Trane PJSR (Pre-job Safety Review)

• Client / Site

• Service agreement details/term

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Access requirements

• Are there any requirements to access site<br>Security<br>Parking<br>Training<br>

  Yes

  No

• Is an ID badge required ?<br>

  Yes

  No

• Specific parking locations required ?

  Yes

  No

• Is there site-specific training required ?

  Yes

  No

Interior work

• Is there adequate lighting in working area

  Yes

  No

• Is work area and access free from slip trip or fall hazards<br>Housekeeping<br>Floor type<br>Obstacles<br>Unguarded machinery<br>

  Yes

  No

• Is equipment able to be locked out or tagged out

  Yes

  No

• Is fall protection required ?<br>Fall protection should be applied when work is performed more than 4' above floor level<br>Ladder work does not require fall protection unless customer requires.

  Yes

  No

• Are the electrical panels properly labeled for electrical hazards ?

  Yes

  No

• Safe access to VAV boxes ?

  Yes

  No

• Are there hazardous chemicals present in work area ?

  Yes

  No

• Provide MSDS information

• Add media

  Media

• Is there a refrigerant monitor in the equipment room ?

  Yes

  No

  N/A

• Is there any requirement for respirator protection ?

  Yes

  No

  N/A

• Is there any asbestos in work area

  Yes

  No

• Please take photo of potential asbestos

  Media

• Is asbestos marked with signs identifying

  Yes

  No

• Hot work permits required by facility ?

  Yes

  No

• Will work be conducted near staff or public

  Yes

  No

• Provide any information to surrounding people of work being performed

• Is there any lifting equipment needed to perform work<br>Forklift<br>Scissor lift<br>Rigging equipment<br>

  Yes

  No

• Will there be any confined space work required ?<br>Customer or facility manager should post and identify any confined space entry

  Yes

  No

• Are there any site specific emergency procedures

  Yes

  No

• Fire extinguishers available near work area ?

  Yes

  No

• Equipment needed for any elevated interior work ?

  ladder

  scissor lift

  scoffolding

  N/A

• Estimated height work will be performed

Exterior work

• Will rooftop work be performed

  Yes

  No

  N/A

• How do you access the roof ?

  Internal roof hatch

  Internal doorway

  External fixed ladder

  External portable ladder

  other

• Is there a fixed ladder used to get to roof hatch ?

  Yes

  No

  N/A

• Is fixed ladder and roof hatch in good working condition

  Yes

  No

  N/A

• Are there any fall protection concerns from roof access point to working area<br>Unprotected roof edges <br>Railings or parapet <39" high )<br>Unprotected holes or skylights<br>

  Yes

  No

• Does door have lock on inside or outside

  Yes

  No

• Is access area in and out of roof door safe and in good condition

  Yes

  No

  N/A

• Is external fixed ladder safe and in good condition<br>Properly maintained and in good working condition<br>

  Yes

  No

  N/A

• Are there any additional requirements to access external ladder

  Yes

  No

• Is an extension ladder required to be brought on site for roof access

  Yes

  No

• Please estimate roof access height

• Is there a specific location ladder should be set up at ?

  Yes

  No

• Is working area on roof within 15 of unprotected roof edge or opening ?

  Yes

  No

• Are there roof fall protection anchor points available ?

  Yes

  No

• Please sketch any details or issues needing to be resolved

  Drawing

• Power lines near working area ?

  Yes

  No