Title Page
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Company:
- Borton
- Greenhill Concrete
- Greenhill Materials
- Greenhill Sand
- Klaver
- Millennial Asphalt
- OCM
- Sherwood Construction
- Wildcat CO
- Wildcat KS
- Wildcat Concrete
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Site conducted
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Who is conducting the audit?
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Who wrote the pre task plan?
- John Tyler
- Seth Gerry
- Matt Johnson
- Jim Ruzicka
- Al Mericle
- Trentton Houghton
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Conducted on
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Has the employee signed, dated, and included the job numbers on the pre task?
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PPE Required for Task:
- 0 - Not filled out/left blank
- 1 - Some PPE is selected but missing items required for the job task
- 2 - Proper PPE is selected for the job tasks
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Is the Task for each job stated?
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Sequence of Job Steps:
- Job tasks are vague, unable to understand which task for which job.
- Job tasks are vague, but equipment and/or job is listed for each task.
- Job tasks are broken out into primary steps to allow for adequate hazard ID.
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Hazard Identification:
- 1 - Generic items that DON'T relate to the job task: Slips/Trips/Falls, Weather, Pinch Points
- 2 - Generic items that DO relate to job task: Slips/Trips/Falls, Pinch Points, Etc.
- 3 - Distinct hazard ID related to job task along with some generic items
- 4 - Excellent hazard ID related to job task
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Documented Control Measures:
- 0 - No control measures listed
- 1 - Generic items only for controls: watch footing, wear PPE, watch hand placement
- 2 - Distinct controls documented with some generic items included
- 3 - Clear "instructional" controls documented
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Are Inspections Performed on tools and equipment if applicable?
Photo of JSA
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Front of Pre Task Plan
