Please enable JavaScript in your browser to complete this form.Date / TimeDateTimeJob Location(s):Job Location 1Job Location 2Job Location 3Job Location 4Job Location 5Job Location 6Job Location 7Job Location 8Supervisor/Foreman Safety Planning ChecklistToolbox meeting with staff prior to FLHA *YesNoNot ApplicableApplicable procedures reviewed? *YesNoNot ApplicableAre the work conditions safe? *YesNoNot ApplicableAre all the necessary permits to work available and signed? *YesNoNot ApplicableApplicable Hazard Assessment reviewed? *YesNoNot ApplicableWill the work require employees to work at heights? *YesNoNot ApplicableIf YES, is fall protection training verified and current? *YesNoNot ApplicableAre respirator qualifications verified and current? *YesNoNot ApplicableAre employees fit for work? *YesNoNot ApplicableEquipmentHi Vis VestAppropriate Hand ProtectionFall ProtectionCoveralls/TyvexKnee PadsSplash ProtectionFace ShieldEyeglassesHearing ProtectionHard HatRespiratorBear SprayOtherHousekeepingIs the work area clean? *YesNoNot ApplicableHave all slip, trip and fall hazards been addressed? *YesNoNot ApplicableWhere?Is there dust/fumes in the workplace? *YesNoNot ApplicableIs the task specific PPE worn? *YesNoNot ApplicableAre all the tools and equipment organized? *YesNoNot ApplicableAccessAre the exit signs visible? *YesNoNot ApplicableWhere? Is the exit clear of obstacles? *YesNoNot ApplicableAre warning signs for slippery surfaces in place? *YesNoNot ApplicableErgonomicsIs contract stress considered? (e.g. kneeling, twisting) *YesNoNot ApplicableAre repetitive motions identified and mitigated? *YesNoNot ApplicableLift, push, pull for excessive weight. (Get assistannce) *YesNoNot ApplicableAre awkward body positions identified and mitigated? *YesNoNot ApplicableHave all the lifting procedures been reviewed? *YesNoNot ApplicableWhat are they?Chemical UsageAre hazardous chemicals being used? *YesNoNot ApplicableWhich Ones?Is waste management understood/disposed of correctly? *YesNoNot ApplicableAre cleaning products stored in appropriate containers? *YesNoNot ApplicableIs all emergency safety equipment available? *YesNoNot ApplicableIs the WHMIS book available being reviewed? *YesNoNot ApplicableAre MSDS available and being reviewed? *YesNoNot ApplicableUse of EquipmentIs there potential to impact nearby work areas of others? *YesNoNot ApplicableWhat Impact?Are buildings clear? e.g. swing, travel, landing, 360 walk-around, etc. *YesNoNot ApplicableIs there energized eqiupment nearby? *YesNoNot ApplicableIs Vehicle Daily Inspection complete? *YesNoNot ApplicableIs janitorial equipment in good repair? e.g. vacuums, mops, buckets, brooms, spray bottles *YesNoNot ApplicableHave all pre-use inspections been completed? *YesNoNot ApplicableAre cords, leads and hoses in good repair? *YesNoNot ApplicableAre electrical cords elevated or protected? *YesNoNot ApplicableAre communication devices available? *YesNoNot ApplicableWhat do you have?Are all tools left organized after last use? *YesNoNot ApplicableOtherEnvironmental ControlsIs waste management understood/disposed of correctly? *YesNoNot ApplicableAre gray water disposal locations identified? *YesNoNot ApplicableAre the weather conditions okay to work in? *YesNoNot ApplicableAre Spill Kits available? *YesNoNot ApplicableIs there potential or existsing extreme heat/cold? *YesNoNot ApplicableIs there potential or existing extreme wind? *YesNoNot ApplicableAre conditions slippery or icy? *YesNoNot ApplicableIs there potential rain/snow? *YesNoNot ApplicableAre there noise hazards nearby? *YesNoNot ApplicableIs there a potential to encounter wildlife? *YesNoNot ApplicableGeneral ConditionsAre fall exposures identified? e.g. tools, or materials *YesNoNot ApplicableAre flying particles possible? e.g. gravel, pebbles, dust *YesNoNot ApplicableAre sharp edges identified and protected? *YesNoNot ApplicableWhere?How are you protected?Are burns possible? e.g. hot water *YesNoNot ApplicableAre chemical burns possible? *YesNoNot ApplicableAre pinch points identified? *YesNoNot ApplicableSubmit