Job Safety Plan (JSP)

• Workers covered by JSA

  Select Logan Vanwyck Jackson Grurts Anthony Di Lella Aaron Johnson Ian Song Ethan Jensen Peter Chamberland Allan Whetter Kyle Richardson Ryan Hodgins Lukas Dillabough Randy Langille Ted Roblin Enrico Del Re Louis Desjardins Marc Laprade Patrick Sipos Gilles Barnabe Kevin McCaig Said Garando Stephane Bisson Andy Pilon Brent Mainville David Berard Jiwu Song Martin Touchette Nicholas Lacasse Dirk Wolterbeek John Lockie Chad baker

  • Logan Vanwyck
  • Jackson Grurts
  • Anthony Di Lella
  • Aaron Johnson
  • Ian Song
  • Ethan Jensen
  • Peter Chamberland
  • Allan Whetter
  • Kyle Richardson
  • Ryan Hodgins
  • Lukas Dillabough
  • Randy Langille
  • Ted Roblin
  • Enrico Del Re
  • Louis Desjardins
  • Marc Laprade
  • Patrick Sipos
  • Gilles Barnabe
  • Kevin McCaig
  • Said Garando
  • Stephane Bisson
  • Andy Pilon
  • Brent Mainville
  • David Berard
  • Jiwu Song
  • Martin Touchette
  • Nicholas Lacasse
  • Dirk Wolterbeek
  • John Lockie
  • Chad baker

• Location at site

• Job Description

• Date

  Date

• Work order #

• Weather if working outdoors

• Prevention measures to protect against weather conditions. (eg. Cleats, Extra breaks in excessive heat or cold, Fluids, Winter Coat Etc.)

• Prepared by

Job Task Being Assessed

Tasks, Hazards and Preventive Measures

• Permits Required

  Yes

  No

• What type of permit

  Hotwork

  Confined Space

  Lock Out

  Excavation

• 9 Life Saving Rules

  

• Life Saving Rules - Choose all that apply

  Select Do not walk or stand under a load Stay out of the path of moving vehicles, plant and equipment Clip on your harness when working at height Only enter a trench if the appropriate wall supports are in place The atmosphere must be tested safe before entering a confined space and monitored as you work Do not perform hot work unless the fire or explosion risks have been eliminated Verify that there is no live energy(mechanical, chemical, electrical, fluids under pressure, etc.) before starting Do not handle your phone or any other communication device when driving Do not drive under the influence of alcohol or drugs

  • Do not walk or stand under a load
  • Stay out of the path of moving vehicles, plant and equipment
  • Clip on your harness when working at height
  • Only enter a trench if the appropriate wall supports are in place
  • The atmosphere must be tested safe before entering a confined space and monitored as you work
  • Do not perform hot work unless the fire or explosion risks have been eliminated
  • Verify that there is no live energy(mechanical, chemical, electrical, fluids under pressure, etc.) before starting
  • Do not handle your phone or any other communication device when driving
  • Do not drive under the influence of alcohol or drugs
Task Step

• Work Order Number

• 1) Break a job down into smaller tasks and observe a worker performing it
  2) Click + to add a "Job Step" and fill in the relevant information
  3) Identify the potential hazards for each task
  4) Determine preventive measures and controls to overcome these hazards

• Enter job step description

• Potential risk or hazard identified while task is being performed (select all that apply)

  Select Chemical (Toxic, Flammable, Corrosive) Explosion (Chemical Reaction, Over Pressurization) Electrical (Shock, Short Circuit, Fire, Static, Loss of Power) Ergonomics (Strain, Sprains, Human Error) Excavation (Collapse) Fall (Slip, Trip) Fire Mechanical (Mechanical Failure, Stuck between objects) Noise Radiation (Alpha, Beta, Gamma, X-rays) Struck by Objects Extreme Temperature Visibility (lack of lighting, Obstructed vision) Weather Other

  • Chemical (Toxic, Flammable, Corrosive)
  • Explosion (Chemical Reaction, Over Pressurization)
  • Electrical (Shock, Short Circuit, Fire, Static, Loss of Power)
  • Ergonomics (Strain, Sprains, Human Error)
  • Excavation (Collapse)
  • Fall (Slip, Trip)
  • Fire
  • Mechanical (Mechanical Failure, Stuck between objects)
  • Noise
  • Radiation (Alpha, Beta, Gamma, X-rays)
  • Struck by Objects
  • Extreme Temperature
  • Visibility (lack of lighting, Obstructed vision)
  • Weather
  • Other

• Enter other potential risk/s identified

• Rate risk/ hazard before control measures

  Extremely High Risk

  High Risk

  Moderate Risk

  Low Risk

• Hazard Control Measures

  Select Engineering Controls Administrative Controls Personal Protective Equipment Other

  • Engineering Controls
  • Administrative Controls
  • Personal Protective Equipment
  • Other

• Engineering Controls

• Administrative Controls

• Personal Protective Equipment

• Other preventive measures

• Explanation of control measures

Recommendation

• Recommendations

Completion

• Name of Supervisor - Can be added by Operator

  Select Robert Boileau Archie Scully Cory Lacosse Ken Taylor Gord Ferguson Matt Doucette Joseph Perrier Randy Langille Chad Baker Patrick Sipos Gilles Barnabe Said Garando Stephane Bisson Kyle Richardson

  • Robert Boileau
  • Archie Scully
  • Cory Lacosse
  • Ken Taylor
  • Gord Ferguson
  • Matt Doucette
  • Joseph Perrier
  • Randy Langille
  • Chad Baker
  • Patrick Sipos
  • Gilles Barnabe
  • Said Garando
  • Stephane Bisson
  • Kyle Richardson

• All workers involved in this job understand and agree with JSP

  Yes

  No

• Were there any incidents, near misses, observations etc. ?

  Yes

  No

• Did you notify your supervisor and enter it into IAuditor

  Yes

  No

• Describe the incident