EMCOR Betlem (abridged) Pre-Task Planning Checklist

• Conducted on

  Date

• Job/Work Name & Number

• Location
  Address

• Prepared by

• Short Description of Work to be Performed

PPE & Safety Equipment Required: (Check all that apply.)

• Eye/Face: safety glasses, goggles, face shield

• Head/Ear: hard hat, bump cap, ear plugs

• Hand: gloves, leather, gauntlet, cut or chemical resistant

• Fall Protection/Restraint Harness

• NFPA 70E Arc Flash Protection Gear

• Welding: goggles, hood, sleeves, gloves

• Knee/Shin/Foot: safety toe, rubber soles, knee pads

• Ground Fault Circuit Interrupter (GFI)

• Lock Out/ Tag Out equipment

• Fire Extinguisher for hot work

Work Site Inspection: (Check all that apply.)

• Emergency phone numbers

• Tripping and slipping hazards identified

• Unprotected edge, skylight, other fall hazard

• Confined space

• Do you have correct manpower to proceed

Tools and Equipment Inspection: (Check all that apply.)

• Ladders

• Hand and power tools

• Material handling equipment

• Aerial, scissor lifts, crane

• Scaffolds