessment and implementation trips included as ATTACHMENT ___ titled “xyz”.New Electrical Pole & Transformer: The Community Water Company described earlier in this report is working with the Peace Corps representative, the local mayor’s office and CLESA, the public electric utility, to install a new pole and 25 kva transformer at the location of the proposed new pump and sump well. This work is outside the scope of the EWB-XYZ pump project, but it does have a bearing on the completion schedule.Contract with Pump Vendor: Based on the pump calculations described above, the Peace Corps worker contacted several pump vendors in El Salvador to ask about their expertise and their interest in the project. Following these interviews, one group, named Sagrisa, sent a representative to the project site to perform a field investigation in advance of submitting a written proposal. The scope of work to be provided by the pump vendor includes; a) supplying the pump, b) specifying a 24 hour timer for pump operation, c) installing the pump in the new pump security structure, d) connecting to the newly installed electrical transformer described in task #2 above, e) installing the pump timer, and f) making the necessary connections to the sump well and the piping delivering water to the community water system. It is our expectation that the local Community Water Company will contract directly with the pump vendor.Purchase Materials: The EWB-XYZ team, working with the Peace Corps representative and the Community Water Company representatives will purchase the materials necessary for the sump well and the pipe connection to the community water system. We intend to rely on the mayor’s office for help with deliveries. Construct Sump Well: A design for the sump well is included with the drawings included as ATTACHMENT ___ titled “xyz”. The Community Water Company, working with equipment and manpower from the mayor’s office, will be responsible for the construction of the sump well. EWB-XYZ’s role will be to ensure that the plans are followed and that the sump well is located properly.Construct Pump Security Structure: The Community Water Company will be responsible for working with the pump vendor to construct a small security structure for the new pump. The pump security structure is outside the scope of EWB-XYZ. As such, no plans have been provided.Install Piping: The Community Water Company, working with equipment and manpower from the mayor’s office, will be responsible for installation of the new 2” piping to allow delivery of water from the new pump to the existing El Bosque tank. As noted earlier in this report, the Community Water Company has extensive experience installing and maintaining pipe in this region. Local custom will be followed regarding trenching, backfilling and other aspects of the pipe installation.Install Pump & Make Connections: The pump vendor will be responsible for completing the pump installation and for making the connections as described in task #3 above.Test System: Working closely with the pump vendor and the Community Water Company, the EWB resident engineer/s will coordinate a rigorous testing program. Such testing will include operation of the pump, timer operation, measuring outflow, ensuring that the pump is operational after loss of power, and such other tests as may be suggested by the involved parties.Education & Maintenance Training: The EWB-XYZ resident engineer will be responsible for ensuring that the Community Water Company employees are versed in the operation and maintenance of the system. Of particular importance will be scheduling necessary third party maintenance on the pump per the manufacturer’s recommendations.3.2 Point-to Point Travel DetailsThe implementation trip will involve the following travel:Table 3.2: Point To Point Travel Details-27305013970INSTRUCTIONS – SECTION 3.2 Point-to-point Travel DetailsUse this section to provide a detailed schedule of the travel arrangements for the upcoming trip only. Please indicate arrival/departure dates for the team, locations of the team (with GPS coordinates, when possible) and method of transport (type of vehicle and transportation service). If the team plans to drive themselves at any point in the trip, a note should be added to the table to explain why the team thinks this is appropriate. EWB-USA strongly discourages its members from self-driving when in country. Repeated trips (i.e. daily trips to the site from a hotel) can just be indicated once. Also note where your team will get food and water throughout the trip. Travel teams are encouraged to consult with International SOS regarding any risk mitigation plans that need to be implemented for point-to-point travel in-country. Travel teams traveling to an ISOS high risk country or area of a country, or to a country with a U.S. Department of State issued Travel Warning are required to contact ISOS to determine a point-to-point transportation plan. Please see the individual procedures for these countries found on the EWB-USA website – Health and Safety Program – Travel Resources – Travel Restrictions.00INSTRUCTIONS – SECTION 3.2 Point-to-point Travel DetailsUse this section to provide a detailed schedule of the travel arrangements for the upcoming trip only. Please indicate arrival/departure dates for the team, locations of the team (with GPS coordinates, when possible) and method of transport (type of vehicle and transportation service). If the team plans to drive themselves at any point in the trip, a note should be added to the table to explain why the team thinks this is appropriate. EWB-USA strongly discourages its members from self-driving when in country. Repeated trips (i.e. daily trips to the site from a hotel) can just be indicated once. Also note where your team will get food and water throughout the trip. Travel teams are encouraged to consult with International SOS regarding any risk mitigation plans that need to be implemented for point-to-point travel in-country. Travel teams traveling to an ISOS high risk country or area of a country, or to a country with a U.S. Department of State issued Travel Warning are required to contact ISOS to determine a point-to-point transportation plan. Please see the individual procedures for these countries found on the EWB-USA website – Health and Safety Program – Travel Resources – Travel Restrictions.TRAVEL DATESTRAVEL DESCRIPTIONSeptember 1, 2010Arrive in San Salvador airport13°26′27.41″N89°03′20.62″W September 1, 2010Take taxi to Arbol De Fuego Hotel Avenida Antiguo Cuscatlán #11c Colonia La SultanaSan Salvador, El SalvadorTel: (503) 2275 – 7065Tel/fax: (503) 2243-301013° 52' 46"N89° 46' 3" WSeptember 2, 2010Depart San Salvador, El Salvador and travel via hired microbus to Juayua, El SalvadorSeptember 2, 2010Arrive At Hotel Posada El EncantoColonia La Esmeralda #7677Juayua, El SalvadorTel: (503) 3235 – 3341Tel/fax: (503) 2341 – 982113° 52' 46"N89° 46' 3" WSeptember 2, 2010 to October 30, 2010Stay at Hotel Posada El Encanto and community center with regular trips to local hardware stores and nearby city for internet access and food. Travelling by hired drivers and/or community partner vehicles..13° 98' 65"N89° 47' 3" WOctober 30, 2010Depart Jauyua, El Salvador and travel via hired microbus to San Salvador, El SalvadorOctober 30, 2010Stay overnight at Arbol De Fuego HotelAvenida Antiguo Cuscatlán #11c Colonia La SultanaSan Salvador El SalvadoTel: (503) 2275 – 7065Tel/fax: (503) 2243-301013° 52' 46"N89° 46' 3" WOctober 31, 2010Taxi to and depart from San Salvador airport13°26′27.41″N89°03′20.62″W3.3 Project ScheduleThe activities scheduled for this trip are indicated in Table 3.3 titled “Schedule”.Table 3.3 – Schedule79726597155INSTRUCTIONS – SECTION 3.3 Project ScheduleProvide a detailed schedule for the upcoming trip only. Travel activities should appear in section 3.3. If your schedule does not fit here, feel free to include the schedule as an attachment or refer the reviewer to the pre-trip report that is submitted at the same time as this HASP .00INSTRUCTIONS – SECTION 3.3 Project ScheduleProvide a detailed schedule for the upcoming trip only. Travel activities should appear in section 3.3. If your schedule does not fit here, feel free to include the schedule as an attachment or refer the reviewer to the pre-trip report that is submitted at the same time as this HASP .4.0 TASK SAFETY AND HEALTH RISK ANALYSES762000332740INSTRUCTIONS – SECTION 4.1 Preliminary EvaluationProvide a brief overview of the anticipated tasks and the relevant hazards.00INSTRUCTIONS – SECTION 4.1 Preliminary EvaluationProvide a brief overview of the anticipated tasks and the relevant hazards.4.1 Preliminary EvaluationThe anticipated tasks and associated hazards are listed in the attached Task Hazard Analyses, Attachment K. A brief summary of tasks and associated general hazards are further defined in the following table. This analysis forms the basis for health and safety planning and preparations. It is also the primary basis for execution of the plan in the field, but recognizes that additional or reduced risks may be encountered in the field that will require modification to the plan by the HSO. Table 4.1 – Task Health & Safety Risk AnalysisExample 1 – Site Assessment Trip-152400247015INSTRUCTIONS – TABLE 4.1 Task Health & Safety Risk AnalysisUse this section to give a brief overview of the anticipated tasks if there is a potential chemical, biological, or physical hazard associated with the task.00INSTRUCTIONS – TABLE 4.1 Task Health & Safety Risk AnalysisUse this section to give a brief overview of the anticipated tasks if there is a potential chemical, biological, or physical hazard associated with the task.TASK IDTASKCHEMICAL HAZARDSBIOLOGICAL HAZARDSPHYSICAL HAZARDS01TravelXX02Eating / DrinkingX03Trail HikingXX04Work Site InspectionXX05Labor OversightXX06SurveyingXXExample 2 – Implementation TripTASK IDTASKCHEMICAL HAZARDSBIOLOGICAL HAZARDSPHYSICAL HAZARDS01Travel to/from siteXX02Eating/drinking on siteX03Tour and stake out siteXX04Excavate/Backfill TrenchXX05Assemble piping and chlorinatorXX06Chlorination of reservoirXXX07Set chlorinator dosingXXX08Chlorine monitoring/adjustmentXXX09O&M training of localsXXX10Investigate/Repair Distribution System XXX11Soil investigationXX12Supplemental health assessmentXX-340360160020INSTRUCTIONS – SECTION 4.2 SecurityState whether there is a U.S. Department of State (DOS) Travel Warning or Travel Alert for the country and state the International SOS Country Risk rating and the Area of the Country Risk rating where your chapter will be located. Please refer to the 609 – Travel Safety Procedures document on the Sourcebook Downloads page of the EWB-USA website for how these restrictions will affect your travel plans. We strongly encourage each travel team to call International SOS prior to travel to receive location-specific and itinerary-specific travel advice. The phone number is: 1-215-942-8226 and the website is: . You will need the membership number to access the website and when you call: 11BCPA000270. For the following situations, please provide the required documentation, as described below:Travel teams planning to travel through areas within a country rated as “High Risk” by the ISOS Country Risk Guide are required to provide the following information in this section: The travel team must acknowledge who is picking the team up from the airport and confirm that the team will be accompanied from the airport to where the team will be staying for the duration of the approved work schedule.The travel team must acknowledge that they will not be spending time in the high risk region, including an overnight stay. If the travel team’s itinerary requires them to spend a limited period of time in the high risk area, they must consult with ISOS before traveling and provide details regarding the ISOS travel advice and risk mitigation plan. In addition, the team must acknowledge that they will be accompanied by a local contact while spending time in the high risk area.Travel teams planning to travel to any country which has a U.S. Department of State “Travel Alert” issued are required to provide the following information in this section: Review, copy, and paste the Department of State Travel Alert. Travel teams are required to contact ISOS and provide details regarding the ISOS travel advice. For special cases where EWB-USA has decided to allow established programs to continue in ISOS high risk areas, as well as in countries with a DOS issued Travel Warning, the travel team will need to follow additional safety requirements. These can be found on the EWB-USA website – Health and Safety Program – Travel Resources – Travel Restrictions. As of March 2013, there are additional travel procedures for the following ISOS high risk countries/areas: Haiti, Honduras, Kenya, Nigeria, Sierra Leone, and areas of Mexico. As of March 2013, there is a DOS Travel Warning issued for the following countries which have EWB-USA programs: El Salvador, Honduras, Haiti, Kenya, Mexico, Niger, Nigeria, and Philippines. If a chapter is traveling to a country with both a DOS Travel Warning and an ISOS high risk rating, the chapter should follow the ISOS high risk procedures for that country. Chapters should use Attachment L to document how the team will address the additional requirements.00INSTRUCTIONS – SECTION 4.2 SecurityState whether there is a U.S. Department of State (DOS) Travel Warning or Travel Alert for the country and state the International SOS Country Risk rating and the Area of the Country Risk rating where your chapter will be located. Please refer to the 609 – Travel Safety Procedures document on the Sourcebook Downloads page of the EWB-USA website for how these restrictions will affect your travel plans. We strongly encourage each travel team to call International SOS prior to travel to receive location-specific and itinerary-specific travel advice. The phone number is: 1-215-942-8226 and the website is: . You will need the membership number to access the website and when you call: 11BCPA000270. For the following situations, please provide the required documentation, as described below:Travel teams planning to travel through areas within a country rated as “High Risk” by the ISOS Country Risk Guide are required to provide the following information in this section: The travel team must acknowledge who is picking the team up from the airport and confirm that the team will be accompanied from the airport to where the team will be staying for the duration of the approved work schedule.The travel team must acknowledge that they will not be spending time in the high risk region, including an overnight stay. If the travel team’s itinerary requires them to spend a limited period of time in the high risk area, they must consult with ISOS before traveling and provide details regarding the ISOS travel advice and risk mitigation plan. In addition, the team must acknowledge that they will be accompanied by a local contact while spending time in the high risk area.Travel teams planning to travel to any country which has a U.S. Department of State “Travel Alert” issued are required to provide the following information in this section: Review, copy, and paste the Department of State Travel Alert. Travel teams are required to contact ISOS and provide details regarding the ISOS travel advice. For special cases where EWB-USA has decided to allow established programs to continue in ISOS high risk areas, as well as in countries with a DOS issued Travel Warning, the travel team will need to follow additional safety requirements. These can be found on the EWB-USA website – Health and Safety Program – Travel Resources – Travel Restrictions. As of March 2013, there are additional travel procedures for the following ISOS high risk countries/areas: Haiti, Honduras, Kenya, Nigeria, Sierra Leone, and areas of Mexico. As of March 2013, there is a DOS Travel Warning issued for the following countries which have EWB-USA programs: El Salvador, Honduras, Haiti, Kenya, Mexico, Niger, Nigeria, and Philippines. If a chapter is traveling to a country with both a DOS Travel Warning and an ISOS high risk rating, the chapter should follow the ISOS high risk procedures for that country. Chapters should use Attachment L to document how the team will address the additional requirements.13GPS MappingX4.2 SecurityAs of July 28, 2010, the ISOS Rating for El Salvador is MEDIUM. The ISOS summary of risk is as follows:“Opportunistic and violent crime present the main security risks to foreign personnel. Individuals are targeted based on perceived wealth and it is advisable to exercise caution while in tourist areas and crowded marketplaces. Street crime, such as bag-snatching, is a problem. Travelers to the Honduran border region should consider travelling with a local guide because there are concerns over landmines and unexploded ordnance close to the border. The country is vulnerable to tropical storms and hurricanes during the Caribbean region's hurricane season (June-November), which can cause severe travel disruption. Internal travel and communications are complicated by infrastructure deficiencies”As of July 28, 2010, the U.S. State Department has no Travel Warnings for El Salvador. This trip is registered with the U.S. Embassy. Up-to-date security information can be found by calling 1-888-407-3737 in the U.S./Canada or 202-501-4444. This line is open from 8am-8pm Eastern Time M-F. The U.S. State Department security entry on El Salvador reads (in part) as follows.“Most travelers to El Salvador experience no safety or security problems, but the criminal threat in El Salvador is critical.? Random and organized violent crime is endemic throughout El Salvador.? U.S. citizens have not been singled out by reason of their nationality, but are subject to the same threat as all other persons in El Salvador.? See the section below on Crime for additional related information.Political or economic issues in the country may give rise to demonstrations, sit-ins or protests at any time or place, but these activities occur most frequently in the capital or on its main access roads.? U.S. citizens are cautioned to avoid areas where demonstrations are being held and to follow local news media reports or call the U.S. Embassy for up-to-date information.?“4.3 Chemical HazardsExample 1663575177800INSTRUCTIONS – SECTION 4.3 Chemical HazardsIdentify anticipated chemical hazards. List and attached appropriate hazard management strategy for each. Specify specific hazard management strategy for this project. MSDSs for chemicals should be included at the end of the HASP as an attachment00INSTRUCTIONS – SECTION 4.3 Chemical HazardsIdentify anticipated chemical hazards. List and attached appropriate hazard management strategy for each. Specify specific hazard management strategy for this project. MSDSs for chemicals should be included at the end of the HASP as an attachmentChemical hazards are not anticipated for the site assessment trip. If a chemical hazard is encountered during the trip, proper skin and respiratory protection will be utilized. Relevant management strategies include:TH 29 Falling Objects, Punctures, Abrasions, Dust, and Noise (Personal Protective Equipment)Example 2The most significant chemical hazard at the project site is exposure to the calcium hypochlorite tablets that will be installed with the chlorination system. The MSDS information for this chemical is located in Attachment E. Chlorine is corrosive and may cause skin and eye irritation and may be fatal if swallowed. The following precautions will be used when dealing with the chemical:TrainingOur team will review the MSDS sheet prior to the chemical being removed from the container.StorageThe tablets will be stored in a closed container in a dry, well ventilated area that is lockable to keep the chemicals out of reach from any children.HandlingSafety goggles and rubber gloves shall be worn when handling this product. It may also be irritating to the nose and throat so to avoid breathing any vapors the use will be limited to ventilated areas.Response In Case Of Accidental Exposure Eyes: If contact with eyes occurs immediately flush with cold water for at 15 minutes and seek immediate medical attention.Skin: In skin contact occurs, brush off excess chemical and flush skin with cold water. If irritation persists get medical attention.Ingestion: If swallowed, promptly drink large quantities of water. Do not induce vomiting. Avoid alcohol. Call a physician or immediately.Inhalation: If inhaled remove to fresh air. Give oxygen if available. Call a physician immediately.Relevant management strategies include:TH 19 Hazardous Materials Use and storageTH 27 Hazardous MaterialsTH 29 Falling Objects, Punctures, Abrasions, Dust, and Noise (Personal Protective Equipment)4.4 Biological HazardsWaterborne and food-borne diseases are a concern; as a result the EWB team will utilize food and water transported to the site from established safe sources. Properly designed lavatory facilities will be constructed as needed at the work site. Recommended vaccinations include yellow fever, typhoid, and hepatitis A. All recommended vaccinations are required for the EWB travel team. Antimalarials will also be required, and we have consulted a travel medicine specialist to select the appropriate medication. 659219-553246INSTRUCTIONS – SECTION 4.4 Biological HazardsIdentify anticipated biological hazards. Biological hazards include hazards from infected water, soil, or common diseases such as malaria. Describe appropriate hazard management strategy for each, including drinking water, sanitation, mosquito/pest control, recommended and required inoculations/medication. Poisonous/hazardous creatures such as snakes/spiders/parasites also belong here. is a good starting point for researching the local venomous snakes. Additional resources include and . Summaries and images should be placed in the Appendix. In researching snakes and spiders, the location of appropriate treatment facilities for envenomation should be noted. The contact information for those facilities should be put in the emergency contact page, and the map should appear in the clinic listing at the beginning of the HASP. Dangerous animals are not limited to snakes/spiders/scorpions, but can also include such animals as feral dogs, bats, and crocodiles. The potential for dangerous animals should be researched and discussed with locals on the assessment trip. 00INSTRUCTIONS – SECTION 4.4 Biological HazardsIdentify anticipated biological hazards. Biological hazards include hazards from infected water, soil, or common diseases such as malaria. Describe appropriate hazard management strategy for each, including drinking water, sanitation, mosquito/pest control, recommended and required inoculations/medication. Poisonous/hazardous creatures such as snakes/spiders/parasites also belong here. is a good starting point for researching the local venomous snakes. Additional resources include and . Summaries and images should be placed in the Appendix. In researching snakes and spiders, the location of appropriate treatment facilities for envenomation should be noted. The contact information for those facilities should be put in the emergency contact page, and the map should appear in the clinic listing at the beginning of the HASP. Dangerous animals are not limited to snakes/spiders/scorpions, but can also include such animals as feral dogs, bats, and crocodiles. The potential for dangerous animals should be researched and discussed with locals on the assessment trip. In addition, working in a moist tropical environment will increase the risk of exposure to parasitic organisms. Such exposure is also possible through improperly prepared food and drinking unclean water. Team members will limit avoid prolonged exposure to wet environments and eat only safely prepared food and drink bottled water. No direct contact with water will be allowed, rubber boots will be required for those working in water.A post trip health assessment is recommended for all travelers 2-4 months after return from the trip. All general information regarding possible adverse health effects from the trip will be submitted to EWB-USA by the Health and Safety leads to aid in future trip preparations.El Salvador has several common species of venomous snakes and insects. The most commonly known are the Guatemalan jumping pitviper, Cantil frijolillo, Middle American rattlesnake, Western Hog-nosed pit viper, and the Coral snake. Summaries and photos of these snakes have been included in the Appendix. El Salvador also has several varieties of scorpions and spiders, including the South American Wandering Spider. The Hospital De Metapan has several of the common antivenoms in stock.Relevant management strategies include: TH 10 HousekeepingTH 13 Working Over/Near WaterTH 26 Biological Hazards 4.5 Physical Hazards60960037465INSTRUCTIONS – SECTION 4.5 Physical Hazards Identify anticipated physical hazards. List and attach appropriate hazard management strategy for each. Specify specific hazard management strategy for this project.00INSTRUCTIONS – SECTION 4.5 Physical Hazards Identify anticipated physical hazards. List and attach appropriate hazard management strategy for each. Specify specific hazard management strategy for this project.Physical hazards exist in every significant phase of the project, from traveling on foot and in vehicles to and from the project site, to all tasks listed in Section 3.1. The following physical hazards have been identified at the project site:Heat stress is possible at all times, particularly at times of heavy manual labor.Foot care is also important at all phases of the site investigation process due to the site only being negotiable by foot and the potential for slippery conditions on the roofs. Manual lifting will occur when moving ladders into placeRough terrain is present at the project site in the form of brush and grasses but no rocky ground or cliffs are present nearbyHousekeeping is important at all times both at the project site and at the hotel of residence to limit clutter.Structural hazards while on the roof of the existing structures and care will need to be taken to ensure the roof will support the person walking on it.Remote area work will be performed and proper precautions must be followed such as not traveling aloneTraffic may be an issue traveling to and from the project siteFall protection and ladder safety is important at all times during the investigation of the existing roof and during the chlorinator installation.Potholing will be required to research potential tank locations and special care must be given to proper sloping and excavation techniques.Trenching may be required if repairs or maintenance of the water line are required and special care must be given to trenching with proper sloping and excavation techniques. Noise protection will be required for operators of power tools and those in close proximity.Chemical hazards will exist during chlorination of the reservoir and after the chlorinator is installed during chlorination. calibration, and maintenance of the chlorination system . Hand tool (hammers, shovels and hand saws) and power tool safety (circular saws) is relevant at all times during the installation of the chlorinator.Relevant management strategies include: TH 02 Inclement WeatherTH 03 Heat stressTH 05 Foot careTH 08 Manual Lifting and Handling Of Heavy ObjectsTH 09 Rough TerrainTH 10 House keepingTH 11 Structural HazardsTH 12 Remote AreasTH 13 Working Over/Near WaterTH 14 TrafficTH 16 Working At Elevations and Fall ProtectionTH 17 LaddersTH 18 Shoring and TrenchingTH 21 Active and Abandoned Utilities and LandminesTH 23 Hand and Power Hand ToolsTH 26 Biological HazardsTH 29 Falling Objects, Punctures, Abrasions, Dust, and Noise 5.0 COMMUNICATIONS 382772153522INSTRUCTIONS – SECTION 5.0 COMMUNICATIONSProvide details regarding your team’s communication plan, including communications equipment such as radios and cell phones. Provide details on how the team will communicate with each other as well as local emergency responders. Refer to the task hazard management strategy: “hand and emergency signals”. Additionally, identify the translators on the team or the local individual(s).Note: Each EWB-USA team is required to have at least one telephone that will work at the project site and the places where the team will be staying. This telephone must be in the possession of the EWB-USA travel team at all times. Satellite phones should be rented if the team is to be out of cell tower reception for a significant amount of time. Satellite phones are required for travel to countries with an ISOS “high risk” security rating. The primary team telephone cannot be borrowed from locals or the local NGO. The team must also identify an alternate telephone which can include an NGO phone, land lines, internet café, additional cell phones, etc. The team should specify the location of phone, special dialing/operating instructions, and relevant phone numbers, including where possibleMedical responseFire responsePoliceLocal medical clinic/nearest trained medical professionalMeans/phone number for others to contact teamOther key community contacts (water board president, hotel, etc.)U.S. Check-In ContactInternational SOSMedical insuranceU.S. EmbassyUniversity Emergency ContactEWB-USA Emergency LineEmergency Numbers are listed on the 606- Emergency Contact Page, but can be repeated here. In addition, team members are encourage to fill-out and print the Emergency Contact Card. The template can be found on the Health and Safety Program page, under the Travel Resources section.00INSTRUCTIONS – SECTION 5.0 COMMUNICATIONSProvide details regarding your team’s communication plan, including communications equipment such as radios and cell phones. Provide details on how the team will communicate with each other as well as local emergency responders. Refer to the task hazard management strategy: “hand and emergency signals”. Additionally, identify the translators on the team or the local individual(s).Note: Each EWB-USA team is required to have at least one telephone that will work at the project site and the places where the team will be staying. This telephone must be in the possession of the EWB-USA travel team at all times. Satellite phones should be rented if the team is to be out of cell tower reception for a significant amount of time. Satellite phones are required for travel to countries with an ISOS “high risk” security rating. The primary team telephone cannot be borrowed from locals or the local NGO. The team must also identify an alternate telephone which can include an NGO phone, land lines, internet café, additional cell phones, etc. The team should specify the location of phone, special dialing/operating instructions, and relevant phone numbers, including where possibleMedical responseFire responsePoliceLocal medical clinic/nearest trained medical professionalMeans/phone number for others to contact teamOther key community contacts (water board president, hotel, etc.)U.S. Check-In ContactInternational SOSMedical insuranceU.S. EmbassyUniversity Emergency ContactEWB-USA Emergency LineEmergency Numbers are listed on the 606- Emergency Contact Page, but can be repeated here. In addition, team members are encourage to fill-out and print the Emergency Contact Card. The template can be found on the Health and Safety Program page, under the Travel Resources section.The project team will have the following means and methods of communication while on site and traveling thru the country:5.1.1 Cell PhonesThe team will purchase a minimum of two cellular phones at the airport for use on the trip. It has been determined through a previous trip that cell phone coverage does exist at the project site. The project lead and primary health and safety officer will have possession of the cell phones.The following numbers will be programmed into all cell phones when they are purchased:Team Cell Phone NumbersGroup’s DriverHotelADESCO PresidentLocal NGO Community ContactLocal Ambulance ServiceResident Government Health Care WorkerWater System Manager & Resident Engineer Host FamilyTranslatorsU.S. Check In ContactInternational SOSU.S. EmbassyUniversity ContactEWB-USA Emergency LineThe following directions are special dialing and operating instructions for the cell phones: None5.1.2 RadiosThe project team also will use a set of 2-way radios for distance communication among the group in past trips 2-way radio communication has been possible at all remote work sites and while traveling in multiple vehicles. The radio frequency will be selected while the radios are in use.5.1.3 Hand SignalsHand signals will be used as a last resort and Task Hazard management strategy TH 26 “Hand and Emergency Signals” will be followed when hand signals are used. The team will follow the task hazard management strategy outlined in TH 24 ‘Hand and Emergency Signals’ when hand signal use is required.5.1.4 Emergency SignalsThe likelihood of needing emergency signals is likely to be slim but may be necessary in the event of a storm, natural disaster, or security situation. The team will follow the task hazard management strategy outlined in TH 24 ‘Hand and Emergency Signals’ when emergency signal use is required.The team will use the following radio signal to indicate an emergency one long sound, then one short sound, followed by one long sound. After such is sent, the team will use a short sound to indicate to come to the location the team is in trouble or one long sound to indicate the team needs to meet at the home base outlined in section 6.0.5.1.5 Translator NamesExample #1For this trip, our team will not require the use of translators because our travel team will have three (3) persons (Mike Xxxxx, Mary Xxxxxx, Peggy Xxxxxx) fluent in Spanish, in addition to the local NGO contacts (Moses Xxxxx, Rachel Xxxxx).Example #2The project team will require the use of translators to ensure clear communication is maintained with the community and our local translator will be Juan Xxxxx who’s contact information is located in “Table 2.1 – Key Project Personnel”. 5.1.6 International SOSEWB-USA has contracted with International SOS, to provide 24-hour access to the latest health, safety and travel advice worldwide. Their informational website provides information about vaccinations, country safety, appropriate hospitals and the political stability within the country to which they are traveling. We strongly recommend that all EWB-USA members visit the ISOS website and research the country to which you will be traveling to. You may access the service provided by ISOS through their website or by calling 215.942.8226. Please note that you will need EWB-USA’s membership number: 11BCPA000270.Additionally, the EWB-USA membership through ISOS provides support to EWB-USA members who face a non-medical related emergency while traveling on an approved EWB-USA trip. If you are currently traveling abroad and need emergency assistance for a non-medical emergency, contact ISOS immediately at 215.942.8226. You will need to provide them with the EWB-USA membership number 11BCPA000270. Medical-related emergencies should first contact Seven Corners Insurance or the university/college’s insurance company.Please visit the EWB-USA website, Health and Safety Program page – Travel Resources – International SOS for a summary of the resources and services provided by ISOS.5.1.7 EmailThe project team will have access to email thru the thru the use of a computer at a local computer store.5.1.8 Local Medical Clinic / Nearest Medical ProfessionalThe primary contact will be the Peace Corps representative. However, if the Peace Corps volunteer is not available, then any member of the residents from the community can help. Please see the list of individuals with cell phones listed above in the contact information for the translator is located in “Table 2.1 – Key Project Personnel”. . Medical and ambulance service are available approximately 4.5 miles away via paved road in the neighboring community of Juayua.5.1.9 Fire ResponseFire response is provided by in-country fire professionals located 4.5 miles away in the neighboring community of Juayua.5.1.10 Police ResponsePolice response is provided by in-country police professionals located 4.5 miles away in the neighboring community of Juayua.5.2 U.S. Check-In Contact57415818991INSTRUCTIONS – SECTION 5.3 U.S. Check-In ContactProvide the method(s) and frequency of check-in with the U.S. Check-In Contact. The U.S. Check-In Contact is to maintain contact with the team while they are in-country. This person must remain in the U.S. and be available for emergency contact by either the EWB-USA Headquarters or the project team. If the team fails to make contact, and the Check-In contact is unable to reach the team within 24 hours, he/she will contact the EWB-USA Emergency number. The team will need to leave a copy of the final 606 Emergency Contact Page with the U.S. Check-In Contact.00INSTRUCTIONS – SECTION 5.3 U.S. Check-In ContactProvide the method(s) and frequency of check-in with the U.S. Check-In Contact. The U.S. Check-In Contact is to maintain contact with the team while they are in-country. This person must remain in the U.S. and be available for emergency contact by either the EWB-USA Headquarters or the project team. If the team fails to make contact, and the Check-In contact is unable to reach the team within 24 hours, he/she will contact the EWB-USA Emergency number. The team will need to leave a copy of the final 606 Emergency Contact Page with the U.S. Check-In Contact.The US Check-In Contact is Johnny Xxxxxxxx. He will be contacted every other day via email or text message and given a personnel count. Internet access and cellphone reception near the project area can be unreliable, and so daily communication may not be possible. We are also maintaining a project blog on the chapter website () that we intend to update while on-site.If the team fails to make contact, and he is unable to reach the team via team cellphone or text message within 24 hours, he will contact the EWB-USA Emergency number. He will have a copy of the final 606 Emergency Contact Page to ensure he has all of the most up-to-date phone numbers.6.0 PROTOCOLS 6.1 Task By Task Health & Safety Protocols568665417106INSTRUCTIONS – SECTION 6.1 Task Hazard Management ProtocolsProvide a task-by-task description of the health and safety considerations/practices to be followed for each of the tasks defined above where a potential hazard has been identified. Components of this overview will be selected based on project-specific needs. Emphasis will be made by simplicity, cost minimization, and consideration of available resources in planning stages and at the project location.If your team does not expect to encounter the hazard, please note it as such.00INSTRUCTIONS – SECTION 6.1 Task Hazard Management ProtocolsProvide a task-by-task description of the health and safety considerations/practices to be followed for each of the tasks defined above where a potential hazard has been identified. Components of this overview will be selected based on project-specific needs. Emphasis will be made by simplicity, cost minimization, and consideration of available resources in planning stages and at the project location.If your team does not expect to encounter the hazard, please note it as such.The following health and safety considerations / practices (i.e., protocols) will be used during the site assessment trip. The team will focus on accident prevention throughout the entire trip and Attachment I contains the detailed task hazard management strategies that will be employed to prevent injuries on each of these project-specific protocols.01 Noise And Hearing ConservationExample #1 – The team does not expect to encounter excessive noise and hearing conservation issues during the trip because we will not be working around heavy equipment or using power hand tools. Example #2 – Noise protection in the form of ear plugs will be required for all operators and those in close proximity of high decibel power tools, such as saws (jigsaw, drill/hole saw), drills, etc. Exposure to noise is only anticipated potentially during assembly and installation of the chlorinator.02 ?Inclement?Weather?Inclement weather exists in the form of hot humid weather and the potential for torrential rainfall. Wide brimmed hats, plenty of hydration, and light colored loose clothing are recommended for participants. The risk of heavy rainfall is minimal due to work occurring in the dry season, however light rain storms are common. Shelter is available in the nearby host community for moisture sensitive equipment.03 ?Heat?Stress?Bottled water for the day will be purchased every morning at the hotel the group will be staying at. Baggies of clean water are available from local merchants in the event of an emergency. Ample shade will be available for workers to take breaks from the heat. Lightweight, light-colored, loose-fitting clothing will be recommended. Sunburn affects a body's ability to cool itself and causes a loss of body fluids. It also causes pain and damages the skin. Wide-brimmed hats, sunglasses, and sunscreen of SPF 15 or higher (the most effective products say "broad spectrum" or "UVA/UVB protection" on their labels) 30 minutes prior to going out are all recommended to combat heat stress and exposure to ultraviolet radiation. When working in the heat, monitor the condition of your co-workers and have someone do the same for you. Heat-induced illness can cause a person to become confused or lose consciousness.04 Cold StressGiven the time of travel, the team does not expect to encounter a cold stress situation. 05 FootcareSturdy shoes or hikers will be required at all times. Socks made specifically for comfort and breathability will also be highly advised. 06 Confined SpaceA confined space issue will exist during inspection of the water holding tank because it will have limited access. The team will utilize a lanyard and tri-pod when we are inside the tank. 07 Hot WorkExample #1 – The team will not be using torches, power hand tools, or chain saws so we do not expect to encounter any hot work situations. Example #2 – An arc welder and acetylene torch may be deemed necessary for the chlorinator installation, but will not be used in-line with t he closed water system. Only skilled, Tout Bagay workers will use the arc welder. A fire-watch is required during any use of these tools, and fine extinguishing equipment commensurate with the surrounding ignitable material must be immediately available. 08 Manual LiftingTraining in proper lifting will be provided ahead of time, and sturdy gloves for protection will be available for a variety of tasks. 09 Rough TerrainAll team members will be fit enough to traverse rough terrain and have appropriate footwear to do so. 10 HousekeepingAll team members will be expected to keep their personal spaces at the hotel free of clutter. Everyone will participate in grounds keeping of the site at the end of the day. 11 Structural HazardsExample #1 - Structural hazards exist at the project site through the course of inspection of the existing roofs. Prior to stepping on any roof, a thorough inspection of the roof supporting members and underlayment will be made. If it is determined safe for foot traffic, we will proceed to inspect the roof. If it is determined unsafe for foot traffic, the team will not go on the roof and will use an alternate method of inspection (i.e., ladders).Example #2 – Structural hazards may exist throughout the project area primarily in the form of deteriorated conditions of existing containers (drums, tanks) and buildings (including associated appliances). If any further repair of the water system is required, excavations and trenches present structural hazards as well. 12 Remote AreasDue to the remote nature of the site, everyone is required to travel in groups, if possible with an interpreter and with one of the team’s mobile phones. Everyone must inform the Project Manager before leaving the vicinity of the site. 13 Working Over/Near WaterExample #1 – Water will be encountered while working near the lake or near the existing water storage tanks. No direct contact with the water will be allowed. If water is encountered, waterproof boots will be worn at all times. Example #2 – The site is located in a coastal town, however work in and/or around the coast is not anticipated. Chlorination of the existing reservoir is the only work anticipated near water and will be done without entering the reservoir itself. If any further repair is done to the distribution system, care should be taken of breaks in the pipe and subsequent filling of trenching and excavations with water. If the water is entered for any reason, waterproof boots will be worn at all times. 14 TrafficExample #1 – Roadway work will be required and the team will have traffic control in place prior to the work starting. Our traffic control plan will consist of flag persons with signs 500-feet from the work area and directional signs to guide the traffic. In the event a vehicle does not abide by the directions given by the traffic control person a air horn will be blasted to warn the workers of a potential safety issue headed in their direction. Travel from the airport located in San Salvador to the nearby community of Juayua will be by bus. Travel to and from the sites will be generally by truck taxis and by foot.Example #2 - Travel from the airport located in San Salvador to the nearby community of Juayua will be by bus. Travel to and from the sites will be generally by truck taxis and by foot.Example #3 – Roadway work will not be an issue. Materials will generally be delivered to the project site instead of retrieved by the team. Passengers will ride only in the vehicles supplied by Tout Bagay15 Heavy Equipment OperationsHeavy equipment will be operated by local contractors. The equipment will be given a cursory review for operation by an EWB-XYZ member and the equipment operator prior to its use on the project. Particular attention will be focused on the correct safety alert devices (i.e., backup alarms, lights, horn, etc.) to ensure safe operation when the equipment is used on site. Additionally, no EWB-XYZ member shall operate any piece of equipment unless they are certified to operate the equipment.16 Fall ProtectionThe site assessment will be at elevations of up to 6-feet for inspection of the existing roofs. Harnesses and lanyards are the preferred method for anyone at these elevations if there is an adequate tie off point. Because a fall test will not be performed, a 6-feet distance from the roof edge will be maintained during inspection of the roof to mitigate the fall hazard and the 6-feet buffer zone will be inspected from a ladder. 17 LaddersLadders will be used, after they have been inspected for use, to access or inspect the existing roofs. 18 Shoring and TrenchingThere will be excavations for the planned sump well and the associated pipe into the lake. The soil has been previously identified as Class C. As such, a slope equal to 1 to 1 ? will be maintained at all times to minimize slumping and other potential hazards (please see Figure V:2-13 below). The anticipated depth of the sump well is approximately 13’. In addition, a trash pump will be rented in a nearby community to facilitate the digging when working at or below the water table.19 Hazardous Materials Use and StorageCalcium Hypochlorite shall be stored for use in the chlorinator. The material safety data sheets (MSDS) for the calcium hypochlorite are located in Attachment E.20 DemolitionThe team will perform visual inspections only so the team does not expect to encounter a demolition type of situation.21 Active and Abandoned Utilities and LandminesThe team will travel with use safe digging tactics when trying to locate existing utilities. Potential landmines will be avoided by only staying in areas the local community have deemed safe for travel.22 Electrical SafetyThe team will not be working on any electrical item so the team does not expect to encounter a demolition type of situation.23 Hand and Power ToolsThe team will use hand and power tools to cut wood, cut piping, and remove trees. All hand and power tools will be inspected daily for the proper safety devices (i.e., guards, lose blades, damaged cords, etc.) prior the tools use.Likely hand tools include trenching tools, shovels, wrenches, hand saw, mallet/hammer, file, tin snips, screwdrivers, and pliers. Likely power tools include a jigsaw, drill/hole saw, and hammer drill with the possibility of an arc welder and acetylene torch. All personnel using these will have proper training in the inspection and use of these tools, including the use of gloves, safety glasses and any other PPE that would be appropriate.24 Hand and Emergency SignalsThe team does not expect to use hand and emergency signals during the trip, but to be proactive we will perform a training session prior to travel, on the first day we are in the country, and asn necessary during the trip.Hand and emergency signals will be required when the ability to vocally communicate is lost may be necessary in the event of a storm, natural disaster, or security situation.25 Lock Out Tag OutOur team expects to use lock out tag out procedures to inspect the existing water tank. Currently we anticipate locking out the fill valves and the electrical panels to the pumps. We will be bringing with use padlocks and chain to accomplish the locak out safely. 26 Biological HazardsBiological hazards include water borne and food borne illnesses and parasitic infections. All food and water will be obtained from previously verified “safe” sources at the hotel and certain restaurants. Uncooked and “washed” food items such as salads and water with ice in it in restaurants should be avoided. Direct contact will be avoided at all times will any untreated water source including streams. The tap water at the hotel is treated and is safe for bathing and washing but direct ingestion should be avoided as the actual quality is unknown. Bottled water is readily available. Required vaccinations include yellow fever, typhoid, and hepatitis A. 27 Hazardous MaterialsCalcium Hypochlorite shall be used to chlorinate the existing reservoir, and shall be installed as pellets in the chlorinator once installed. Exposure to Calcium Hypochlorite could occur during any chlorination or water testing thereafter. The material safety data sheets (MSDS) for the calcium hypochlorite are located in Attachment E.28 Clearing, Grubbing, and LoggingLadders will be used, after they have been inspected for use, to access or inspect the existing roofs. 29 Falling Objects, Punctures, Abrasions, Dust, and Noise Close toed shoes and sturdy pants are required for the implementation. No open shoes, shorts, or sandals are allowed during the site assessment. 30 SilicaExposure to silica will occur when mixing concrete for the footings and mortar for the masonry blocks. The team will wear long sleeve shirts and use rubber gloves to keep the silica from direct contact with the skin, safety glasses or goggles to prevent wet silica from getting in the eyes, and a dust mask for the person mixing the concrete / mortar to prevent breathing in silica dust particles. The team will also have clean, soapy water available for use to wash the wet silica from the skin when it gets on the skin.6.2 Emergency Response PlansOur travel team will follow the 614-Emergency Response Plan that is included Attachment K. 82740513335INSTRUCTIONS – SECTION 6.2 General Incident ProtocolProvide a description of your team’s emergency response plan, which should include reference to Attachment K, 614 – Emergency Response Plan. Student chapters should compare the EWB-USA Emergency Response Plan with their University’s Emergency Response Plan and confirm that there are no discrepancies. Any discrepancies should be stated here with a clear plan for reconciling the differences. In addition, any emergency response plans that are specific to the project site should be included in this section. 00INSTRUCTIONS – SECTION 6.2 General Incident ProtocolProvide a description of your team’s emergency response plan, which should include reference to Attachment K, 614 – Emergency Response Plan. Student chapters should compare the EWB-USA Emergency Response Plan with their University’s Emergency Response Plan and confirm that there are no discrepancies. Any discrepancies should be stated here with a clear plan for reconciling the differences. In addition, any emergency response plans that are specific to the project site should be included in this section. Additional site-specific emergency response procedures are included below.Designated Meeting PointThe designated meeting point for all team members in the event of an emergency will be the MEBSH Church compound in Les Anglais which is a little less than 2 miles from the project site at the Basin Simbe reservoir. The church compound is surrounded by a wall and the locked access gate is guarded 24 hours a day.Land Ambulance ServiceLand ambulance service is available in the town of Juayua, approximately 4.5 miles from the project site. The phone number for the ambulance service is (xyz) xyzz-xzyz.Air Ambulance ServiceAir ambulance service is available thru ISOS. The phone number for the ambulance service is (xyz) xyzz-xzyz.7.0 TRAINING Training will be provided prior to the team departing on the trip and while on site during daily task hazard review meetings.7.1 Pre Mobilization Training6165852168525INSTRUCTIONS – SECTION 7.1 TrainingAttach copies of required training certifications (First Aid/CPR, or Wilderness First Aid plus any project specific training, if appropriate). At minimum, both HSOs must have current training in First Aid with CPR. Other pre-trip H&S training (fall protection, electrical safety, etc) should be included here. 00INSTRUCTIONS – SECTION 7.1 TrainingAttach copies of required training certifications (First Aid/CPR, or Wilderness First Aid plus any project specific training, if appropriate). At minimum, both HSOs must have current training in First Aid with CPR. Other pre-trip H&S training (fall protection, electrical safety, etc) should be included here. The project lead, Bert Sandell, is First Aid/ CPR Certified and has completed and been certified by the Red Cross for Wilderness First Aid Training (May 2010). Health and Safety Officer, Heath Pope, is certified in CPR and he has completed first responder medical training (Title 22). Relevant certifications are listed in Attachment H. A general training and review on the following protocols will be provided prior to the teams departure:TH 02 Inclement WeatherTH 03 Heat stressTH 05 Foot careTH 08 Manual liftingTH 09 Rough TerrainTH 10 House keepingTH 11 Structural HazardsTH 12 Remote AreasTH 13 Working Over/Near WaterTH 14 TrafficTH 16 Fall ProtectionTH 18 Shoring and TrenchingTH 26 Biological HazardsTH 29 Falling Objects, Punctures, Abrasions, Dust, and Noise7.2 On Site Training5905506195060INSTRUCTIONS – SECTION 7.2 On-Site TrainingNotes of the daily safety meeting should be kept by the HSO. The notes should list out those present for the meeting (with signatures, if possible). Community members used in the implementation should be included in the daily safety talk. 00INSTRUCTIONS – SECTION 7.2 On-Site TrainingNotes of the daily safety meeting should be kept by the HSO. The notes should list out those present for the meeting (with signatures, if possible). Community members used in the implementation should be included in the daily safety talk. The Health and Safety Officers will hold daily safety meetings at the project site prior to the commencement of activities. All relevant hazards potentially encountered over the course of the day will be identified and management strategies will be discussed. 8.0 PERSONAL PROTECTIVE EQUIPMENT (PPE) 8474301463675INSTRUCTIONS – SECTION 8 Personal Protective Equipment (PPE)Describe the PPE that will be used during the project, including hard hats, safety glasses, gloves, steel-toed boots, etc. If recommended PPE will not be used, provide rational for excluding PPE use.This section is not limited to the EWB-USA volunteers. If community members are participating in the implementation, their PPE should be addressed in this section.Update the Personal Protective Equipment table in Attachment D.00INSTRUCTIONS – SECTION 8 Personal Protective Equipment (PPE)Describe the PPE that will be used during the project, including hard hats, safety glasses, gloves, steel-toed boots, etc. If recommended PPE will not be used, provide rational for excluding PPE use.This section is not limited to the EWB-USA volunteers. If community members are participating in the implementation, their PPE should be addressed in this section.Update the Personal Protective Equipment table in Attachment D.Required Personal Protective Equipment (PPE) will include hardhats, safety glasses, and sturdy hiking boots. Additional PPE, which is task dependent, includes gloves, waterproof boots, and harness and lanyards.8.1 Rationale For UseThis project is for the implementation of a pump project. For this reason, the minimum required PPE includes hardhats, safety glasses, and sturdy hiking boots for the anticipated hazards. 8.2 Criteria For SelectionHard hats and glasses will be ANSI certified and of construction grade. Boots will be appropriate for hiking. Waterproof Boots/Gloves will be used for construction to protect hands from cuts, chemicals, and silica products.. 8.3 Listing By TaskHardhats, glasses, and boots will be worn regardless of activities. This is required to instill a safety attitude while on the project site. Rubber boots will be required if water is encountered during potholing prevent contact. See Attachment D for a detailed overview by task.9.0 SITE CONTROL MEASURES 9.1 Exclusion ZonesAtmospheric839470114300INSTRUCTIONS – SECTION 9.1 Exclusion ZoneExclusion zones will only be necessary for specific hazardous tasks, such as those that may create a hazardous atmosphere. Review the task hazard summaries and determine if you have the potential for this requirement.Atmospheric Exclusion Zones are air based issues such as chemicals and silica exposure.Physical Exclusion Zones are areas that pose an immediate danger if someone is in the area and exposed to a risk that is not readily apparent. Examples are demolition, overhead work, and excavations00INSTRUCTIONS – SECTION 9.1 Exclusion ZoneExclusion zones will only be necessary for specific hazardous tasks, such as those that may create a hazardous atmosphere. Review the task hazard summaries and determine if you have the potential for this requirement.Atmospheric Exclusion Zones are air based issues such as chemicals and silica exposure.Physical Exclusion Zones are areas that pose an immediate danger if someone is in the area and exposed to a risk that is not readily apparent. Examples are demolition, overhead work, and excavationsExample 1: The team does not anticipate any atmospheric exclusion zones for this trip as we will not be working with chemicals or cutting/mixing silica based products.Example 2: The area around the concrete mixer and masonry block cutting operation will be an exclusion zone as it will have silica particles in the air and the potential exists that someone could breathe these particles in. We will identify this area thru the use of red danger tape with a sign identifying the hazard in English and Spanish. The danger tape will be placed such that there will be no exposure and adjusted for wind conditionsExample 3: The area where the chemicals are stored and injected will be an exclusion zone to prevent unnecessary exposure to chemicals. We will identify this area thru the use of red danger tape with a sign identifying the hazard in English and Spanish.Physical ZonesExample 1: The team does not anticipate any physical exclusion zones for this trip as we will not be performing demolition, excavation, or overhead work tasks. Example 2: The area around the building demolition is classified as an exclusion zone to prevent people from being injured by flying debris. We will identify this area thru the use of red danger tape with a sign identifying the hazard in English and Spanish. The danger tape will be placed such that there will be no exposure to flying debris and water will also be used to try and keep the dust to a minimum.Example 3: The area around under the scaffolding is classified as an exclusion zone to prevent people from being injured by objects falling from the scaffolding. We will identify this area thru the use of red danger tape with a sign identifying the hazard in English and Spanish. The danger tape will be placed 6-feet away from the scaffolding.Example 4: The area around excavation will be classified as an exclusion zone to prevent people from being injured by falling into the excavation or being hit by the equipment. We will identify this area thru the use of red danger tape with a sign identifying the hazard in English and Spanish. The danger tape will be placed far enough away from the excavation to allow the work to proceed without being impeded and to keep the general workers safe.9.2 Site Hygiene91440042884INSTRUCTIONS – SECTION 9.2 Site HygieneReview and attach “housekeeping” and if applicable “hazardous materials management” task hazards. Describe the project specific plan to address each.00INSTRUCTIONS – SECTION 9.2 Site HygieneReview and attach “housekeeping” and if applicable “hazardous materials management” task hazards. Describe the project specific plan to address each.All team members will be expected to keep their personal spaces at the hotel free of clutter. Everyone will participate in grounds keeping of the site at the end of the day. 10.0 MEDICAL CONSIDERATIONS 10.1 Medications and Vaccinations5528931562986INSTRUCTIONS – SECTION 10.1 Medications and VaccinationsUse this section to list the immunizations/inoculations, general physicals, medications, individual emergency contacts, allergies, treatment permissions, and training recommended for travel to the project site.00INSTRUCTIONS – SECTION 10.1 Medications and VaccinationsUse this section to list the immunizations/inoculations, general physicals, medications, individual emergency contacts, allergies, treatment permissions, and training recommended for travel to the project site.All travel team members are recommended to obtain a physical prior to departure, and are required to fill out a personal health and emergency contact form listing medical conditions, treatments, location of medications, and relevant contact information. Recommended and required vaccinations include: Current TetanusTyphoidHepatitis A. All recommended vaccinations are required for the EWB travel team. Travelers are also advised to maintain US health insurance for at least one year after returning from the trip. All general information regarding possible adverse health effects from the trip will be submitted to EWB-USA by the Health and Safety leads to aid in future trip preparations. Management Strategies are available in Attachment I. 10.2 Location of and person responsible for First Aid Kit(s)6718304157345INSTRUCTIONS – SECTION 10.2 Location of and person responsible for First Aid Kit(s) The HSO must know how to use all components of the first aid kit. First aid kits must include contents described in Medical Kit Contents (Form 604), and be stored in a weatherproof container. Contents shall be inspected for completeness prior to departure. The HSO should identify where the first aid kit is located on-site during the daily safety meetings so that all team members and in-country partners know where it is located. All team members should also be notified of the location of the first aid kit when off the project site.00INSTRUCTIONS – SECTION 10.2 Location of and person responsible for First Aid Kit(s) The HSO must know how to use all components of the first aid kit. First aid kits must include contents described in Medical Kit Contents (Form 604), and be stored in a weatherproof container. Contents shall be inspected for completeness prior to departure. The HSO should identify where the first aid kit is located on-site during the daily safety meetings so that all team members and in-country partners know where it is located. All team members should also be notified of the location of the first aid kit when off the project site.At all times there will be a minimum of (1) HSO at the project site. The HSO will possess at all times the first aid kit. 10.3 Exposure/Injury/Medical Support (on site and off)Minor injuries, such as abrasions, will result in on-site treatment by qualified first aid responders. Significant injuries will result in transportation to the nearest qualified medical clinic. 659130305435INSTRUCTIONS – SECTION 10.4 Medical Treatment FacilitiesIf the nearest medical facility or hospital is not known prior to departure, it will be discovered as soon as possible upon arriving at the project site. A sketch of the route to the facility including time and means to get there must be included and posted where all team members can view it.00INSTRUCTIONS – SECTION 10.4 Medical Treatment FacilitiesIf the nearest medical facility or hospital is not known prior to departure, it will be discovered as soon as possible upon arriving at the project site. A sketch of the route to the facility including time and means to get there must be included and posted where all team members can view it.10.4 Medical Treatment Facilities (Location & Transportation)The location of and map to the nearest medical treatment facility is identified in the preface and will be clearly posted at the site. 10.5 Incident Report66985190436INSTRUCTIONS – SECTION 10.5 Incident Report (Form 612)If there were any health and safety incidents during the trip, fill-out and submit your completed 612 - Incident Report document as a separate attachment with the post-trip report. An incident report should be submitted anytime an incident occurs during an EWB-USA trip. If the HSO is uncertain about the type of incidents that would necessitate the submittal of this report, please see the list in document 612 – Incident Report. EWB-USA uses the information and lessons learned from the incident reports to create more comprehensive procedures and policies. The chapter will not be penalized in any way for submitting an incident report. NOTE: Reporting of incidents and near-miss incidents is required. Failure to report an incident may result in the chapter not being approved for future projects.00INSTRUCTIONS – SECTION 10.5 Incident Report (Form 612)If there were any health and safety incidents during the trip, fill-out and submit your completed 612 - Incident Report document as a separate attachment with the post-trip report. An incident report should be submitted anytime an incident occurs during an EWB-USA trip. If the HSO is uncertain about the type of incidents that would necessitate the submittal of this report, please see the list in document 612 – Incident Report. EWB-USA uses the information and lessons learned from the incident reports to create more comprehensive procedures and policies. The chapter will not be penalized in any way for submitting an incident report. NOTE: Reporting of incidents and near-miss incidents is required. Failure to report an incident may result in the chapter not being approved for future projects.The form in Attachment J will be completed within 24 hours of any incident. The incident will be reported to the appropriate Health and Safety Committee member at the earliest possible time via telephone or email. The EWB Health and Safety Committee representative for this project is identified in Section 2.2. 11.0 POST MOBILIZATION REPORTING 11.1 System To Capture And Report Project Related Injury And Illness8070851584960INSTRUCTIONS– SECTION 11.1 Post-Mobilization ReportingUpdates and continued reporting and evaluation of any incidents or near incidents may continue, if necessary after the team has returned to the U.S. Please send an e-mail to your chapter relations manager (CRM) once the incident has been resolved in its entirety.00INSTRUCTIONS– SECTION 11.1 Post-Mobilization ReportingUpdates and continued reporting and evaluation of any incidents or near incidents may continue, if necessary after the team has returned to the U.S. Please send an e-mail to your chapter relations manager (CRM) once the incident has been resolved in its entirety.Weekly or daily reports will be submitted to the EWB-USA H&S Committee representative as required until the incident is deemed closed. 11.2 Participant Signatures HSOs will organize a briefing for EWB-USA participants about this document before departure, and this document will be available for them to read in its entirety before travel.Participants are required to acknowledge that they have read, understand, and will comply with the protocols contained in this document. They will indicate their agreement in the travel waiver document submitted to EWB-USA.ATTACHMENT A: AREA MAPTable A-1: Area Site CoordinatesITEMDESCRIPTIONNORTHINGEASTINGCOMMENTS1209040197104000A01San Salvador Airport13° 26′ 27.41″ N89° 03′ 20.62″ W1205865229679500A02Arbol De Fuego Hotel13° 52' 46" N89° 46' 3" W1205865261874000A03Posada El Encanto Hotel13° 52' 46" N89° 46' 3" W1205230293306500A04Basin Simbe Reservior13° 52' 46"N89° 46' 3" W92329045694601209040326517000A05Sanitary Assessment13° 22' 33"N89° 56' 15" W84645597967INSTRUCTIONS – ATTACHMENT A: Area MapThe area map should include the following information for each significant location the team will be at:Table with GPS CoordinatesThis information is critical in the event an emergency evacuation is needed. Map showing relative locations“Significant” locations are defined as:AirportHotelsProject SiteAttach as many maps as possiblePLEASE NOTE: The GPS Coordinates in the example are not real.00INSTRUCTIONS – ATTACHMENT A: Area MapThe area map should include the following information for each significant location the team will be at:Table with GPS CoordinatesThis information is critical in the event an emergency evacuation is needed. Map showing relative locations“Significant” locations are defined as:AirportHotelsProject SiteAttach as many maps as possiblePLEASE NOTE: The GPS Coordinates in the example are not real.Picture A-1: Area Map23368006830060002453640684276000238760067310000040132007416800004171950695960000ATTACHMENT B: PROJECT SITE MAPTable B-1: Site Coordinates-200025147320INSTRUCTIONS – ATTRACHMENT B: Project Site MapThe area map should include the following information for each significant location the team will be at:Table with GPS CoordinatesThis information is critical in the event an emergency evacuation is needed. Map showing relative locations“Significant” locations are defined as:HotelProject SiteMedical ClinicDesignated Meeting PointAttach as many maps as possible.00INSTRUCTIONS – ATTRACHMENT B: Project Site MapThe area map should include the following information for each significant location the team will be at:Table with GPS CoordinatesThis information is critical in the event an emergency evacuation is needed. Map showing relative locations“Significant” locations are defined as:HotelProject SiteMedical ClinicDesignated Meeting PointAttach as many maps as possible.ITEMDESCRIPTIONNORTHINGEASTINGCOMMENTS1228090199644000S01Posada El Encanto Hotel13° 52' 46" N89° 46' 3" W1226820232219500S02Basin Simbe Reservior13° 52' 46"N89° 46' 3" W1226820264414000S03Sanitary Assessment13° 22' 33"N89° 56' 15" W1236980294132000S04Medical Clinic13° 42' 46"N89° 56' 3" W1235075329057000S05Designated Meeting Point13° 22' 33"N89° 56' 15" W-577851109345Picture B-1: Project Site Coordinates3200401880870Designated Meeting Point(MEBSH Church)00Designated Meeting Point(MEBSH Church)38119053721100Medical Clinic00Medical Clinic549910078511400028930606610350002819403109595Posada el Encanto Hotel00Posada el Encanto Hotel36347402893695Kes Anglais Center(Sanitary Assessment)00Kes Anglais Center(Sanitary Assessment)977900991870Basin Simbe Reservoir(Chlorinator Installation)00Basin Simbe Reservoir(Chlorinator Installation)226060073590150034899605683250004624705769556500ATTACHMENT C: TASK HAZARD ANALYSESTable C-1 titled “Site Specific Task Hazard Analysis” summaries the tasks and the anticipated hazards associated with each activity.Table C-1 – Site Specific Task Hazard Analysis154940-460375INSTRUCTIONS – ATTACHMENT C: Task Hazard AnalysesThe task hazard analysis table is used to help determine the task hazards. It is included here for reference and as an example of what is expected. A task hazard analysis for each task scheduled in section 3.3 shall be performed.00INSTRUCTIONS – ATTACHMENT C: Task Hazard AnalysesThe task hazard analysis table is used to help determine the task hazards. It is included here for reference and as an example of what is expected. A task hazard analysis for each task scheduled in section 3.3 shall be performed.TASKSTYPEINDIVIDUAL HAZARDSCHEMICALBIOLOGICALPHYSICALTH 01 – Noise And Hearing TH 02 – Inclement WeatherTH 03 – Heat StressTH 04 – Cold StressTH 05 – Foot CareTH 06 – Confined SpaceTH 07 – Hot WorkTH 08 – Manual Lifting TH 09 – Rough TerrainTH 10 – HousekeepingTH 11 – Structural HazardsTH 12 – Remote AreasTH 13 – Working Over /Near WaterTH 14 – Traffic And VehiclesTH 15 – Heavy Equipment TH 16 –Fall ProtectionTH 17 – LaddersTH 18 – Shoring And Trenching TH 19 – Hazardous Mat Use StorageTH 20 – DemolitionTH 21 – Utilities and LandminesTH 22 – Electrical SafetyTH 23 – Hand and Power ToolsTH 24 – Hand & Emergency SignalsTH 25 – Lock Out Tag OutTH 26 – Biological HazardsTH 27 – Hazardous MaterialsTH 28 – Clear, Grubb, LoggingTH 29 – Falling Objects, Punctures, Abrasions, Dust, And Noise (PPE)TH 30 – SilicaTH 31 – Note Used 01TravelXXXXXXXXX02Eating / DrinkingXXXXX03Trail HikingXXXXXXXXXXX04Work Site InspectionXXXXXXXXXXXXXXXXX05Labor OversightXXXXXXXXXXXXXX06SurveyingXXXXXXXX07Excavate/Backfill TrenchXXXXXXXXXX08Assemble piping and chlorinatorXXXXXXXXXXXX09Chlorination of reservoirXXXXXXXXXXXXX10Set chlorinator dosingXXXXXXXXXXX11Chlorine monitoring and adjustmentXXXXXXXXXXX12O&M Training of LocalsXXXXXXXXXX13Investigate/Repair Distribution System (if needed)XXXXXXXXXXXXXXX14Soil investigationXXXXXXX15Supplemental health assessmentXXXXXXX16Existing latrine documentationXXXXXATTACHMENT D: PERSONAL PROTECTIVE EQUIPMENT ANALYSES38100048260INSTRUCTIONS – ATTACHMENT D: Personal Protective Equipment AnalysisThe personal protective equipment analyses table is used to help determine the necessary Personal Protective Equipment for each task identified in the schedule in section 3.3. It is included here for reference as a guideline and the HSO is responsible for reviewing the requirements prior to the work starting and implementing additional PPE if necessary. 00INSTRUCTIONS – ATTACHMENT D: Personal Protective Equipment AnalysisThe personal protective equipment analyses table is used to help determine the necessary Personal Protective Equipment for each task identified in the schedule in section 3.3. It is included here for reference as a guideline and the HSO is responsible for reviewing the requirements prior to the work starting and implementing additional PPE if necessary. Table D-1 titled “Site Assessment & Investigation PPE Analysis” summaries the tasks and the PPE associated with each activity.Table D-1 – Site Assessment & Investigation PPE AnalysisTASKGENERALFOOTWEAREYE / HEARINGHAND PROTECTIONSPECIAL TRAININGSeat BeltsHard HatsLong PantsLong Sleeve ShirtRain GearWork BootsRubber BootsSafety GlassesSafety GogglesWelding Helmet with Lens ShadeHearing ProtectionLeather GlovesAlkali- ResistantRubber GlovesPersonal Fall ProtectionRespiratory ProtectionExcavationTravel to/from site X???A??????Eating/drinking on site ???A??????Stacking cinder blocks xxxAx?x?????Cut and bend rebar ???xxAx?x?????Concrete pouring xxxAxx??????Concrete mixing xxxAxx?????If dry mixingBuilding formwork xxxAx?x???????Welding and installing trusses ?xxAx??????If no ventilationScaffolding xxxAx?x???????Roofing xxxAx?x???????Digging septic tank hole ???xxAx?x?????Installing leach field ???xxAx?x?????Installing plumbing ???xxAx?x?????General electrical wiringxxxAx?x?????Stuccoing xxxAx?x?????Painting ???xxAx?x????Ensure adequate ventilationChemical Handling?????????A???????????Taking pictures of site A = As RequiredX = Required?? = HSO To DetermineATTACHMENT E: MATERIAL SAFETY DATA SHEETS (MSDS)796290158115INSTRUCTIONS – ATTACHMENT E: Material Safety Data Sheets (MSDS)Provide the material safety data sheets (MSDS) for any chemical or items your team requires an MSDS sheet for. Other examples include cements, non standard cleaners, oils/greases, etc. If you team does not anticipate using or encountering materials that require an MSDS sheet, please do not delete this section. Please add a note indicating none are expected and why.An easy way to look up the MSDS information is to go to Google, type in the product name and add MSDS to the end. 00INSTRUCTIONS – ATTACHMENT E: Material Safety Data Sheets (MSDS)Provide the material safety data sheets (MSDS) for any chemical or items your team requires an MSDS sheet for. Other examples include cements, non standard cleaners, oils/greases, etc. If you team does not anticipate using or encountering materials that require an MSDS sheet, please do not delete this section. Please add a note indicating none are expected and why.An easy way to look up the MSDS information is to go to Google, type in the product name and add MSDS to the end. ATTACHMENT F: POTENTIAL VENOMOUS SNAKES & SPIDERS 851535445770INSTRUCTIONS – ATTACHMENT F: Common Venomous Snakes & SpidersIn many of our project sites we have a realistic possibility of encountering hazardous animals such as snakes and spiders. Summaries and images of your team’s research on hazardous animals should be provided here. This summary can assist team members in avoiding these animals. Similar care should be taken with other types of hazardous animals (i.e., javelinas, lions, tigers, etc.).There are some websites that can help you in your research, such as: you team does not anticipate encountering potential venomous snakes or spiders, please do not delete this section. Please add a note indicating none are expected.00INSTRUCTIONS – ATTACHMENT F: Common Venomous Snakes & SpidersIn many of our project sites we have a realistic possibility of encountering hazardous animals such as snakes and spiders. Summaries and images of your team’s research on hazardous animals should be provided here. This summary can assist team members in avoiding these animals. Similar care should be taken with other types of hazardous animals (i.e., javelinas, lions, tigers, etc.).There are some websites that can help you in your research, such as: you team does not anticipate encountering potential venomous snakes or spiders, please do not delete this section. Please add a note indicating none are expected.ATTACHMENT G: TRAINING COPY CERTIFICATES762000147320INSTRUCTIONS– ATTACHMENT G: Training Certificate CopiesThis attachment is used for copies of all training certificates. Both HSOs are required to have current First Aid training with CPR.00INSTRUCTIONS– ATTACHMENT G: Training Certificate CopiesThis attachment is used for copies of all training certificates. Both HSOs are required to have current First Aid training with CPR.ATTACHMENT H: REQUIRED MEDICAL KIT CONTENTS7429501637665INSTRUCTIONS – ATTACHMENT H: Required Medical Kit ContentsPlease identify the medical kit(s) that the group will be taking on the trip. In some cases it may be more efficient to have a large kit in a central location and smaller, more portable kits for the team to use while performing the daily tasks.00INSTRUCTIONS – ATTACHMENT H: Required Medical Kit ContentsPlease identify the medical kit(s) that the group will be taking on the trip. In some cases it may be more efficient to have a large kit in a central location and smaller, more portable kits for the team to use while performing the daily tasks.Required Group Medical Kit Contents There will be one (1) large medical kit with the contents listed in Table I-1. Additionally, each group with have a smaller travel site medical kit with them when they travel. Currently it is anticipated there will be 6-8 people traveling with each group performing site assessments in a groups of two (2) at a minimum. Based on the potential for up to four (4) groups traveling at the same time, we will have four (4) medical kits. Additionally, EWB-USA members will not provide treatment for host country community members beyond first aid unless they are licensed medical professionals and understand the local laws on practicing medicine. NUMBER IN KITITEM-10668052705INSTRUCTIONS – TABLE H-1: Required Medical Kit Contents (Form 604)First aid kits should be inventoried and restocked before every trip. See form 604 of the Sourcebook Downloads page of the EWB-USA website. 00INSTRUCTIONS – TABLE H-1: Required Medical Kit Contents (Form 604)First aid kits should be inventoried and restocked before every trip. See form 604 of the Sourcebook Downloads page of the EWB-USA website. 1Site Specific Health and Safety PlanPage one is the Emergency Contact Page, laminated and printed on brightly colored paperThe personal medical checklists should be placed in a sealed envelope immediately following the Emergency Contact Page, or the location of the Checklists should appear here. HSOs must return the checklists to their owners at the end of the trip.1A field manual of first aid can be very useful for rapid reference. One recommended book is: “The Field Guide of Wilderness and Rescue Medicine” by Jim Morrissey and David Johnson *1Small notebook and pen/pencil for recording vital signs2Safety glasses (for bloodborne pathogens)2CPR face shields or (even better) pocket mask1 boxSterile and non-sterile gloves, 1 box or a minimum of 12 pairs1 boxAntiseptic wipes or “baby wipes” - 1 box1 bottleAlcohol-based gel hand cleanser - 1 bottle12Providone Iodine swabs or a small bottle of betadine1 bottleAntibacterial soap1 bottleHydrogen peroxide 3 bottleSterile Eye Wash. Opened bottles should be replaced at the start of every trip. 3 bottles recommended for those doing concrete work or working with chemicals.1Cold pack – 4 in. x 5 in3Extra soft toothbrush for cleaning wounds1 tubeAntibiotic ointment (Neosporin, Bacitracin, or generic equivalent) - 1 tube1Topical over the counter anesthetic (Anbesol or Chloraseptic spray) Fouille First Aid Ointment if you can get it.1 boxBand-Aid assortment; and Blister dressings (Bandaid blister, moleskin, etc. Choose band-aids with elasticized cloth that stay on for days. Plastic ones don't last as long.)3Absorbent compress or Trauma Dressings ~ 32 sq. in. (81.3 sq. cm.) with no side smaller than 4 in. (10 cm)1Adhesive tape, 5 yd. (457.2 cm) total6Burn treatment, 0.5 g (0.14 fl. oz.) applications4Triangular bandages, 40 in. x 40 in. x 56 in. (101 cm x 101 cm x 142 cm)2Roller bandage - 4 in. (10 cm)1Roller bandage - 2 in. (5 cm)1Ace Wraps – try to get a few sizes of these1 boxSterile gauze pads, 4x4” 1 boxNon adherent dressing (Telfa), 4x4” 1Roll of Coban wrap (a.k.a. Vet Wrap) 2Scissors, one pair of trauma shears for slicing bandages and cutting clothing, and one small pair for cutting more delicate things (like skin)2Tweezers, one small for pulling splinters and stingers, and a broader tip with grippers for picking rocks out of wounds.Small boxSafety pins of various sizes1Thermometer1Ziplock bag containing a clean XL t-shirt. Can be cut up for bandages, used as a sling, or put on a patient for modesty. 2 of eachExtra syringes/needles of varying sizes (for local physician to use if a member of the team is taken to a local medical facility. Team members should avoid using local syringes or needles whenever possible. (If supply is a problem, advise reusing needles in the same person. This is reasonably safe - we don't in medicine but most diabetics do. They get dull after a while, but the risk of infection is very small compared to using needles in many developing world clinics.)Needles: 20g x 1", 22g x 1" Syringes: 3 ml, 5 ml, (20 ml for irrigation of wounds)18g and 20g IV catheters and/or butterfly needles1Portable water filter, such as the ceramic type with the 0.2 pm filter. Three stage MSR or PUR water filters are probably the best. If the water is clear, the new light sterilizers work. *1Emergency Dental Kit (Cavit if you can get it) *1Stethoscope *1Four inch SAM splint *1Finger splint *1 box eachMylanta Pepto Bismol Imodium tabletsCimetidine *Dramamine (Motion sickness pills are also useful in vomiting illnesses and much safer than what might be given at the local clinic)Benadryl or generic diphenhydramine, 25 mg capsules (allergies)Tylenol (500 mg tablets) (mild pain relief/fever reduction)Ibuprofen (200 mg tablets) (anti-inflammatory/pain relief)Aspirin (heart attacks)Appropriate to trip duration and number of travelers,Primatene Mist (asthma)*Steroid cream for rashesPowder (Monkeybutt) for chafes *Antifungal cream *Antiyeast tablets or cream for women *NeoSynephrine nasal spray (decongestant)*Sodium tablets (heat cramps) *Small hard candies like Jolly Ranchers or LifeSavers (must contain sugar – for diabetics) *Iodine tablets OR chlorine tablets with neutralizer for disinfecting water *1 ft square of muslin cloth for filtering sediment from water before disinfection *Up to 1/dayGatorade packets 1 packQuikclot1Dermabond or super glue ** Optional componentsNotes:1. This list can and should be customized to your site, and optional components are marked by *. 2. The first aid kit should be repacked, inventoried and restocked before every trip.3. Antibiotics are not on this list, but travelers can generally get a personal prescription for Cipro or other antibiotics from their primary care physician or a travel medicine specialist.4. Those with a history of asthma/allergies are advised to investigate a prescription for epinephrine (Epipen)4. EWB-USA volunteers are not permitted to provide medical treatment or medicines beyond first aid to locals unless they are licensed to do so. 5. Most of the equipment can be purchased from the drug store. For more specialized items or prepackaged kits, here are some online vendors:conterra-?First Aid Packs and Bags?Complete First Aid Kits?Complete First Aid Kits?First Aid Supplies?First Aid SuppliesATTACHMENT I: TASK HAZARD MANAGEMENT STRATEGIESTask Hazards List-102870-15875INSTRUCTIONS – ATTACHMENT I: Task Hazard Management StrategiesAll task hazard pages shall be included in the printed copy of the health and safety plan in the event an unexpected hazard arises during a project. They are available in PDF format on the EWB-USA website (Health and Safety Program Page). The Task hazard pages do not have to be submitted for review unless changes are made to the protocols.If the team would like to modify items in this section, the proposed modifications must be brought to EWB-USA’s attention.00INSTRUCTIONS – ATTACHMENT I: Task Hazard Management StrategiesAll task hazard pages shall be included in the printed copy of the health and safety plan in the event an unexpected hazard arises during a project. They are available in PDF format on the EWB-USA website (Health and Safety Program Page). The Task hazard pages do not have to be submitted for review unless changes are made to the protocols.If the team would like to modify items in this section, the proposed modifications must be brought to EWB-USA’s attention.TASK HAZARDDESCRIPTIONREVISION DATETH 01Noise and Hearing ConservationMay 2008TH 02Inclement WeatherMay 2008TH 03Heat StressMay 2008TH 04Cold StressMay 2008TH 05Foot CareMay 2008TH 06Confined SpaceMay 2008TH 07Hot WorkMay 2008TH 08Manual Lifting and Handling of Heavy ObjectsMay 2008TH 09Rough TerrainMay 2008TH 10HousekeepingMay 2008TH 11Structural HazardsMay 2008TH 12Remote AreasMay 2008TH 13Working over or near waterMay 2008TH 14Traffic and VehiclesMay 2008TH 15Heavy Equip OperationMay 2008TH 16Working at Elevation and Fall ProtectionMay 2008TH 17LaddersMay 2008TH 18Shoring and TrenchingMay 2008TH 19Hazardous Materials Use and StorageMay 2008TH 20DemolitionMay 2008TH 21Active and Abandoned Utilities and LandminesMay 2008TH 22Electrical SafetyMay 2008TH 23Hand and Power Hand ToolsMay 2008TH 24Hand and Emergency SignalsMay 2008TH 25Lock Out Tag OutMay 2008TH 26Biological HazardsMay 2008TH 27Hazardous MaterialsMay 2008TH 28Clearing Grubbing and LoggingMay 2008TH 29Falling Objects, Punctures and Abrasions May 2008TH 30SilicaMay 2008TH 31Not UsedMay 2008ATTACHMENT J: INCIDENT REPORT (Form 612) & ROOT CAUSE ANALYSIS (Form 613) 531628109456.INSTRUCTIONS – ATTACHMENT J: Incident Report (Form 612) & Root Cause Analysis (Form 613)A copy of a blank Incident Report (Form 612) and a blank Root Cause Analysis (Form 613) should be placed here. These forms are both found on the Sourcebook Downloads page of the EWB-USA website. 00.INSTRUCTIONS – ATTACHMENT J: Incident Report (Form 612) & Root Cause Analysis (Form 613)A copy of a blank Incident Report (Form 612) and a blank Root Cause Analysis (Form 613) should be placed here. These forms are both found on the Sourcebook Downloads page of the EWB-USA website. ATTACHMENT K: EMERGENCY RESPONSE PLAN (FORM 614)64770099695.INSTRUCTIONS – ATTACHMENT K: Emergency Response Plan (Form 614)A copy of the 614 – Emergency Response Plan (form 614 found on the Sourcebook Downloads page of the EWB-USA website) should be placed here. All team members must review and understand the team’s Emergency Response Plan.00.INSTRUCTIONS – ATTACHMENT K: Emergency Response Plan (Form 614)A copy of the 614 – Emergency Response Plan (form 614 found on the Sourcebook Downloads page of the EWB-USA website) should be placed here. All team members must review and understand the team’s Emergency Response Plan.ATTACHMENT L: ADDENDUM FOR TRAVEL TO A HIGH RISK COUNTRY/AREA OR TO A COUNTRY WITH A U.S. DEPARTMENT OF STATE TRAVEL WARNING83997289491.INSTRUCTIONS – ATTACHMENT L: Addendum for Travel to a High Risk Country/Area or to a Country with a U.S Department of State Travel WarningFor special cases where EWB-USA has decided to allow established programs to continue in ISOS high risk areas, as well as in countries with a DOS issued Travel Warning, the travel team will need to follow additional safety requirements. These can be found on the EWB-USA website – Health and Safety Program – Travel Resources – Travel Restrictions. As of March 2013, there are additional travel procedures for the following ISOS high risk countries/areas: Haiti, Honduras, Kenya, Nigeria, Sierra Leone, and areas of Mexico. As of March 2013, there is a DOS Travel Warning issued for the following countries which have EWB-USA programs: El Salvador, Honduras, Haiti, Kenya, Mexico, Niger, Nigeria, and Philippines. If a chapter is traveling to a country with both a DOS Travel Warning and an ISOS high risk rating, the chapter should follow the ISOS high risk procedures for that country. Chapters should include the addendum here to document how the team will address the additional requirements.00.INSTRUCTIONS – ATTACHMENT L: Addendum for Travel to a High Risk Country/Area or to a Country with a U.S Department of State Travel WarningFor special cases where EWB-USA has decided to allow established programs to continue in ISOS high risk areas, as well as in countries with a DOS issued Travel Warning, the travel team will need to follow additional safety requirements. These can be found on the EWB-USA website – Health and Safety Program – Travel Resources – Travel Restrictions. As of March 2013, there are additional travel procedures for the following ISOS high risk countries/areas: Haiti, Honduras, Kenya, Nigeria, Sierra Leone, and areas of Mexico. As of March 2013, there is a DOS Travel Warning issued for the following countries which have EWB-USA programs: El Salvador, Honduras, Haiti, Kenya, Mexico, Niger, Nigeria, and Philippines. If a chapter is traveling to a country with both a DOS Travel Warning and an ISOS high risk rating, the chapter should follow the ISOS high risk procedures for that country. Chapters should include the addendum here to document how the team will address the additional requirements.ATTACHMENT M: ADDENDUM FOR SMALL TRAVEL TEAMS/EXTENDED STAYS847725205105.INSTRUCTIONS – ATTACHMENT M: Addendum for small travel teams/extended staysApproval for travel teams that are very small (less than 3 people) or who will be staying for an extended period of time (any time outside of the scheduled team trip) may be granted, but additional requirements may be put into place on a case-by-case basis. The full list of requirements is listed in Section 8.0 of the EWB-USA Health and Safety Policy. After reading the policy, the chapter can use this table to document how they plan to address each applicable requirement.00.INSTRUCTIONS – ATTACHMENT M: Addendum for small travel teams/extended staysApproval for travel teams that are very small (less than 3 people) or who will be staying for an extended period of time (any time outside of the scheduled team trip) may be granted, but additional requirements may be put into place on a case-by-case basis. The full list of requirements is listed in Section 8.0 of the EWB-USA Health and Safety Policy. After reading the policy, the chapter can use this table to document how they plan to address each applicable requirement.No.RequirementApplicability?(Yes/No)1General Understanding of Additional RisksChapter Response:2Established ProgramChapter Response:3Pre-Trip Physicals Chapter Response:4Additional Local ContactsChapter Response:5Language ProficiencyChapter Response:6General Travel ExperienceChapter Response:7Medical TrainingChapter Response:8Back-up Transportation PlansChapter Response:9U.S. Check-In ContactChapter Response:10Travel Route DocumentationChapter Response:11Additional In-Country SupportChapter Response: ................
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