Information
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Type "FLRA" then location
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Date
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You can take pictures!
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List each person
Name
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Add signature
FLRA
- Task
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Hazards
Hazard
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Mitigation
Controls
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Check all permits required
- Confined Space
- Hot Work
- Digging
- Pipeline Breaking
- N/A
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Are the proper permits available and in view?
Checklist
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Tripping hazards removed or identified?
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Proper PPE available and in good condition?
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Equipment inspected?
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Working properly?
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Can and will continue to work safely?
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Working alone?
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Check in every 2 hours.
