IME - JHA and Daily Log

• Job Name DIA 5 gate expansion

• Job Number DC3041

• Site DIA

• Location Concourse C west
  Address

• Conducted on

  Date

• Prepared by

• Supervisors Name Les Gehauf

• Weather

• Temp

Equipment

Add Equipment and Tools

• Equipment Scissor lifts

• Quantity 2

Man Power

• General Foreman

• Number 1

• Apprentice

• Number 1

• Construction Electrician

• Number 4

Daily Tasks

Work in Progress
Pull wire, #10 home runs
Pull wire #12 branch circuits
Terminate, label and cover J boxes
Roof work, mount J boxes,



• Five main hazards
  1. Life safety - egress, emergency response, fire protection
  2. Fall hazards
  3. Electrical hazards
  4. Caught in hazards
  5. Struck by issues- vest, material handling, moving equipment

• Work in Progress Today (Who, What, When, Where, Why)

• Hazards Struck by issues- vest, material handling, moving equipment Fall hazards- when within 6 ' of edge, use fall restraint equipment Multi craft work areas- keep your area clean and clear

• Abatement (Corrective Action)

• Add media

  Media

Job Factors

• Impacts to the job

• Does everyone have the following

• Materials received

• Phone calls / Visitors

Safety Requirements

• Hard Hat yes

  Safe

  At Risk

  N/A

• Safety Glasses, Face Shield, Goggles yes

  Safe

  At Risk

  N/A

• Proper Foot Ware yes

  Yes

  No

  N/A

• Proper Gloves yes

  Yes

  No

  N/A

• Lock Out / Tag Out no

  Yes

  No

  N/A

• Hot Work PPE no

  Yes

  No

  N/A

• Fall Protection yes

  Yes

  No

  N/A

• Meters / Testers no

  Yes

  No

  N/A

• Trench Safety Equipment no

  Yes

  No

  N/A

• Confined Space Equipment no

  Yes

  No

  N/A

• Hearing Protection as needed

  Yes

  No

  N/A

• Respirator no

  Yes

  No

  N/A

• Stretch & Flex Daily

  Yes

  No

  N/A

• Monthly AED Check

  Yes

  No

  N/A

• Comments:

Personnel

Add Personnel

• Employee #

• Employee Name

• Employee Title

• Signature

  Sign

Comments

Add comments

• Employee Name

• Comments

Review

• Signature of Supervisor

  Sign

• Signature of Director or Vice President

  Sign

• If this is an ACCIDENT please fill out an Accident report (This is a different form!)
  
  Accident - undesired event that CAUSES HARM or damage to people, property, or process. (Not always an OSHA recordable)
  Examples:
  Cut that could require first aid (including bandaid).
  Used eye wash station to remove foreign body.
  Vehicle accident resulting in damage with or without personal injury.
  
  Incident - undesired event that under slightly different circumstances COULD have caused harm to people, property, or process. (Near Miss)
  Examples:
  Almost get struck by a loader on job site.
  Carrying iPad up a ladder without a hands free strap. (could not maintain 3 points of contact)

Add New Incident

• Type

  Select Personal Injury Auto / Equipment Tools General Liability Other

  • Personal Injury
  • Auto / Equipment
  • Tools
  • General Liability
  • Other

• Severity

  Mild

  Moderate

  Severe

• Review if this should be an Accident!

• Description