Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • 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

  • 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?

Tunnel Information

  • Will this work require entry into the steam tunnels?

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

GENERAL WORK ENVIRONMENT/HOUSEKEEPING

  • Is there acceptable acc/egress to the worksite?

  • Tripping hazards removed and addressed?

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

  • Is there adequate illumination for all work?

  • Barricades maintained and appropriate?

  • 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?

TOOLS AND EQUIPMENT

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

MATERIAL STORAGE

  • Has a material storage area been identified and approved?

FALL PROTECTION

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

  • Have they been installed

PERSONAL PROTECTIVE EQUIPMENT

  • What PPE is required for the task?

  • Other PPE required:

EQUIPMENT

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

  • Do they have current inspections

  • Employee Certifications/Training Required:

  • Other Training/Certifications required:

PERMITS AND OTHER FORMS REQUIRED

  • Permits Required:

  • Required Inspection forms:

  • Other Permits or forms required:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.