PSU OPP SAFETY - Pre-Task Planning Guide

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

The Pre Task Planning Guide should be completed to determine safety requirements needed prior to the work being completed. Each employee involved with the task shall review this Guide. If deviation occurs, work must be stopped and re-evaluated. Notify your supervisor and/or Safety for any deviations.

• Select date

  Date

• Work Order #:

• Supervisor:

• Building and area of task:

• Task Description:

TASK INFORMATION

• What are the hazards associated with the job?

• What will be done to eliminate/control the above hazards?

• Have the hazards and controls been reviewed with the affected employees?

  Yes

  No

  N/A

Tunnel Information

• Will this work require entry into the steam tunnels?

  Yes

  No

• Notification MUST be made to service desk prior to entry.

GENERAL WORK ENVIRONMENT/HOUSEKEEPING

• Is there acceptable acc/egress to the worksite?

  Yes

  No

  N/A

• Tripping hazards removed and addressed?

  Yes

  No

  N/A

• Materials handling: Should carts or other means be used to keep materials and tools off the floor?

  Yes

  No

  N/A

• Is there adequate illumination for all work?

  Yes

  No

  N/A

• Barricades maintained and appropriate?

  Yes

  No

  N/A

• What weather conditions could effect safe performance of this task?

FIRE PROTECTION

• Identify below the location of the nearest extinguisher and communication source:

• Are flammable/combustible materials stored, separated, inspected, labeled, and secured?

  Yes

  No

  N/A

TOOLS AND EQUIPMENT

• User inspection is required on all tools, ladders, GFI's, electrical cords, rigging, and safety equipment?

  Yes

  No

  N/A

MATERIAL STORAGE

• Has a material storage area been identified and approved?

  Yes

  No

  N/A

FALL PROTECTION

• Have areas been identified as as requiring fall protection systems? (ie PFAS, guardrails, hold covers.)

  Yes

  No

  N/A

• Have they been installed

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• What PPE is required for the task?

  Select Safety Glasses Face Shield Hard Hat Hearing Protection Gloves Safety Shoes PFAS Respirator NFPA 70E (Arc Flash) Welding/fire rated Coveralls/Tyvek

  • Safety Glasses
  • Face Shield
  • Hard Hat
  • Hearing Protection
  • Gloves
  • Safety Shoes
  • PFAS
  • Respirator
  • NFPA 70E (Arc Flash)
  • Welding/fire rated
  • Coveralls/Tyvek

• Other PPE required:

EQUIPMENT

• List mechanized equipment, platforms, personnel lifts, etc.

• Do they have current inspections

  Yes

  No

  N/A

• Employee Certifications/Training Required:

  Select Crane Operator Forklift Operator Aerial Lift Powder Actuated Tool NFPA 70E Competent Person Excavation Competent Person Scaffold

  • Crane Operator
  • Forklift Operator
  • Aerial Lift
  • Powder Actuated Tool
  • NFPA 70E
  • Competent Person Excavation
  • Competent Person Scaffold

• Other Training/Certifications required:

PERMITS AND OTHER FORMS REQUIRED

• Permits Required:

  Select Confined Space Hot Work None Required

  • Confined Space
  • Hot Work
  • None Required

• Required Inspection forms:

  Select Ladders Inspection Form Scaffold Inspection Form Forklift Inpsection Form Excavation Inspection Form CDL Pre Trip Inspection Form Non CDL Pre Trip Inspection Form Crane Operator Inspection Form None Required

  • Ladders Inspection Form
  • Scaffold Inspection Form
  • Forklift Inpsection Form
  • Excavation Inspection Form
  • CDL Pre Trip Inspection Form
  • Non CDL Pre Trip Inspection Form
  • Crane Operator Inspection Form
  • None Required

• Other Permits or forms required: