Information
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Document No.
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Safety Involvement Report
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Prepared by
Use this application to report one or more safety involvement activities in which you have participated. Select activities by using the checkbox below.
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Lead or participate in morning stretching.
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Please enter the name of the jobsite where this activity was completed.
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Pease enter the date this activity was completed.
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Attend or conduct a Toolbox Talk safety meeting.
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Please enter the name of the jobsite where this activity was completed and the Toolbox Talk topic.
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Pease enter the date this activity was completed.
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Conduct a "Jobsite Safety Survey".
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Please enter the name of the jobsite where this activity was completed.
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Pease enter the date this activity was completed.
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Conduct a pre-construction meeting that includes safety planning for your project.
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Please enter the name of the jobsite where this activity was completed.
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Pease enter the date this activity was completed.
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Complete a method of procedure (MOP), pre-task plan, or integrated work plan (IWP) required for your job.
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Please enter the jobsite and task/process for which this plan was created.
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Pease enter the date this activity was completed.
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Complete a "Near Miss or Hazard Report" card.
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Please enter the name of the jobsite where this activity was completed.
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Pease enter the date this activity was completed.
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Employee Safety Contact
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Enter the type of employee safety contact this was.
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Please describe employee contact, include employee & jobsite name(s).
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Enter date and time:
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Check in with a newly hired Apprentice or Journeyman to stress our safety focus.
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Pease document your conversation, including the name of the employee and the jobsite.
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Pease enter the date this activity was completed.
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Participate in an accident or near miss incident review.
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Please indicate the name of the jobsite where the incident occurred, and the result of the review.
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Pease enter the date this activity was completed.
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Attend and participate in a jobsite safety recognition lunch.
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Please enter the name of the jobsite where this activity was completed.
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Pease enter the date this activity was completed.
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Attend or participate in Leadership Safety Training (held 3x per year).
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Pease enter the date this activity was completed.
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Attend and participate in OSHA consultation meetings at your jobsite.
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Please enter the name of the jobsite where this activity was completed. List any recommendations made for Hunt.
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Pease enter the date this activity was completed.
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Read the book "Safety by Objectives" or "Safety, A Human Approach" by Dan Peterson.
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Pease enter the date this activity was completed.
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Other (create your own, and describe what you did below):
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Document your activity here:
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Pease enter the date this activity was completed.
