Daily HUDDLE/JSA

• Foreman Job/Phase:

• Job Location / Address
  Address

• Date:

  Date

Employees in Attendance

• Names

  Select Jeff West Carson Tippie Shaun Tippie David Leaf Derik Tippie Alec Diehl Rebecca Tippie

  • Jeff West
  • Carson Tippie
  • Shaun Tippie
  • David Leaf
  • Derik Tippie
  • Alec Diehl
  • Rebecca Tippie

Jobsite Conditions:

• Start Time:

  Date

• Weather:

Jobsite Setup:

• Side Walks Secure:

  Yes

  No

  N/A

• Traffic Plan Secure:

  Yes

  No

  N/A

• Walk down of site completed, and all hazards identified?

  Yes

  No

  N/A

• Proper PPE:

  Yes

  No

  N/A

• Special PPE:

  Select FR Clothing SCBA/Resp. Other PPE NA

  • FR Clothing
  • SCBA/Resp.
  • Other PPE
  • NA

• Please specify Other PPE

Daily Objective and Job Hazard Analysis:

Daily Task

• Steps in the Plan

  Directional Drilling

  Hydro Vac

  Pot Hole

• Identified Hazards in Task

  Select Overhead Utilities Lifting Equipment Underground Utilities Excavation Hazards Fire Hazards Vehicular or Heavy Equipment Traffic Noise Exposure Hand & Power Tools Hand Hazards Manual Lifting Ladders Slips, Trips & Fall Hazards Pinch Point Hazards SDS/Chemical Hazards Heat Stress Cold Stress Environmental Hazards Natural or Site Hazards Adjacent Work Work Zone Ergonomics Confined Spaces

  • Overhead Utilities
  • Lifting Equipment
  • Underground Utilities
  • Excavation Hazards
  • Fire Hazards
  • Vehicular or Heavy Equipment Traffic
  • Noise Exposure
  • Hand & Power Tools
  • Hand Hazards
  • Manual Lifting
  • Ladders
  • Slips, Trips & Fall Hazards
  • Pinch Point Hazards
  • SDS/Chemical Hazards
  • Heat Stress
  • Cold Stress
  • Environmental Hazards
  • Natural or Site Hazards
  • Adjacent Work
  • Work Zone
  • Ergonomics
  • Confined Spaces

• Safe Mitigation Plan

  Select Required clearances met Spotter in place Red Zone Barricaded/Signal Person in place Tag Lines utilized Dig Ticket/ Review Dates/ Review Extent Review Prints/ Inspect for UNMARKED Utilities Inspection before each entry Observing 2'4'5' Rules Tab. Data available on site & in compliance with excavation requirements Protection from cave-in. Shoring box on site Fire Extinguisher Inspected/Fire Watch in place Flammables removed from area Cones/Signs/Barricades/Flaggers Hearing Protection (Ear plugs or muffs) Cords and GFCI Inspected prior to use Guarding in Place Proper Gloves for task Cut-proof gloves FR Rated gloves Protection against uncontrolled release of gas or air Potential for Hazardous Waste identified Pollution prevention in place Identified signs of Animals/Reptiles/Insects

  • Required clearances met
  • Spotter in place
  • Red Zone Barricaded/Signal Person in place
  • Tag Lines utilized
  • Dig Ticket/ Review Dates/ Review Extent
  • Review Prints/ Inspect for UNMARKED Utilities
  • Inspection before each entry
  • Observing 2'4'5' Rules
  • Tab. Data available on site & in compliance with excavation requirements
  • Protection from cave-in. Shoring box on site
  • Fire Extinguisher Inspected/Fire Watch in place
  • Flammables removed from area
  • Cones/Signs/Barricades/Flaggers
  • Hearing Protection (Ear plugs or muffs)
  • Cords and GFCI Inspected prior to use
  • Guarding in Place
  • Proper Gloves for task
  • Cut-proof gloves
  • FR Rated gloves
  • Protection against uncontrolled release of gas or air
  • Potential for Hazardous Waste identified
  • Pollution prevention in place
  • Identified signs of Animals/Reptiles/Insects

Equipment:

• Equipment inspected/proper condition:

  Yes

  No

  N/A

• Veh/Equip. parked to protect Work Area:

  Yes

  No

  N/A

• Overhead utilities located/identified:

  Yes

  No

  N/A

Tooling:

• Tools in proper working condition:

  Yes

  No

  N/A

• Special Tools & Equipment being used for the day:

• Qualified to operate specialty tools:

  Yes

  No

  N/A

• Fire Extinguishers placed upwind and inspected:

  Yes

  No

  N/A

Safety Precautions:

• Stretch & Flex Completed:

  Yes

  No

  N/A

• Cones & Barricades properly placed:

  Yes

  No

  N/A

• Slips, Trips & Falls Hazards Identified:

• Personal Impacts (fatigue, repetitive tasks, distractions, etc.) addressed and communicated.

  Yes

  No

  N/A

• Are All Crew Members aware of Crossings:

  Yes

  No

  N/A

• ***All Crossings Visual Verified:

  Yes

  No

  N/A

• ***Signature of Crew Member Verifying Crossings:

  Sign

• Excavation Inspection completed by Competent Person and requirements met?

  Yes

  No

  N/A

• Environmental/other potential Hazards:

• Provide any additional notes, Near Miss and Stop Work Authority actions below:

• Attach Photos Below:

  Media

• Post Job Review (Post-job reviews gives employees that were involved in the work activity to provide feedback What went right? Wrong? Is there follow up needed? What lessons learned from this job can be shared to help others performing similar task?)

Signature

• Add signature

  Sign