Title Page

  • Jicarilla: 021579 - 0372

  • Conducted on

  • Prepared by

  • Location

Untitled Page

Jicarilla Power Station

  • Check one:

  • Date:

  • Site Lead:

  • Total on site

  • Task:

  • Safety Notes:

Weather

  • Wind speed

  • Wind direction

  • Temp

  • Weather Delay

  • All icy walk areas have been controlled?

Daily Summary:

  • JSA Completed?

  • Daily Summary notes:

Work Activity

  • Work activity

  • Number Of Workers

  • Total Hours

ACOUNTABILITY REPORT

  • Accountability for all on site

Other Items

  • Attach additional media

Signature

  • Type name

  • Sign name

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.