Information

  • Work Order # (scan bar code):

  • Work Order Title

  • Prepared on date

  • Prepared by

  • Estimated cost of work:

  • Earliest material delivery or execution date:

  • Work Description:

  • The work is Job Jar work if the follow are true: 1) Work may require an orange LOTO to complete work. 2) People required to do the work are normally on site. 3) Materials required are on site or readily available on demand (i.e. Canadian Tire, Home Depot, etc...). 4) Work is ~1 h in duration but always less than 4 h.

  • The work is Simple Plan if the following are true: 1) Work requires an orange LOTO and may require a white LOTO. 2) People required to do the work are normally on site. 3) Materials required are in stores or have a stock # from which they may be ordered. 4) Work is ~4 h in duration but always less than 12 h.

  • The work is a Coordinated Plan if any of the following are true: 1) The work must have a white LOTO. 2) People whom are not normally on site are required to do the work. 3) Materials, other than consumables, must be purchased outside inventory. 4) Work duration is greater than 12 h.

  • Type of Plan:

  • Indicate the items included in this Planning Package:

Job Planning Package

Work Execution Plan and Hazard Assessment

  • Step

  • Step
  • Add media

  • Hazards encountered when doing this step of work:

  • Hazard Frequency Level

  • Severity Category

  • Controls Required to Mitigate Hazards:

Parts, Services & Special Tools

  • Identify parts for the work. Identify the most likely parts to be required even if a restocking charge is incurred if they are not needed.

  • Part
  • Part Description:

  • OEM or After Market Vendor

  • CPC Stock # or OEM Part#

  • Estimated Cost in Canadian $ (attach screenshots of quotes).

  • Add media

  • Identify the trades required to complete the work.

  • Service or Trade
  • Select the trade required for the work.

  • How many trades people are required for how many hours for what total (i.e. 2x6=12).

  • What external services are required, include quotes.

  • External Service
  • Name the external service provider.

  • Add media

  • What special tools are required (crane, vacuum truck, etc...) and include cost estimate?

  • Special Tool
  • Name tool (Attach screenshot of quote).

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.