IAEC - Climbing Competency for the Electric Line Worker (version 3)

IAEC - Climbing Competency for the Electric Line Worker

• Cooperative

• Conducted on

  Date

• Safety Trainer Performing Evaluation

• Location
  Address

• Employee is knowledgeable of the proper clothing used when climbing a pole - gloves, long sleeve shirt, hard hat and safety glasses. Employee understands how to inspect his/her compliant fall arrest climbing equipment.

• Employee describes hazards to look for before climbing a pole: Depth of pole setting, soil conditions, insect nests, vegetation on or near pole, fences against, on or near pole, burn marks, cracks, knots, woodpecker holes, pole rake, rotted condition, unauthorized attachments (nails, tacks, signs, wire, basketball hoops, clothes line), ground wire, staples, energized wires, telephone, cable tv.

• Employee successfully and safely demonstrated his/her proficiency in the following tasks: Climbing up the pole, climbing over a structure (crossarm), once above the structure, circled the pole in both directions and reached out with both hands/arms when instructed and climbing down (back over the structure). Employee demonstrated compliance in not being able to fall more than 2' to a lower surface when disconnecting and re-connecting his/her fall arrest equipment (including secondary rope/strap) when crossing over the structure (crossarm). Employee adjusted his/her fall arrest equipment according to manufacturers recommendations.

• IAEC personnel performed the annual inspection of climbing gear today

  Yes

  No

  N/A

• Please add any additional information as it relates to the question(s) above

Employee Name and Signature - I acknowledge that I successfully completed the annual climbing competency requirements

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Employee(s) listed below did not successfully complete the annual climbing competency requirement(s) as identified below. Employee has signed in agreement.

• Employee is knowledgeable of the proper clothing used when climbing a pole - gloves, long sleeve shirt, hard hat and safety glasses.<br>Employee performed an inspection of his/her compliant fall arrest climbing equipment.

  Yes

  No

  N/A

• Employee describes hazards to look for before climbing a pole: Depth of pole setting, soil conditions, insect nests, vegetation on or near pole, fences against, on or near pole, burn marks, cracks, knots, woodpecker holes, pole rake, rotted condition, unauthorized attachments (nails, tacks, signs, wire, basketball hoops, clothes line), ground wire, staples, energized wires, telephone, cable tv.

  Yes

  No

  N/A

• Employee successfully and safely demonstrated his/her proficiency in the following tasks: Climbing up the pole, climbing over a structure (crossarm), once above the structure, circled the pole in both directions and reached out with both hands/arms when instructed and climbing down (back over the structure).<br><br>Employee demonstrated compliance in not being able to fall more than 2' to a lower surface when disconnecting and re-connecting his/her fall arrest equipment (including secondary rope/strap) when crossing over the structure (crossarm).<br><br>Employee adjusted his/her fall arrest equipment according to manufacturers recommendations

  Yes

  No

  N/A

• Please add additional information as it relates to the question(s) above

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Iowa Statewide Safety Trainer/Evaluator Signature

• Matt Pociask

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• Jim Wolfe

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• Scott Meinecke

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• Jason Thorson

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