Daily Pre-Task Plan Contractor: _______________________ Project: _________________ Date: ____________
Location(s) of tasks to be performed today:
What tasks are we doing today? What hazards are we exposed to? How are we doing it safely?
Tools & Required PPE (check all that apply)
Air Compressor Drill Generator Laser (with signs) X Safety Glasses Vacuum – Silica Dust
Band Saw X Drinking Water -cups GFCI Pigtail Mono Goggles Safety Signs Posted Voltage Tester
Boom Lift Duct Jack Grinder w/Guard Pipe Threader Sawzall Welding Machine
Bubble Level Extension Cord Hammer Drill Pipe Vise Scaffold (Tagged) Whistle
Cart / Dolly Extension Ladder Hand Tools Pipe Wrench Scissor Lift X Work Boots
Caution / Danger Tape Face Shield X Hard Hat Platform Ladder Stop / Slow Paddle
Chain Fall Fire Extinguisher Headlamp Powder Actuated Tool Sump Pump
Chop Saw Flag (Hand Held) Hearing Protection X Reflective Vest / HV Shirt Task / Work Light Hand Wash Station
Cut-Resistant Gloves Forklift Hose Respirator Tent / Shade Social Distancing
Diesel / Gas Cans Full Body Harness Lanyard / SRL (Yo-Yo) Rigging (Straps) Tool Guards Face Mask
FALL PROTECTION CRANES & RIGGING TODAY’S CREW:
Guardrails are at all perimeters/shafts? Y N N/A Working near overhead power lines? Y N N/A 1.
Aerial lifts used by trained operators? Y N N/A Has rigging been inspected before use? Y N N/A 2.
All ladders are inspected before use/OK? Y N N/A Qualified rigger / signal person verified? Y N N/A 3.
Fall protection equipment inspected/OK? Y N N/A Crane & operator paperwork verified? Y N N/A 4.
Anchor points can hold 5,000 lbs.? Y N N/A FIRE PREVENTION 5.
Will your work require use of a scaffold? Y N N/A Are flammable materials stored properly? Y N N/A 6.
PERSONAL PROTECTIVE EQUIPMENT Inspected fire extinguisher nearby & ready? Y N N/A 7.
Hard Hat, Safety Glasses, Boots being worn? Y N N/A SILICA 8.
Face Shields or Gloves used when required? Y N N/A HEPA vacuum / water controls in place? Y N N/A 9.
Hi-Visibility Vest or Shirt being worn? Y N N/A EXCAVATIONS 10.
ELECTRICAL Trench > 4 ft. deep, ladder or ramp? Y N N/A 11.
Temp. power & lighting in good condition? Y N N/A Trench > 5 ft. deep, cave-in protection? Y N N/A 12.
Extension cords elevated and inspected? Y N N/A Has competent person performed inspection? Y N N/A 13.
GFCI used on permanent power outlets? Y N N/A HEAT EXHAUSTION 14.
Working near overhead powerlines? Y N N/A Water, Rest, Shade available for workers? Y N N/A 15.
TOOLS MATERIAL HANDLING 16.
Hand & power tools inspected before use? Y N N/A Are materials stacked or stored properly? Y N N/A 17.
Are tool guards connected? Y N N/A Workers trained in safe lifting techniques? Y N N/A 18.
HOUSEKEEPING Is equipment available to move material? Y N N/A 19.
Is work area free of trip hazards & trash? Y N N/A CONFINED SPACE 20.
Barricades/ Tape/ Signs maintained? Y N N/A Are confined space procedures in use? Y N N/A
FOREMAN: SAFETY/COMPETENT PERSON:
Name: Name: Foreman Signature
Phone: Phone: Date