Johnson Controls Pre-Job Checklist - BD

• Site conducted

  Select

• Client / Site

• Work Order No.

• Location
  Address

• Supervisor

• Conducted on

  Date

• Job Description:

• Prepared by

• Personnel

• Tap to enter information

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• Tap to enter information

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• Tap to enter information

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• Is a lockout required?

  Yes

  No

  N/A

• Working on/near live electrical?

  Yes

  No

  N/A

• Confined space?

  Yes

  No

  N/A

• Working from heights?

  Yes

  No

  N/A

• Other activities in area :

Hazards (Enviormental)

• Wind Chill

  Yes

  No

  N/A

• Airborne Particles

  Yes

  No

  N/A

• Vapours

  Yes

  No

  N/A

• Hot/cold surfaces, materials

  Yes

  No

  N/A

• Noise

  Yes

  No

  N/A

• Lighting

  Yes

  No

  N/A

• Heat Stress

  Yes

  No

  N/A

• Wind

  Yes

  No

  N/A

• Controls used :

Hazards (Body)

• Fall Potential

  Yes

  No

  N/A

• Pinch Point

  Yes

  No

  N/A

• Electric Shock

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

• Slip - Trip

  Yes

  No

  N/A

• Flying Particles

  Yes

  No

  N/A

• Thermal Burn

  Yes

  No

  N/A

• Manual Lifting KG

  Yes

  No

  N/A

• Sharp Objects

  Yes

  No

  N/A

• Work Over Head

  Yes

  No

  N/A

• Falling Objects

  Yes

  No

  N/A

• Proper Positioning

  Yes

  No

  N/A

Hazards (Chemical)

• Chemicals Identified

  Yes

  No

  N/A

• MSDS Reviewed

  Yes

  No

  N/A

• System Under Pressure

  Yes

  No

  N/A

• Chemical Burn

  Yes

  No

  N/A

• Skin/Eye Irritation

  Yes

  No

  N/A

• Inhalation

  Yes

  No

  N/A

• Radiation

  Yes

  No

  N/A

• Are you working alone?

  Yes

  No

  N/A

• Contact Person :

• Phone Number :

• Scissor Lift

  Yes

  No

  N/A

• Personal Basket

  Yes

  No

  N/A

• Forklift

  Yes

  No

  N/A

• Boom-type Lift

  Yes

  No

  N/A

• Crane

  Yes

  No

  N/A

• Chainfall

  Yes

  No

  N/A

• Is the equipment in good condition?

  Yes

  No

  N/A

• Do you have the proper rigging?

  Yes

  No

  N/A

• Have you done an inspection of the surrounding area?

  Yes

  No

  N/A

• Are the hand tools in good condition?

  Yes

  No

  N/A

• Is the scaffold in good condition?

  Yes

  No

  N/A

• Is the ladder in good condition?

  Yes

  No

  N/A

• Is the ladder secure?

  Yes

  No

  N/A

• Do I have the right ladder for the job?

  Yes

  No

  N/A

• Fixed Barricades (used if tape has potential to become damaged)

  Yes

  No

  N/A

• (Tape) Danger (used to keep people out)

  Yes

  No

  N/A

• (Tape) Caution (used to alert people to hazards)

  Yes

  No

  N/A

• Barricade Tags (required with barricades)

  Yes

  No

  N/A

• Are signs of warning required?

  Yes

  No

  N/A

• Are holes covered?

  Yes

  No

  N/A

• Are handrails in good condition?

  Yes

  No

  N/A

• Is a fire extinguisher required?

  Yes

  No

  N/A

• Safety shower # :

• Eyewash # :

• Muster point :

• Closest Door # :

• ERT contact (confined space) :

• Comments :