+---------------------------+-------+-----+------+------+-----+-----+
| **Name(s) of "Sample"     | **    | **  | *    | *    | **  | **  |
| Risk Team Members:**      | Point | 1** | *2** | *3** | 4** | 5** |
|                           | Value |     |      |      |     |     |
| R. Backofen;,A. Reben; F. | →**   |     |      |      |     |     |
| Horn                      |       |     |      |      |     |     |
|                           | *     |     |      |      |     |     |
|                           | *Para |     |      |      |     |     |
|                           | meter |     |      |      |     |     |
|                           | ↓**   |     |      |      |     |     |
+---------------------------+-------+-----+------+------+-----+-----+
| **Name(s) of Specific     |       |     |      |      |     |     |
| Application Risk Team     |       |     |      |      |     |     |
| Members:**                |       |     |      |      |     |     |
|                           |       |     |      |      |     |     |
| R. Backofen ;A. Reben; F. |       |     |      |      |     |     |
| Horn                      |       |     |      |      |     |     |
+---------------------------+-------+-----+------+------+-----+-----+
| **Job Title: Photography  | **F   | **  | **   | *    | **[ | *   |
| location/studio shoot**   | reque | [\< | [\<] | *[\< | \<] | *\> |
|                           | ncy** | ]{. | {.un | ]{.u | {.u | onc |
| **Job Number or Job       |       | und | derl | nder | nde | e/s |
| Identifier: PG_VIDEO**    | **    | erl | ine} | line | rli | hif |
|                           | (B)** | ine | once | }onc | ne} | t** |
|                           |       | }on | /mon | e/we | onc |     |
|                           |       | ce/ | th** | ek** | e/s |     |
|                           |       | yea |      |      | hif |     |
|                           |       | r** |      |      | t** |     |
+---------------------------+-------+-----+------+------+-----+-----+
| **Job Description:        | **    | *   | *    | **   | **P | *   |
| Equipment setup, and      | Sever | *Fi | *Med | Lost | art | *De |
| shooting video and        | ity** | rst | ical | Ti   | ial | ath |
| operation of editing and  |       | Aid | Tre  | me** | Dis | or  |
| duplication equipment**   | **    | Onl | atme |      | abi | Per |
|                           | (C)** | y** | nt** |      | lit | man |
|                           |       |     |      |      | y** | ent |
|                           |       |     |      |      |     | Dis |
|                           |       |     |      |      |     | abi |
|                           |       |     |      |      |     | lit |
|                           |       |     |      |      |     | y** |
+---------------------------+-------+-----+------+------+-----+-----+
| Training Procedures List  | **Li  | **V | **Un | **Po | **P | **M |
| (Optional): TQ-LADDER,    | kelih | ery | like | ssib | rob | ult |
| TQ-BACKSAFE, GERT         | ood** | U   | ly** | le** | abl | ipl |
|                           |       | nli |      |      | e** | e** |
| Applicable Standard       | **    | kel |      |      |     |     |
| Operating Procedures:     | (D)** | y** |      |      |     |     |
+---------------------------+-------+-----+------+------+-----+-----+
| Approved by: R. Backofen  |       |     |      |      |     |     |
| Date: 04/01/08 Rev. #: 2  |       |     |      |      |     |     |
|                           |       |     |      |      |     |     |
| (signature on file in     |       |     |      |      |     |     |
| building 197B room 1-101) |       |     |      |      |     |     |
+---------------------------+-------+-----+------+------+-----+-----+
| **Stressors (if           |       | **  |      |      | *   |     |
| applicable, please list   |       | Rea |      |      | *Co |     |
| all) Workload, weather    |       | son |      |      | mme |     |
| conditions**              |       | for |      |      | nts |     |
|                           |       | Re  |      |      | :** |     |
|                           |       | vis |      |      | No  |     |
|                           |       | ion |      |      | c   |     |
|                           |       | (if |      |      | han |     |
|                           |       | ap  |      |      | ges |     |
|                           |       | pli |      |      |     |     |
|                           |       | cab |      |      |     |     |
|                           |       | le) |      |      |     |     |
|                           |       | :** |      |      |     |     |
|                           |       | Pe  |      |      |     |     |
|                           |       | rio |      |      |     |     |
|                           |       | dic |      |      |     |     |
|                           |       | Rev |      |      |     |     |
|                           |       | iew |      |      |     |     |
+---------------------------+-------+-----+------+------+-----+-----+

<table>
<colgroup>
<col style="width: 12%" />
<col style="width: 11%" />
<col style="width: 23%" />
<col style="width: 3%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 3%" />
<col style="width: 13%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 4%" />
</colgroup>
<thead>
<tr class="header">
<th></th>
<th></th>
<th></th>
<th colspan="9"><strong>Before Additional Controls</strong></th>
<th></th>
<th colspan="7"><p><strong>After Additional</strong></p>
<p><strong>Controls</strong></p></th>
<th></th>
</tr>
<tr class="odd">
<th><strong>Activity</strong></th>
<th><strong>Hazard</strong></th>
<th><strong>Control(s)</strong></th>
<th colspan="2"><blockquote>
<p><strong>Stressor</strong></p>
</blockquote></th>
<th colspan="2"><blockquote>
<p><strong># of People A</strong></p>
</blockquote></th>
<th colspan="2"><blockquote>
<p><strong>Frequency B</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>Severity C</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>Likelihood D</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>Risk* AxBxCxD</strong></p>
</blockquote></th>
<th><h1 id="controls-added-to-reduce-risk">Control(s) Added to Reduce
Risk</h1></th>
<th><h1 id="stressors">Stressors</h1></th>
<th><blockquote>
<p><strong># of People A</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>Frequency B</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>Severity C</strong></p>
</blockquote></th>
<th colspan="2"><blockquote>
<p><strong>Likelihood D</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>Risk* AxBxCxD</strong></p>
</blockquote></th>
<th><blockquote>
<p><strong>% Risk Reduction</strong></p>
</blockquote></th>
</tr>
</thead>
<tbody>
<tr class="odd">
<td>Driving to and from Video shoot location.</td>
<td></td>
<td>SEE <a
href="http://www.bnl.gov/PGA/Docs/OSH/JRA/PG_JRA_DRIVING.pdf">PG_JRA_DRIVING</a></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td rowspan="5">Lifting, setup and carrying equipment</td>
<td>Lifting, bending, twisting, slip, trip, fall, muscle pull, back
strain</td>
<td>Tool Box training, work planning, Back Safety training
(TQ-BACKSAFE)</td>
<td>Y</td>
<td colspan="2">1</td>
<td colspan="2">5</td>
<td colspan="2">2</td>
<td>2</td>
<td>20</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td>Being struck by dropped load</td>
<td>Back Safety training (TQ-BACKSAFE), worker awareness, safety
shoes</td>
<td>Y</td>
<td colspan="2">1</td>
<td colspan="2">5</td>
<td colspan="2">1</td>
<td>2</td>
<td>10</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td>Fall</td>
<td>Sufficient lighting, surface maintenance, housekeeping, hand
truck</td>
<td>Y</td>
<td colspan="2">1</td>
<td colspan="2">3</td>
<td colspan="2">2</td>
<td>2</td>
<td>10</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td>Exposure to natural elements, insect, bites sunburn</td>
<td>BNL Tick Awareness video, clothing precautions, sun block if
necessary</td>
<td>Y</td>
<td colspan="2">1</td>
<td colspan="2">3</td>
<td colspan="2">1</td>
<td>3</td>
<td>9</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td>Radiation exposure from working in restricted areas</td>
<td>TLD Badge, GERT Training, FS Escort</td>
<td>N</td>
<td colspan="2">1</td>
<td colspan="2">3</td>
<td colspan="2">2</td>
<td>2</td>
<td>12</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td rowspan="2">Use of Portable ladder</td>
<td>Overexertion injuries, strain, struck by object,</td>
<td>Proper lifting techniques (TQ-BACKSAFE)</td>
<td>N</td>
<td colspan="2">1</td>
<td colspan="2">2</td>
<td colspan="2">1</td>
<td>2</td>
<td>4</td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td rowspan="2"></td>
<td colspan="2" rowspan="2"></td>
<td rowspan="2"></td>
</tr>
<tr class="even">
<td>Fall to lower level</td>
<td>TQ-LADDER</td>
<td>N</td>
<td colspan="2">1</td>
<td colspan="2">2</td>
<td colspan="2">2</td>
<td>2</td>
<td>8</td>
</tr>
<tr class="odd">
<td rowspan="3"><p>Operation of Editing and Duplication equipment</p>
<p>Operation of Editing and Duplication equipment (cont.)</p></td>
<td>Repetitive motion injuries</td>
<td>Adjustable chairs, ergonomically designed keyboards and mouse,
alternating tasks, work breaks, keyboard and mouse wrist cushions</td>
<td>N</td>
<td colspan="2">1</td>
<td colspan="2">5</td>
<td colspan="2">2</td>
<td>2</td>
<td>20</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td>Eye strain</td>
<td>Proper lighting, , adjustable chairs, alternating tasks, work
breaks, Proper prescription eyewear if applicable</td>
<td>N</td>
<td colspan="2">1</td>
<td colspan="2">5</td>
<td colspan="2">1</td>
<td>2</td>
<td>10</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td>Neck &amp; Back strain from static posture</td>
<td>Adjustable chairs, work breaks, alternating tasks, speaker phones,
head sets</td>
<td>N</td>
<td colspan="2">1</td>
<td colspan="2">5</td>
<td colspan="2">1</td>
<td>2</td>
<td>10</td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td></td>
</tr>
</tbody>
</table>

  ------------- ---------------- ---------------- -------------- ----------------- -----------------
  **\*Risk:**   **0 to 20**      **21 to 40**     **41-60**      **61 to 80**      **81 or greater**

                **Negligible**   **Acceptable**   **Moderate**   **Substantial**   **Intolerable**
  ------------- ---------------- ---------------- -------------- ----------------- -----------------