Making Safety an Ongoing Part of the Construction Process Through ...

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Pre-Task Planning Form Prepared By: _______________________ Supervisor: ___________________________ Task/ Activity:_________________________ Project: __________________________________ Date: _____________ Location:_________________________________ Potential Hazards Present Excavations / Trenches Hazardous Materials Vehicles / Equipment Elevated Work: Falls Water Confined Space Elevated Work: Public Exposure Open to Below Leading Edge Air Quality / Vapors Chemicals (Burns, Inhalation,etc.) Fire / Heat Lighting Temperature Flying Particles / Debris Electricity Noise Other Hazard Elimination Protective Clothing Head Protection Eye / Face Protection Ear Protection Respirator Safety Lanyard / Harness Fire Protection Slope / Shore / T- Flagmen / Audible Warning Adequate Eyewash / Shower Restrict Area Additional Lighting Floatation Device Toeboards / Barricades / Rails Other Items To Be Verified PPE Present MSDS First-Aid Kit Emergency Plan Reviewed Supervision Present First-Aid Training Permitting Obtained Lockout / Tagout Immidiate Response Safety Equipment Present Safety Guards Others Informed Other Figure 1. Example of a Pre-Task Planning Form
Description of procedure to perform task: ______________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Scope of work communicated to each worker: Yes No All known hazards have been addressed in task plan: Yes No Conflict with other trades addressed: Yes No Proper safety equipment on site and available: Yes No Proper tools and materials on site and available: Yes No Applicable permits have been issued: Yes No excavation confined space Hot work (welding) crane lockout/tagout Other: ____________________________ Nature of work communicated to others in the area: Yes No Persons responsible for actions are assigned: Yes No Comments: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Signatures of persons performing the work (By signing this form, crew members indicate that they understand the task plan and feel fully prepared to proceed to perform the work safely.) ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Prominently post the pre-task plan in work area as the task is being performed Figure 1. Example of a Pre-Task Planning Form (continued)
Page 1 and 2: ISBN 1-886431-09-4. © Copyright 19
Page 3 and 4: consider all the potential hazards
Page 5: some consideration might be given t
Page 9 and 10: Maintaining Close Monitoring of the
Page 11: the early 1990s, pre-task planning

Making Safety an Ongoing Part of the Construction Process Through ...

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