KEC-Pole Top Rescue For The Electric Line Worker

• Cooperative

• Conducted on

  Date

• Prepared by

• Location
  Address

Annual Pole Top Rescue

• The employee's listed below have successfully demonstrated their ability to perform pole top rescue by completing the following tasks: Calls to victim, makes May Day call, climbs safely with fall restraint equipment, takes handline (if not already on pole), makes proper attachment to victim, removes slack before cutting strap, controls victims descent, rescuer descends safely using fall restraint equipment, removes/loosens handline from victim, checks victims vitals and begins CPR if necessary.

Employee Signature

• Each signature verifies the employee agrees that he/she has successfully performed the tasks necessary for pole top rescue

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