Foushée Pre-Task Plan DAILY PRE-TASK PLAN “PLAN YOUR WORK – WORK YOUR PLAN” PROJECT NAME/JOB NUMBER: TASK DESCRIPTION:CONTRACTOR/SUB: Date MM slash DD slash YYYY FOUSHÉE CONTACT: SUPERINTENDENT/FOREMAN: COMPETENT PERSON: LOCATION: HAZARD CONTROL MEASURES: Reviewed with Crew? Competent Person On-Site? SDS Reviewed with Crew? Coordination Necessary with Other Trades? Barricade/Signage in Place? Area House Kept? Overhead powerlines: voltages and distances known? Security/fence in place? **MINIMIZE OR ELIMINATE HAZARDS THROUGH ENGINEERING CONTROLS, I.E., WET METHODS, VENTILATION, BARRIERS, TOOLS, EQUIPMENTREQUIRED PPE: Hard Hat Gloves Respirator HI Visibility Vest Safety Glasses Work Boots Face Shield Goggles ASSOCIATED WORK HAZARDS: Asbestos Lead Silica Carbon Monoxide Changes in Grade Chain-Handling Confined Space Flying Debris/Grinding Slips/Trips/Falls Electrical Hazards Elevated Work Environmental Hazards Awkward Body Falling Objects Fumes/Vapors Steam Access/Egress High Voltage Power Lines Inadequate Ventilation Open Hole Pinch Points Repetitive Motion Rotating Equipment Moving Equipment Congested Areas Cranes in Area Inadequate Lighting PPE Inspected Overhead Work Excessive Noise Housekeeping Pneumatic Tool Use Chemicals Vehicle Traffic Twisting/Bending Line of Fire NOTES:FALL PROTECTION PLAN (Equipment & Method):FALL PROTECTION PLAN (Equipment & Method): Fall protection required at elevations 4’ or more Competent person has inspected equipment prior to use Vertical/horizontal life line 100% tie off with full body harness Lanyard, deceleration device Anchor point identified by competent person Written fall protection plan in place for fall hazards of >/= 10’ Guard rails in place ** MEANS OF EMERGENCY RESCUE:SCAFFOLDS/LADDERS: Competent person has inspected scaffold before use and signed/dated inspection tag Inspect all ladders before use Ladders are secured top/bottom CONFINED SPACE ENTRY: Competent person on-site to evaluate entry Confined space entry permit filled out fork lifts/heavy equipment/aerial lifts: Trained/qualified/certified Inspect equipment prior use Alarms functional, fire extinguisher, seat belt, spotter as required TRENCH/EXCAVATION ENTRY: Daily trench/excavation inspection checklist signed by competent person Protective system installed at 4 ft Egress/ladders every 25 ft of travel Spoils at least 2 ft away from trench edge CRANES & RIGGING: Crane lift plan completed Pre lift crane meeting Certified operator, rigger, signaler Rigging inspected and set up by competent person Designated Lift Director PERMITS: Dig Safe Good Faith Survey Silica Work Plan Trench Crane Lift Plan Plans/Designs/Data Available Training Certification/Documentation on File Hot Work LOTO Other Confined Space Engineering Required COMPLETE CHECKLIST PRIOR TO BEGINNING NEW TASK. ALL ITEMS MUST BE ADDRESSED PRIOR TO WORK. SIGNATURES:SignatureSignatureSignatureSignatureSignatureSignatureSignatureSignatureSignatureSignatureAnswer the following when evaluating your work:Prior to start, have you walked your work area to address lighting, housekeeping, slip/trip issues etc.? Yes No N/A Is there a new hire, or new team member on the project who will need support? Yes No N/A Are enough people assigned to safely complete the task? (lifting, repetition, spotters etc.) Yes No N/A Do you have an injury to report or were you injured the prior working day? Yes No N/A Safety items identified on the front side check boxes must be addressed on the table below:1Steps for WorkToolsHazardsSteps Taken to Address Hazards2Steps for WorkToolsHazardsSteps Taken to Address Hazards*If you need more space, attach another PRE-TASK PLAN SHEETWork Planner Foreman Safety Coordinator Crew Members – additional crew members sign on back or a separate page if necessary: Add RemoveSend a copy of this form to your email: Enter Email Confirm Email
