Trane Contracting Controls Technician PJA

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

Focus Four

• Will you be working around any fall hazards?

  Safe

  At Risk

  N/A

• Will you be working around equipment or machinery that you could get caught-in or between?

  Safe

  At Risk

  N/A

• Will you be working around any struck by hazards?

  Yes

  No

  N/A

• Will you be working on any electrical equipment today?

  Safe

  At Risk

  N/A

• Please photograph any immediate hazards on the job site

  Media

PPE and Equipment

• Do you have all required ppe for the jobsite?

  Yes

  No

  N/A

• Do you have the LOTO locks or hasps needed for the job?

  Yes

  No

  N/A

• Is your ladder in good working order?

  Yes

  No

  N/A

• Are your tools in good working order?(No frayed cords, no missing guards)

  Yes

  No

  N/A

• Any additional safety concerns:

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  Sign