Example Customer Example Customer City, St

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Guarding Evaluation For Example Customer Example Customer City, St "This report is a sample document and is an example of materials produced by. This report for display and discussion purposes only. t to be shared or reproduced without authorization. Liberties were taken in development of the report and does not imply actual risk analysis for any demonstration ry. Rev. 5/00

24 th October, 2016 October 2016 BevCorp, 4711 Customer East 355th Information Street, Willoughby, OH 44094 Attention: Cary Customer Meler Contact Subject: Guarding Assessment Report, Filler/Seamer. Dear Cary, Customer Contact s Safety Services business is pleased to provide the results of the guarding assessment for the Filler/Seamer that you are producing for your end user. The objective of the assessment is to identify and document potential point of operation hazards and power transmission hazards associated with the operations of the equipment. Once the hazards are identified, potential mitigation techniques are to be identified. The guarding assessment performed is not a complete risk assessment as per ANSI B11.TR3 and all hazards may not have been identified. This guarding assessment can be the first phase of a safeguarding initiative. The results can be useful for reviewing the current equipment status with identified areas for potential guarding and control improvements. The guarding and control improvements if designed, applied and maintained properly can lead to compliance with current standards and OSHA safeguarding regulations. The equipment evaluated is the Filler/Seamer. The assessment took place at the Willoughby, Customer OH Facility facility. looks forward to working with you to help create a safe and more productive environment. Please let us know if you have any questions regarding our report. I may be reached at 440-665 2541. Respectfully, Jed Hepfner, Contact Machine Safety Consultant Page 2 of 12

Machine Layout tes on Existing Installation 1) Current perimeter guards are constructed from stainless steel and polycarbonate. 2) Operator access doors have safety rated interlocks installed to prevent opening while is in motion. 3) Guard doors that have double doors have a single locking interlock on the left hand door. The right hand door has a non-contact interlock installed. The physical construction of the doors requires that the right most door be closed first, with the left most door encapsulating the right hand door to keep both locked. 4) Guarding that is mounted underneath the interlocked guards is attached with tool-toremove fasteners. 5) The jog pushbutton at the operator station is blue, due to the color this is not in compliance with a required action or reset according to NFPA79 regulations. Page 3 of 12

Assessment Analysis Area Injury Type Origin / Cause Energy / Hazard Source LO FE DPH NP HRNi S F P PLr Current Safeguards Quick Reference 1. Infeed 1. Infeed 1. Infeed Chemical Exposure 5. Exposure to CIP / Washdown chemicals. 1. Infeed Cut/Laceration 6. Laceration 2. Outfeed 2. Outfeed Electrical 8 2.5 6 1 120 S2 F1 P2 Pld Electrical 10 5 6 1 300 S2 F2 P2 Ple Chemical 10 2.5 6 1 150 S2 F1 P2 Pld Mech. Kinetic 10 2.5 0.5 1 13 S2 F1 P2 Pld Electrical 8 2.5 6 1 120 S2 F1 P2 Pld Electrical 10 5 6 1 300 S2 F2 P2 Ple [PPE] Based on MSDS for washdown chemicals [PPE] Cut resistant gloves Page 4 of 12

2. Outfeed 2. Outfeed 2. Outfeed 3. Filler 3. Filler 3. Filler 3. Filler 3. Filler Chemical Exposure Cut/Laceration 4. Unexpected motion. 5. Exposure to CIP / Washdown chemicals. 6. Laceration 2. Vertical movement of 4. Unexpected motion. 4. Unexpected motion. Electrical 8 1 6 1 48 S2 F1 P2 Pld Chemical 10 2.5 6 1 150 S2 F1 P2 Pld Mech. Kinetic 10 2.5 0.5 1 13 S2 F1 P2 Pld Electrical 10 5 6 1 300 S2 F2 P2 Ple Electrical 8 2.5 6 1 120 S2 F1 P2 Pld Pneumatic 8 2.5 6 1 120 S2 F1 P1 Plc Electrical 8 2.5 6 1 120 S2 F1 P2 Pld Electrical 8 1 6 1 48 S2 F1 P2 Pld [PPE] Based on MSDS for washdown chemicals [PPE] Cut resistant gloves Page 5 of 12

3. Filler Chemical Exposure 5. Exposure to CIP / Washdown chemicals. 3. Filler Cut/Laceration 6. Laceration 4. Seamer 4. Seamer 4. Seamer 4. Seamer 4. Seamer 4. Seamer Chemical Exposure Cut/Laceration 4. Unexpected motion. 4. Unexpected motion. 5. Exposure to CIP / Washdown chemicals. 6. Laceration Chemical 10 2.5 6 1 150 S2 F1 P2 Pld Mech. Kinetic 10 2.5 0.5 1 13 S2 F1 P2 Pld Electrical 8 5 6 1 240 S2 F2 P2 Ple Electrical 10 2.5 6 1 150 S2 F1 P2 Pld Electrical 8 2.5 6 1 120 S2 F1 P2 Pld Electrical 8 1 6 1 48 S2 F1 P2 Pld Chemical 10 2.5 6 1 150 S2 F1 P2 Pld Mech. Kinetic 10 2.5 0.5 1 13 S2 F1 P2 Pld [PPE] Based on MSDS for washdown chemicals [PPE] Cut resistant gloves [PPE] Based on MSDS for washdown chemicals [PPE] Cut resistant gloves Page 6 of 12

5. Transfer Conveyor 5. Transfer Conveyor 5. Transfer Conveyor 5. Transfer Conveyor 5. Transfer Conveyor 5. Transfer Conveyor Nip/Pinch Point Nip/Pinch Point Chemical Exposure Cut/Laceration 3. Nip points from conveyor. 3. Nip points from conveyor. 4. Unexpected motion. 5. Exposure to CIP / Washdown chemicals. 6. Laceration Electrical 5 2.5 6 1 75 S2 F1 P2 Pld Electrical 8 5 6 1 240 S2 F2 P2 Ple Electrical 8 2.5 6 1 120 S2 F1 P2 Pld Electrical 8 1 6 1 48 S2 F1 P2 Pld Chemical 10 2.5 6 1 150 S2 F1 P2 Pld Mech. Kinetic 10 2.5 0.5 1 13 S2 F1 P2 Pld [PPE] Based on MSDS for washdown chemicals [PPE] Cut resistant gloves Page 7 of 12

Hazard Photographs and References Page 8 of 12

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Page 10 of 12

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Guarding Filler/Seamer 1) Update button and indicator colors to conform to NFPA 79 color standards. 2) Guarding in Image 8 should be extended upward above the interlocked door to prevent reach over into the seamer. Page 12 of 12