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HBI- Pre-Task Plan

HBI

PRE-TASK PLAN

The supervisor and crew will create this plan establishing safe work practices
and common hazard control measures for preventing the occurrence of injuries.

Job Information

MM slash DD slash YYYY
MM slash DD slash YYYY

Work Task & Environment Evaluation

Is every crew member orientated to the site and familiar with the work environment?
Has the work area been walked by the crew to identify safety and/or impact concerns?
Will the task require special permits or plans? (i.e. confined space entry, hot work, fall protection work plan)
Will the task involve exposure to falls of 4’ or greater?
Will barricading and or signage be required to protect personnel, facilities, or equipment?
Will the task require the use of ladders, MEWPs, scaffolds or work platforms?
Will the task require the LOTO of energized systems?
Will the task involve the use of chemicals? If so, has an SDS been reviewed to proceed with the task?
Will the task involve exposure to high noise levels greater than 85 dBA?
Will the task involve musculoskeletal/ergonomic risk factors? (i.e. repetetive motion, awkward position, joint stress)
Will weather conditions effect the safe completion of the task?
Will the task require additional coordination with other crafts in the work area?
Have all tools & equipment been inspected for safe use prior to starting work tasks?
Has emergency equipment been identified & located? (i.e. fire extinguishers, eyewashes, first aid kit, AED)

Personal Protective Equipment

PPE

Signatures


By signing below, I acknowledge that I participated in the creation of this pre-task plan and understand the steps of the task, associated hazards, and hazard control methods.

MM slash DD slash YYYY
Crewmember Name:
Use the + icon next to a crew member name to add additional crew members.

Pre-Task Plan Revisions


Describe the deviations from the original pre-task plan and detail the revised hazard control methods.

Send a notification to an additional email
Send a notification to an additional email

If work conditions change, work MUST STOP and the Pre-Task Plan must be revised.

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