Brookfield PWO- SWO & JP Form

• Document No.

• Wind Facility / Hydro Plant

• Specific work location

• Observers

• Description work / job task

• Contractor involved

• Contractor involved

• Risk Ranking of Task Being Observed

  High

  Medium

  Low

• Conducted on

  Date

• Crew Leaders

• Crew members

Work observation Form

• Job / Project Plan ( Available, well written / Communicated, hazard properly identified with effective control barriers)

  Acceptable

  Needs improvement

  N / A

• Hazardous Energy Control (lock-out/tag-out, de-energized, tested and grounded, insulation, cover-up, minimum approach distance):

  Acceptable

  Needs improvement

  N / A

• Work / Job site set-up: (Housekeeping, Work Area identified and protected, ladder set-up, Vehicle set up)

  Acceptable

  Needs improvement

  N / A

• Personal Protective Equipment ( hard hat, eye / face protection, hearing protection, safety shoes, rubber gloves / Sleeves, fall protection)

  Acceptable

  Needs improvement

  N / A

• Work Methods ( entry permits, rigging/crane operations, ergonomics, Welding, work from heights)

  Acceptable

  Needs improvement

  N / A

• Cranes / Mobile Equipment ( Inspected, operator qualified, proper rigging)

  Acceptable

  Needs improvement

  N / A

• Regulators and Stakeholders (Impact on stakeholders,local communities, adjacent landowners, upstream/downstream stakeholders, special interest groups, First Nations/Native Americans, others) due to work being performed, Communicated project details, Considered and took steps to manage/reduce impacts, Reviewed potential regulatory impacts)

  Acceptable

  Needs improvement

  N / A

• Public Safety Considerations ( protection of the public)

  Acceptable

  Needs improvement

  N / A

• Security Considerations (mechanisms to deter, detect, delay and deny access to people with criminal intent to prevent theft, vandalism, violence against workers, etc.)<br> 0 Acceptable<br>0 Needs Improve<br>0 N/A<br><br>

  Acceptable

  Needs improvement

  N / A

• Environmental Protection ( storage and transfer of oil & chemical, ID of zones to protect, waste classification, storage & disposal, Availability of spill kits, Identification of zones, species and habitat to protect (such as spawning or nesting areas), identification of species at risk and critical habitat, identification of migratory timelines)

  Acceptable

  Needs improvement

  N / A

• Crew comments:

• Corrective Action / Follow-Up Required (Place on tracking and action item database)

• Attendees initials:

  Sign

• Reviewed by manager

  Sign

• Reviewed by HSSE Specialist

  Sign

Section 1: General information

• Date / Time

  Date

• JSSEP Author

• Number of JSSEP's reviewed

• Reviewed By:

Section 2: Evaluation

• Is all required information completed on JP?

  Yes

  No

  N/A

• Are the job steps/tasks adequately and accurately identified?

  Yes

  No

  N/A

• Are the major hazards adequately and accurately identified?

  Yes

  No

  N/A

• Are risk designations accurately identified?

  Yes

  No

  N/A

• Do high risk hazards identify a control barrier?

  Yes

  No

  N/A

• Did the responsible authority approve the JP if high risk hazards are identified without a control barrier?

  Yes

  No

  N/A

• Were multiple secondary barriers employed?

  Yes

  No

  N/A

• Are the barriers specific and correctly identified (i.e. Proper category for control, and safety and support barriers)?

  Yes

  No

  N/A

• Is the JSP updated if conditions have changed?

  Yes

  No

  N/A

• Are environmental risks adequately included on the JP?

  Yes

  No

  N/A

• Are security risks adequately included on the JP?

  Yes

  No

  N/A

Section 3: follow-up and feedback

• Based on the review, does the employee/crew have a good understanding of how to accurately prepare JP's?

  Yes

  No

• Is further employee/crew review/follow up/training required?

  Yes

  No

Section 4: additional information and comments

• Additional information/comments/notable improvements/recommendations: