Title Page
-
Site conducted
-
Job Description and Location
- Bad Pole
- Changing Transformer
- New Service
- Locates
- Primary Line Maintenance
- Line Patrol
- Service Maintenance
- Work on Consumer Prem.
- Other
-
Describe Job
-
Map Location and/or Pole Number
-
Feeder Number or Map Location
-
Date
-
Prepared by
Job Summary
Daily Work Summary
-
What type(s) of work are being performed today?
-
Hazards Associated with Job
- Electrical Contact
- Fall Hazard
- Traffic Control
- Weather
- Terrain
- Excavation
- Locate Required
- Ice
-
Are ice cleats required
-
Does everyone have ice cleats
-
Is locate complete
-
Traffic Control Needed
- Cones
- Lights
- Signs
- Vests
- Flaggers
-
Preflight Completed
-
List any important job tasks
-
Will work be performed on energized equipment or line(s)
-
Will upstream overcurrent device be place on non-reclose
-
Upstream device number
-
Will protective grounds be installed
-
Will trucks be grounded
-
Describe alternate procedure
-
Are switching procedures involved
-
List switching procedures
Designated Observer
-
Doug Byrn
-
Bodie Western
-
Hunter Chase
-
Joseph Hagar
-
Greg Neagle
-
Richard Shaw
-
Dalton Smith
-
Braxton Shaw
-
Hunter Chase
-
Vance Frederick
-
Cameron Kirmse
-
Aaron Olson
-
James Jones
-
Payden McCarty
-
Other
undefined
Personal Protective Equipment
-
What is the required PPE to complete the job safely
- Rubber Gloves
- Rubber Sleeves
- Head/Eye/Face/Foot Protection
- Arc Rated Clothing
- Reflective Traffic Vest
- Fall Protection
- Other
-
Have Rubber Gloves/Sleeves Been Inspected
-
Does every team member have the required PPE for today's work tasks?
-
Will cover up be installed
-
Are there any additional comments
-
List additional comments
Crew Members
-
Doug Byrn
-
Signature
-
Bodie Western
-
Signature
-
Hunter Chase
-
Signature
-
Joesph Hagar
-
Signature
-
Greg Neagle
-
Signature
-
Richard Shaw
-
Signature
-
Dalton Smith
-
Signature
-
Braxton Shaw
-
Signature
-
Denton Jones
-
Signature
-
Vance Frederick
-
Signature
-
Cameron Kirmse
-
Signature
-
Greg Olson
-
Signature
-
James Jones
-
Signature
-
Payden McCarty
-
Signature
-
Other
-
Signature