IX Pre-Construction Meeting

• Prepared by

• Today's Date

  Date

• Project Name

• Job Site Address

• Project Owner

• Projected Start Date

  Date

• Projected End Date

  Date

Emergency Contact Information

• General Superintendent

• Phone:

• Superintendent

• Phone:

• Project Manager

• Phone:

• Number of Laborers:

• Number of Operators:

• Additional Information:

Excavations/Boxes

• Excavations to exceed 20'?

  YES

  NO

• Do you need plans for engineered excavations?

  YES

  NO

• How many pipe crews will be on the job?

• The number of pipe crews you have should be equal to how many trench boxes you have available at the job site.

Utility Protection

• Has a locate ticket been opened?

  Yes

  No

  N/A

• By whom was it opened?

• When was it opened?

  Date

• One call confirmation number:

• Has the information been forwarded to the Safety Administrator for updating?

  Yes

  No

  N/A

• You should be receiving an email notification upon renewal. If not please notify Safety Administrator.

• Are there any known utility locations?

  Yes

  No

• Are there any foreseeable utility concerns? (i.e. Over-head power lines, power line clearances, fiber optics, high pressure underground gas lines?)

  Yes

  No

Equipment Fueling & Tank Protection

• Will you have a fuel tank on site?

  YES

  NO

• What size tank will be on site?

• Tank Number:

• Where will the tank be located?

• Grounding:

• Placarding:

• Fire Extinguishers:

• Spill Kit:

Evaluating The Work Area (Mark Yes or No)

• Have you walked the job site?

  Yes

  No

  N/A

• Working around live systems?

  YES

  NO

• Does this job require specific training? (Owner orientation, 40 hour HAZWOPER, OSHA 10/30, CPR/First Aid)

  YES

  NO

• Check all that apply:

• Fall Protection

  YES

  NO

• T/E Competent Person

  YES

  NO

• Confined Space

  YES

  NO

• OSHA 10

  YES

  NO

• OSHA 30

  YES

  NO

• First Aid

  YES

  NO

• CPR

  YES

  NO

• Competent Person Rigging

  YES

  NO

• NCCCO (Crane Operator)

  YES

  NO

• Crane Signaling

  YES

  NO

• Lull

  YES

  NO

• Skid-Steer

  YES

  NO

• Scaffolding

  YES

  NO

• Aerial Lift

  YES

  NO

• HAZWOPER

  YES

  NO

• GHS (Hazardous Chemicals)

  YES

  NO

• PPE

  YES

  NO

• Radiation

  YES

  NO

• Ladders

  YES

  NO

• Silica Awareness

  YES

  NO

• Lead Awareness

  YES

  NO

• Respiratory Protection

  YES

  NO

• Traffic Control

  YES

  NO

• Bio-Hazards (Wildlife)

  YES

  NO

• Additional Training:

• Is an SDS review necessary for this task? (Will employees be handling or be exposed to unusual chemicals)

  YES

  NO

Hand/Body/Foot Hazards

• Hand/Body/Foot Hazards Possible?

  Yes

  No

  N/A

• Select all that apply:

• Chemical Exposure

  YES

  NO

• High Heat/Cold

  YES

  NO

• UV/IR Radiation

  YES

  NO

• Electrical Shock/Arc

  YES

  NO

• Impact/Compression

  YES

  NO

• Punture

  YES

  NO

• Cuts/Abrasions

  YES

  NO

• Falls

  YES

  NO

• Slippery/Wet Surfaces

  YES

  NO

• Falling Objects

  YES

  NO

• Other:

Head/Neck/Face/Eye Hazards

• Are Head/Neck/Face/Eye Hazards Possible?

  YES

  NO

• Select all that apply:

• Chemical Exposure

  YES

  NO

• High Heat/Cold

  Yes

  No

  N/A

• Dust/Flying Debris

  YES

  NO

• Impact

  YES

  NO

• UV/IR Radiation

  Yes

  No

  N/A

• Electrical Shock

  YES

  NO

• Noise

  YES

  NO

• Other:

Subcontractors

• Will Subcontractors be on site?

  YES

  NO

• Subcontractors:

• Scope:

• Have we received their drug testing info, training, safety program, JSA?

  Yes

  No

  N/A

• Have we received their Silica Program?

  Yes

  No

  N/A

• Will Subcontractors on site be required to open a locate ticket?

  YES

  NO

• Pre-Con Meeting Date

  Date

• Safety Meetings:

• Safety Milestones:

• Notes:

• Fuel Tank?

  YES

  NO

• If you answer yes to any of the questions below you should contact the Risk Management Coordinator (Kellie Tallentire) to ensure proper coverage.

• Operate Cranes

  YES

  NO

• Work Off a Barge

  YES

  NO

• Do any Airborne Work (i.e. - Helicopter Picks)

  YES

  NO

• Do any Shoring

  YES

  NO

• Do blasting or work with explosives

  YES

  NO

• Operate a drone

  YES

  NO

• Work underground or in an area that could explode or collapse

  YES

  NO

• Have a contract or risk loss of $7 million or more

  YES

  NO

Portable Crusher/Active Trucks

• Will there be a portable crusher/Active Trucks onsite?

  YES

  NO

• Indicate below how you are going to keep subcontractors and unauthorized vehicles/people from entering the immediate area:

• Ground Guy

  Yes

  No

  N/A

• Barricades

  Yes

  No

  N/A

• Traffic Pattern

  Yes

  No

  N/A

• Other: