NGM - Working at Heights - General

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Critical Controls: Actions and conditions that must be in place and functioning 100% of the time, without fail, to protect people when working in potentially significant risk situations.
  
  Instructions: For each critical control, select Controlled, AtRisk, or NA (Not Applicable or not observed). See Assessment below for definitions. If something is marked AtRisk, immediately Pause the work until the missing protections are put in place. Write the corrective action taken in the notes box below

• Critical Controls

• Have you completed a Team Risk Assessment prior to starting the job?

  Controlled

  At Risk

  N/A

• Barriers or barricades are in place to prevent falls?

  Controlled

  At Risk

  N/A

• Fall arrest/Restraint and anchor points are certified and inspected?

  Controlled

  At Risk

  N/A

• Is proper fall protection system being used (Arrest, Restraint, etc)?

  Controlled

  At Risk

  N/A

• Escape plan developed, Always working with partner?

  Controlled

  At Risk

  N/A

• Lift/Man Basket is certified for 5,000 lbs tie offs?

  Controlled

  At Risk

  N/A

Assessment

• CONTROLLED The presence of this control is verified and effective

• AT RISK This control is missing or ineffective

• NA / NO Not Applicable to this exposure situation or Not Observed