Information
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Millenium Interiors Hazard Assessment/Daily Inspections
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Client / Site
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Conducted on
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Prepared by
Task Hazards
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Add new tasks throughout workday
Task
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Task
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Use of knife:
Cut away from hands and body, Wear cut resistant gloves if necessary
Heavy Lifting:
Use board cart and get help moving drywall to task locations
Use proper bending and lifting practices -
Special Circumstances/Notes
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Cutting:
Clean ends cuts of steel from barbs
Wear cut resistant gloves if necessary
Heavy Lifting:
Get help with heavy bundles of steel and use cart if necessary -
Special Circumstances/Notes
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Use of snips:
Support materials properly when cutting (pinch points)
Use of knife:
Cut tile away from hands and body
Wear cut resistant gloves if necessary
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Special Circumstances/Notes
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Sanding:
N95 mask to protect from dust particles -
Special Circumstances/Notes
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Task Location
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Select date
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Workers Involved
- Tyler Jenne
- Gilles Debeaudrap
- Dayton Debeaudrap
- James Saylor
- Cam Kereiluk
- Brian Hutchins
- Kieth McLellan
- Tom Davidson
- Harry White
- Micael White
- Mark
- Terry
Working at Heights (to match task number)
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Select type of height hazard for task
Selection
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Height Hazard
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Fall Arrest is required on this type of lift.
(A shock pack is required on lanyard) -
Fall Restraint is required on this type of lift
(no shock pack is required)
Inspection (Select box after inspecting item) *If any selections do not pass inspection, select "RED" under special Information*
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Braces/Decks
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Wheels/Screw Jacks
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Frame Connections Secure
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Special Information
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Scaffold for Millenium use only
Refer to tags located on scaffold frame for details -
Scaffold is not to be used and needs to be inspected or modified by a Millenium supervisor
Flag off immediate area until retagged by general contractor or Millenium supervisor -
Calculate...
Lanyard Length, Lanyard Shock Absorber, Height of Person, and 2' safety Buffer.
Total must be equal to, or less than total fall Distance. (Anchor Point to Ground) -
Fall Pro Plan
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Diagram
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Workers Below
Inspection (Select Safe, Modified or Unsafe after inspection) *If any selections do not pass inspection, select "Unsafe" under special Information*
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Visible Leaks
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Anchor Points
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Ground Controls Up/Down
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Upper Controls Drive/Turn
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Labels
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Special Information
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Lift is to be use by trained and certified personnel only
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Lift has been modified (back rail removed) to accommodate materials
Certified Millenium employees use only. -
Lift is not to be used and needs to be reinspected by a Millenium supervisor or sent in for repair
Lock off unit immediately -
Ground Conditions (Holes/Protrusions/Curbs)
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Elevated Hazards (Protrusions/Lines/Tarps)
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Workers Below
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Select Relevant Workers
- Tyler Jenne
- Gilles Debeaudrap
- Dayton Debeaudrap
- James Saylor
- Cam Kereiluk
- Brian Hutchins
- Kieth McLellan
- Tom Davidson
- Harry White
- Micael White
- Mark
- Terry
Environmental Hazards (to match task number)
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Report high risk hazard to supervisor before proceeding with task
Hazard
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Lighting
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Electrical Hazards
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Cutting/Grinding Hazards
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Tripping Hazards
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Vehicles/Machinery operated in area of work
Emergency Information
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Muster Point
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First Aid Kit/Eye Wash
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Supervisor Signature
