Title Page

  • Document No.

  • Pre task plan

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Job activities

  • Job activities

Pre task checklist

  • New employees on site orientated

  • First aid kit available and stocked

  • Live utilities clearly marked

  • Proper safety equipment on site

  • Proper tools for the job

  • Review SDS of hazardous substance that might be used

  • Communicated work with others working in the are

  • Rescue plan in place

  • Proper signage in place

  • Area barricaded or taped off

  • Caps on all rebar

  • Job scope understood

  • Fire extinguisher in proper location

  • Check rigging

  • Load chart

  • Check oil in welder

  • Fuel before use

  • Leads check

  • Ear plugs, gloves, safety shoes, safety glasses

  • Monitor

  • Crane size

Identify potential hazzards

  • Lower equipment with rope

  • Particle in eye/ cutting, grinding, wind

  • Over exertion/ back and shoulders

  • Rigging for lifts

  • Live utilities above and below ground

  • Possible electric shock

  • Fall protection over six feet

  • Traffic moving equipment

  • Fire/ welding sparks

  • Cutting torch

  • Heat/ cold exposure

  • Slips/trips/falls

  • Confined space

  • Lead/asbestos

  • Loud noises/ tools/ equipment

Identify hazard elimination

  • Face shields/ goggles

  • Proper positioning, get help lifting when needed

  • Clear area for overhead lifts/ good hand signals

  • Inspect rigging equipment

  • Erect barricades to protect from above and below

  • Gopher on call, all lines clearly marked

  • All GFCI's in place and working

  • Proper PPE

  • Pinch points

  • Fall protection/ guard rails/ 6' CAZ line

  • Plenty of fluids/ dress in layers

  • Good housekeeping

  • Don't do it, get the experts

List additional hazards

  • Additional hazards

Near misses

  • Near miss

How near miss may have been avoided

Crew members

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