Title Page
-
Conducted on
-
Prepared by
-
Site Supervisor
-
Location
-
Job description
-
Emergency Contact Phone Number
Site Briefing
Work Procedures
-
Brief description of work procedures for job
-
Will work be performed energized
-
Have protective grounds been installed?
-
Will work be performed as "hot"?
Hazards
-
Energized equipment
-
Terrain (slips, trips & falls)
-
Traffic
-
Working at heights
-
Equipment on site (excavator, backhoe, etc.)
-
Noise (chainsaw, chipper, etc.)
-
Environmental Hazards
-
Underground Utilities
-
Have underground utilities been located?
-
Other:
-
Other:
Energy Source Controls
-
Hot Line Tag Required
-
Circuit
- Winyah Heights
- Church St.
- Ridge St.
- South Fraiser
- North St.
- Front St.
- Maryville North
- Maryville South
-
Has Peak Shaving Plant been taken out of service?
Special Precautions
-
Identify any special precautions that are out of the normal work activities.
PPE
-
Hard Hat
-
Safety Glasses
-
Rubber Gloves
-
Glove Class
-
Rubber Sleeves
-
FR/AR Uniform
-
Hearing Protection
-
Fall Protection
-
High Visibility Clothing
-
Other:
Personnel Onsite
-
Name:
-
Name:
-
Name:
-
Name:
-
Name:
-
Name:
-
Name:
-
Name:
-
Is Inspection Complete?