Title Page

  • What is the Job Site

  • What is the new job site name?

  • Conducted on

  • Prepared by

  • How many crew members total?

Job activities

  • Job activities

Pre task checklist

  • First aid kit available and stocked

  • Is there any damage reported or observed on any rented equipment?

  • Proper tools for the job

  • Do you have material and equipment to perform the days tasks? Add note to what is needed

  • Communicated work with others trades working in the area

  • Areas of hot work barricaded or taped off

  • Are fire extinguishers installed in aerial booms and inspection tag current

  • Is there a dedicated 20 lb minimum sized fire extinguishers located so they are readily available.

  • Has the rigging been pre use inspected (data tag, general condition)

  • Are there any planned crane lifts occurring by Northwest employees?

  • Check that oil and fuel levels in welder(s), generator(s), Aerial booms, lifts, forklifts and other site equipment has been done and service if needed.

  • Welding leads free of damage within 10 feet of stinger?

  • Is there adequate quantities of ear plugs, safety glasses, face shields and other PPE. If items are needed list in note section.

Identify potential hazzards

  • Discuss any utilities on the job site with locations to be aware of (electrical, plumbing, communications)

  • Remind crew of Daily Pre-Use inspections of fall protection devices (harness, pigtail, anchor point, TYPE 2 retractables) . Require a 3-bang check.

  • Confined spaces being worked on?

  • Has the Safety Department been notified?

  • STOP. Contact DSM Safety, then proceed to Confined Space Permit Template. Fill, screen save, add to pictures and upload.

  • Any other hazards identified? List hazards in notes

Identify hazard elimination and discussion

  • Safety glasses worn and face shields being used for cutting, grinding, sanding activities

  • Type 2 Hardhats discussed, reminded for Turner, Weitz jobs by Northwest. No exceptions.

  • Identify heavy lifts, allow for 2 person lift or other way of lifting

  • Erect barricades (red rope, red danger tape, or hard barriers to reduce overhead falling hazards.

  • Pinch points discussed and addressed

  • Fall Protection required 100% - no exceptions.

  • Extension ladders - 3 rungs above the surface level, 4 to 1 rule, get permit if needed.

  • Ladders - Inspect before use, get permit if needed.

  • Plenty of fluids/ dress for the weather

  • Good housekeeping of site before leaving for the day

List additional hazards

  • Additional hazards

JHA's

  • Bolting Up

  • Bridging

  • Chain Fall Come-a-long

  • Compressed Gas Storage

  • Connecting

  • Crane Assembly

  • Decking

  • Edge Angles

  • Forklift Picks

  • Forklift Picks Door Frames

  • Fueling

  • Gantry Picks

  • Grinding

  • Luffer Recovery

  • Mobilization

  • Multi Lift Rigging

  • Precast Demo

  • Precast Erection

  • Rebar Installation

  • Scaffold

  • Steel Erection

  • Unloading Trucks

  • Welding/ Hot Work

  • Working at heights

  • *****Electronic Signature of Foreman

  • Crane Setup

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.