Title Page
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Document No.
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Job # & Name
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Client / General Contractor
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Conducted on
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Prepared by
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Location
Daily Work Summary
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What type(s) of work are being performed today? Select all that apply.
- General
- Abatement
- Demolition
- Pile Driving
- Formwork
- Reinforce Steel
- Steel Erection
- Mechanical
- Electrical
- Plumbing
- Glazing
- Roofing
- Drywall
- Painting
- Sitework
- Excavation
- Underground Work
- Stair Installation
- Cleanup
- OTHER
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Location on site
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Describe the works to be undertaken today
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Have all crew members performed daily stretch and flex activities?
Today's Task Breakdown
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Work Task
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Describe this task
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What category does this task fall under?
- General
- Abatement
- Demolition
- Pile Driving
- Formwork
- Reinforce Steel
- Steel Erection
- Mechanical
- Electrical
- Plumbing
- Glazing
- Roofing
- Drywall
- Painting
- Sitework
- Excavation
- Underground Work
- Stair Installation
- Cleanup
- OTHER
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Select potential hazards that may be encountered while completing this task today.
- Fall / Gravity
- Equipment Issues
- Power Lines
- Electricity
- Sharp Objects
- Slippery / Wet Surfaces
- Gasses
- Dust
- Underground Utilities
- Overhead Obstructions
- Hazardous Substances
- Working In Isolation
- Ignition Sources
- Manual Handling
- High Pressure Lifting Equipment
- Rotating Machinery
- Entry & Exit Hazards
- Ground Openings
- Entanglement
- Animals / Pests
- High Voltage
- Confined Space
- Adverse Weather Conditions
- Pollution
- Grinding
- Hazards to Public Areas
- Hazardous Chemicals
- Extreme Temperature
- Noise
- Radiation
- Biological
- Social / Interpersonal
- Staffing Issues
- Project Delay
- OTHER
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Describe the other potential hazards that may be encountered while completing this task today.
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What categories of hazard control will you apply to this task?
- Elimination - Remove the hazard
- Substitution - Replace the hazard
- Engineering - Isolate people from the hazard
- Administrative - Change the way people work
- PPE - Protect workers with personal protective equipment
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What specific controls will you apply to the above hazards for this task?
- Training
- Replacement
- Removal
- Repair
- Spotters
- Lighting
- Isolation
- Respiratory Protection
- Application of PPE
- Signage
- Barricades
- Fall Arrest
- Extinguishers
- Screens
- Additional Resources
- Fire Blankets
- Updated Procedures
- Competent Persons
- Locating Equipment
- UV Protection
- Gas Detection
- Designated Work Areas
- Supervision of Public
- Elevation to Senior Management
- OTHER
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Describe any other specific controls will you apply to the above hazards for this task.
Final Checks
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Does every member of the on-duty crew have adequate and appropriate PPE for today's work tasks?
Crew Sign Off
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Team Member
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Name & Signature
