Write a pre-task plan for Work permit requirements
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Published by SALUSA robust pre-task plan and permit-to-work system for hazardous work should require the work to be defined, reviewed, authorized, controlled during execution, and formally closed out when complete. Before work starts, the team should scan the equipment, tools, and environment; identify applicable documents such as pre-task plans, SOPs, permits, and JHAs; break the job into steps; identify hazards for each step; assess risk; and establish controls before execution. The permit should clearly state the job scope, location, time limits, responsible personnel, required controls, and completion status. [2] [3] [1]
Key pre-task plan and permit-to-work requirements should include:
- Define the exact task scope, work location, equipment involved, and duration of the permit.
- Identify all applicable hazardous-work permits before starting, such as lockout/tagout, energized electrical work, hot work, confined space, and work-at-height controls.
- Conduct a job safety analysis or job hazard analysis by breaking the work into steps, identifying hazards at each step, evaluating consequences and likelihood, and selecting controls using the hierarchy of controls.
- Hold a site-specific job briefing with all affected workers before work begins, and repeat the briefing if conditions, scope, or controls change.
- Verify isolations, lockout/tagout, de-energization, line breaking, blanking, bleeding, ventilation, barricading, and restricted access as applicable to the task.
- Confirm worker competency, including task-specific training, qualification, and authorization for specialized work such as energized electrical work, gas testing, confined space entry, rescue, and equipment operation.
- Specify required PPE based on documented hazard assessment, and verify that PPE is available, suitable, and used correctly.
- Establish emergency arrangements, including rescue capability, communications, emergency contacts, and stop-work criteria.
- Obtain required approvals from supervisors, managers, safety personnel, and other designated authorizers before work starts.
- Keep the permit and supporting documents at the job site, monitor the work, document changes, and close out the permit when the job is complete or conditions change.
[3] [7] [13] For hazard identification and risk assessment, the safest approach is to document each job step, identify the hazard exposure, what could go wrong, what triggers the hazard, the surrounding conditions, the possible consequences, and contributing factors, then assign risk and define controls. Employees who perform the work should be involved because they best understand the task. The assessment should be documented and used to determine both operational controls and PPE requirements. [3] [3] [9] [3]
Isolation and lockout/tagout controls should be treated as critical permit conditions for hazardous energy and similar tasks.
- Identify every hazardous energy source and required isolation point before work begins.
- Use appropriate energy control devices such as disconnects, valves, blocks, grounding means, bleeding or blanking devices, accident-prevention tags, and individual or group lock devices.
- Verify de-energization, stored-energy release, and try-out or equivalent zero-energy verification before exposure begins.
- Where multiple hazards exist, integrate lockout/tagout with other permits such as confined space or hot work.
- Restrict the area with barricades, signs, or other means to keep unauthorized persons out.
- Do not rely on administrative approval alone; the physical isolation must be in place and verified in the field.
[1] [6] [8] [5] Permit authorization and approval should be formal, role-based, and documented. The permit should identify the requester, the qualified persons performing the work, and the approving authorities. It should also define when the permit expires, when a new permit is required, and where the completed permit is retained. If work conditions change, the permit and job briefing should be updated before continuing. [4] [4] [1] [13]
Competency requirements should match the hazard. Only trained, authorized, and where required qualified personnel should perform hazardous work. This is especially important for energized electrical work, confined space entry, gas testing, rescue, aerial lift operation, and lockout/tagout. Workers should not be assigned tasks beyond their training, knowledge, or experience, and supervisors should verify competency before authorizing the work. [4] [7] [13] [10]
PPE requirements should come from the documented hazard assessment and the specific permit conditions, not from a generic checklist alone.
- Head protection where there is risk from falling objects, low overhead obstructions, or electrical exposure.
- Eye and face protection for impact, splash, arc, dust, or flying-particle hazards.
- Hand protection selected for chemical, thermal, mechanical, or electrical hazards.
- Foot protection such as steel toe, slip-resistant, puncture-resistant, chemical-resistant, or electrically protective footwear as needed.
- Fall protection for unguarded edges, aerial lifts, and other elevated work.
- Respiratory protection when airborne contaminants exceed limits or when oxygen-deficient, toxic, or IDLH atmospheres may exist.
- Task-specific body protection such as flame-resistant clothing, chemical-resistant coveralls, high-visibility garments, or insulated clothing.
[1] [11] [12] [14] Emergency response planning must be completed before hazardous work starts. The plan should address communications, emergency contacts, rescue capability, first aid/CPR resources, fire protection where applicable, and clear triggers for stopping work and evacuating. For confined spaces and similar high-risk work, rescue arrangements, attendants or standby personnel, and monitoring requirements must be established in advance and documented on the permit. [5] [6] [7] [15]
Regulatory compliance and site documentation should be built into the process. At minimum, employers should maintain the pre-task plan, JHA or risk assessment, required permits, hazard assessments for PPE, inspection records, atmospheric testing records where applicable, training and qualification records, emergency plans, and permit closeout or retention records. Site-specific documents must remain available at the job site for the duration of the work, and changes to conditions or procedures should trigger review, re-briefing, and reauthorization. [3] [13] [13] [10]
In practice, a compliant hazardous-work package should include: a pre-task plan, a step-by-step JHA/risk assessment, verification of isolations and zero-energy state where applicable, required permits, a documented job briefing, proof of worker competency, PPE selection based on hazard assessment, emergency and rescue arrangements, supervisor and safety approvals, and a process for stopping work and reissuing documents if conditions change. This creates a defensible system that controls hazards before exposure and maintains control until the work is closed out. [2] [3] [8]
Sources used for this answer
[1] Personal Protective Equipment (PPE) Hazard Assessment Tool
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# Hazard assessment worksheet: Hand protection (cont.) ## PPE required (cont.) OSHA Oregon OSHA Department of Consumer and Business Services # Hazard assessment worksheet: Respiratory protection Salem Central Office [redacted street address]. NE Salem, OR [redacted postal code] Phone: [redacted phone] Toll-free: [redacted phone] osha.oregon.gov Appropriate respirators are required when workers are exposed above permissible exposure limits (PEL) for specific air contaminates, listed in [redacted phone], Oregon Rules for Air Contaminants; see also 1910.134, Respiratory Protection. Work task: <empty> Date: <empty> ## Potential hazards <table><tr><th></th><th>No hazards requiring respiratory protection</th></tr><tr><td></td><td>Nuisance dust or mist</td></tr><tr><td></td><td>Welding fumes</td></tr><tr><td></td><td>Asbestos</td></tr><tr><td></td><td>Pesticides</td></tr><tr><td>ப:ப</td><td>Isocyanates</td></tr><tr><td></td><td>Paint spray</td></tr><tr><td></td><td>Organic vapors</td></tr><tr><td></td><td>Acid gases</td></tr><tr><td></td><td>Oxygen deficient, toxic, or IDLH atmosphere</td></tr><tr><td></td><td>Other hazard:</td></tr></table> ## PPE required <table><tr><th colspan="2">Air-purifying respirators</th></tr><tr><td></td><td>None required</td></tr><tr><td></td><td>Filtering face piece (dust mask)</td></tr><tr><td></td><td>Particulate-removing respirator</td></tr><tr><td></td><td>Gas-and-vapor-removing respirator</td></tr><tr><td></td><td>Combination aerosol filter, gas, or vapor-removing respirator</td></tr><tr><td></td><td>Powered air-purifying respirator</td></tr><tr><td colspan="2">Atmosphere-supplying respirators</td></tr><tr><td></td><td>None required</td></tr><tr><td></td><td>Supplied-air respirator</td></tr><tr><td></td><td>Self-contained breathing apparatus (SCBA)</td></tr><tr><td></td><td>Combination self-contained breathing apparatus and air-line respirator</td></tr><tr><td></td><td>Combination air-purifying and atmosphere-supplying respirato…
[2] Toolbox Talk: Safety Pre-Planning
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# SAFETY PRE-PLANNING Date Published: 05/12/2025 Safe work practices are crucial to ensure that all employees have a standard level of knowledge and perform tasks the same way while prioritizing safety. Ensuring safety at a job site is essential to completing a job successfully. When everyone follows safe practices, the crew will experience fewer accidents, and productivity and efficiency will increase. Safety pre-planning involves planning a task to identify, avoid, prevent, and control hazards to keep our workers safe in their work. Utilizing the S.E.E. process serves as a useful reminder of how to examine a task before starting. S.E.E. stands for: • S-Scan (look at) the equipment, tools, and environment to identify potential hazards. Define the scope of the task and identify if there are any applicable - documents, such as Pre-Task Plan (PTP) requirements, SOPs, permits, or Job Hazard Analysis (JHA), that need review before beginning the task. E - Evaluate the task you intend to complete, break it into steps, associate the hazards with the steps, and plan methods to eliminate or reduce them. Here, teams need to identify situational and inherent hazards or potential hazards. To identify the hazard, each team member should discuss how someone may be injured while performing the task. Examples could include materials, equipment/tools, work locations, worker knowledge, worksite conditions, etc. Develop and implement hazard controls-Once the hazards have been identified, the workers should develop solutions to eliminate the hazards by implementing control measures. Specified methods, tools, and equipment might be used to reduce or eliminate the hazards. When the hazards cannot be eliminated, safeguards must be implemented. Examples include the erection of guardrails if work is performed at elevation or using personal protective equipment. - E - Execute the task. Perform work within hazard controls enacted in the previous step. This step requires workers to dis…
[3] Lockout/Tagout Sample Forms: Evaluation, Procedures, and Permit
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# Equipment-Specific Hazardous Energy Control Evaluation and Certification (cont.) Enter name of your company here # Safety Permit for Hazardous Energy Control (Lockout/Tagout) Work Operations Date of work activity: <empty> Permit issued to: Authorized employee name: <empty> Title: <empty> Company name (if outside contractor): <empty> Contact number: <empty> Date/Time issued: <empty> Date/Time permit expires: <empty> Work activity: <empty> Machine/equipment description: <empty> Work location: <empty> Personal protective equipment (PPE), as required: (also circle specific types within the parentheses) [ ] Face shield [ ] Ear plugs [ ] Hard hat [ ] Safety glasses [ ] Ear muffs [ ] Hood (chemical, thermal) [ ] Safety goggles [ ] Suit (rubber, thermal, Tyvek) [ ] Safety harness & line [ ] Filtering facepiece/N95 [ ] Respirator (dust, vapor, combination, full-face, half-face) [ ] Gloves (thermal) [ ] Gloves (latex, neoprene, nitrile, PVC, rubber) [ ] Rubber boots [ ] Shoes (steel-toed, electrical safety, slip-resistant) [ ] Additional PPE required: <empty> Energy control devices, as required: (also circle applicable activities within the parentheses) [ ] Disconnect [ ] Blocks [ ] Accident prevention tags [ ] Valves (close, block, blind) [ ] Lock devices (individual, group) [ ] Grounding means [ ] Lines (bleeding, blanking/blinding) [ ] Other: <empty> Other safety considerations, as required: (also circle applicable items within the parentheses) [ ] Confined space (requires additional permit) [ ] Fire hazards (fire extinguisher, area free of combustibles) [ ] Restrict area (barricade, safety tape) [ ] Welding (sparks, shield arcs) [ ] Safe access (ladder, aerial device, scissor lift) [ ] Other: <empty> Approval: Signature: <empty> Print name/title (i.e., Safety Manager, Supervisor): <empty> Date: <empty> [ ] Job complete [ ] Job incomplete Notes: <empty> The authorized worker holds this permit during the work activity and returns it to the approver after wo…
[4] Personal Protective Equipment (PPE) Hazard Assessment Tool
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Open source documentSource excerpt
## PPE required (cont.) OSHA Oregon OSHA Department of Consumer and Business Services # Hazard assessment worksheet: Torso protection Salem Central Office [redacted street address]. NE Salem, OR [redacted postal code] Phone: [redacted phone] Toll-free: [redacted phone] osha.oregon.gov Work task: Date ## Potential hazards - No hazards requiring torso protection - Extreme temperatures Hot splashes from molten metal and other hot liquids - Impacts from tools, machinery, and materials Hazardous chemicals lonizing radiation Other hazard: ## PPE required None required Chemical resistant coveralls Cut-resistant sleeves, wristlets Flame-resistant jacket Flame-resistant pants High visibility garment Insulated jacket, hood Lab coat or apron Static control coats or coveralls Other PPE: 440-5871 (07/23/COM)
[5] Confined Space Guide for General Industry
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# ATTACHMENT A # Hot Work Permit Sample (attach to Entry Permit) XYZ Company Date: <empty> Issue time: <empty> Expiration time: <empty> Location of permit space: <empty> Work tasks: <empty> Potential Hazards Authorized Workers O Toxic O Electrical Entrants: O Corrosive O Mechanical O Flammable/Explosive O Fire/heat Attendant(s): O Radioactive O Spills Fire/safety watch: O Energy release O Oxygen Enrichment - O Stored energy Procedures/Precautions: O Procedures O Communications O Entry permit O Ventilation O Training O CPR/first aid O Rescue plan O Sprinkler system in service O Charged fire hose O Surfaces wetted down O Shower/eyewash located Safety Equipment: O Hard hat O Eye protection O Hearing protection O Foot/hand protection O Protective clothing O SCBA O Respirator: <empty> O Tripod O Barricade/cones O Communication devices O First aid kit O Fire extinguisher O: <empty> Vessel Prep/Isolation: O Cleaning/purging O Ventilation O Signs/barriers O Lagging cloths/tarps O Lockout/tagout O Blanking/bleeding O Disconnect mechanical linkages O Secure moving parts O: <empty> O: <empty> O: <empty> Special Tools - O Low voltage - O Non-sparking - O Tools inspected for frayed/broken wires - O Lighting intrinsically safe Special Work Procedures - O Never bring gas cylinders or other large equipment into space - O Never block entry/exit with equipment - O Shut down during breaks or overnight - O Fire watch to remain 30 minutes after completion of hot work O Entry authorizer (name, title, date): <empty> Emergency contact: <empty> 52 2
[6] Confined Space Guide for General Industry
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# ATTACHMENT C # Confined Space Entry Permit Sample (Enhanced Title 8 Version) Permit valid for 8 hours only. All copies of permit will remain at job site until job is completed. Date: Time: Site location and description: Purpose of entry: NATURE OF CONFINED SPACE HAZARD Oxygen deficiency (less than 19.5%) Flammable gases/vapors above 10% of lower explosive limit (LEL) Mechanical hazards Oxygen over 23.5% Toxic gases or vapors greater than permissible exposure limit (PEL) Electrical shock Materials harmful to skin Electrical lockout Engulfment Valve out/isolation Other(s) BOLD DENOTES MINIMUM REQUIREMENTS TO BE COMPLETED AND REVIEWED PRIOR TO ENTRY PREPARATION COMPLETED DATE TIME Lock out/de-energize/try-out Line(s) broken/capped/blanked Secure area (post and flag) Breathing apparatus Resuscitator/inhalator Cleaned, drained, washed, & purged Ventilation for fresh air Emergency response team available Employees informed of specific hazards Procedures reviewed with each employee_ Atmospheric test in compliance Hot work permit attached (if required) Continuous monitoring required Other(s) REQUIREMENTS COMPLETED DATE TIME Full body harness w/ "D" ring Emergency escape retrieval equip. Lifelines Lighting (explosion-proof) Protective clothing (PPE) Respiratory equipment Specify Communication equipment Specify Rescue equipment Specify Rescue Service Phone# <table><tr><th>CONTINUOUS MONITORING</th><th>PERMISSIBLE</th><th>RECORD MONITORING RESULTS/TIME</th></tr><tr><td>TEST(S) TO BE TAKEN</td><td>ENTRY LEVEL</td><td></td></tr><tr><td>Percent of Oxygen</td><td>19.5% to 23.5%</td><td></td></tr><tr><td>Lower flammable limit</td><td>Under 10%</td><td></td></tr><tr><td>Carbon Monoxide</td><td>25 ppm</td><td></td></tr><tr><td>Aromatic Hydrocarbon</td><td>1 ppm - 5 ppm</td><td></td></tr><tr><td>Hydrogen Cyanide</td><td>4.7 ppm (S)</td><td></td></tr><tr><td>Hydrogen Sulphide</td><td>10 ppm* 15 ppm**</td><td></td></tr><tr><td>Sulphur Dioxide</td><td>2 ppm* 5 ppm**</td>…
[7] Confined Space Entry Permit
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# Confined space entry permit Permit date: <empty> Work shift: [ ] 1st [ ] 2nd [ ] 3rd Expires: <empty> Time started: <empty> Permit space to be entered (name and location of space): <empty> Purpose of entry: <empty> ## Names of trained, authorized individuals Emergency contact information Entry supervisor: Emergency responder: Entry attendant: Contact person: Authorized entrants: Phone number: Authorized entrants: Time: ## Pre-entry checklist Do not enter this permit space until the following "needs action" conditions are corrected: <table><tr><th>OK</th><th>Needs action</th><th></th></tr><tr><td></td><td></td><td>Before entering the permit space, the supervisor or designee must notify the rescue team. IDLH conditions require at least one rescue team member located outside the space.</td></tr><tr><td></td><td></td><td>A minimum of two employees must be assigned to work involving permit space entry. One employee must remain outside the permit space at all times</td></tr><tr><td></td><td></td><td>The surrounding area must be surveyed to show that it is free of hazards such as drifting vapors from tanks, piping, sewers, or vehicle exhaust.</td></tr><tr><td></td><td></td><td>Those responsible for operation of the gas monitor have been trained.</td></tr><tr><td></td><td></td><td>Gas monitor calibration tests and functional test (fresh air calibration) have been performed this shift on the gas monitor. If so, by whom?</td></tr><tr><td></td><td></td><td>The atmosphere will be continuously monitored while the space is occupied, if required by entry procedure.</td></tr></table> <table><tr><th colspan="8">Pre-entry requirements</th></tr><tr><td>Requirements</td><td>Yes</td><td>No</td><td>N/A</td><td>Requirements</td><td>Yes</td><td>No</td><td>N/A</td></tr><tr><td>Lockout-tagout/de-energize</td><td></td><td></td><td></td><td>Hot work permit</td><td></td><td></td><td></td></tr><tr><td>Pipes(s) broken or capped or blanked</td><td></td><td></td><td></td><td>Fall …
[8] Cal/OSHA Regulations | Chapter 4 | Subchapter 7: General Industry Safety Orders | §5157. Permit-Required Confined Spaces, Appendix C - Examples of Permit-required Confined Space Programs
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# §5157. Permit-Required Confined Spaces, Appendix C - Examples of Permit-required Confined Space Programs. (cont.) ## A. ENTRY WITHOUT PERMIT/ATTENDANT (cont.) dangerous air contamination or engulfment. Not all laterals to sewers or storm drains require blocking. However, where experience or knowledge of industrial use indicates there is a reasonable potential for contamination of air or engulfment into a occupied sewer, then all affected laterals shall be blocked. If blocking and/or isolation requires entry into the space the provisions for entry into a permit-required confined space must be implemented. Surveillance. The surrounding area shall be surveyed to avoid hazards such as drifting vapors from the tanks, piping, or sewers. Testing. The atmosphere within the space will be tested to determine whether dangerous air contamination and/or oxygen deficiency exists. Detector tubes, alarm only type gas monitors and explosion meters are examples of equipment that may be used to test permit space atmospheres. Testing shall be performed by the LEAD WORKER who has successfully completed the Gas detector training for the monitors he will use. The minimum parameters to be monitored are oxygen deficiency, LFL, and hydrogen sulfide concentration. A written record of the pre-entry test results shall be made and kept at the work site for the duration of the job. The supervisor will certify in writing, based upon the results of the pre-entry testing, that all hazards have been eliminated. Affected employees shall be able to review the testing results. The most hazardous conditions shall govern when work is being performed in two adjoining, connecting spaces. Entry Procedures. If there are no non-atmospheric hazards present and if the pre-entry tests show there is no dangerous air contamination and/or oxygen deficiency within the space and there is no reason to believe that any is likely to develop, entry into and work within may proceed. Continuous testing of the atmosph…
[9] Toolbox Talk: Job Hazard Analysis
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# JOB HAZARD ANALYSIS the ease e, plea e, our organ our a a Risk Assessment plea organ include Hazard Chemical Date Posted: 05/13/2025 # Job Hazard Analysis (JHA) A job hazard analysis (JHA) analyzes a task's associated hazards and risks and focuses on identifying and controlling hazards. Utilizing the JHA will provide a process for analyzing the work activities that will determine the tools, materials, and equipment needed to develop work methods and procedures for accomplishing the task. The process will identify existing and potential hazards, assess the risk, and identify ways to eliminate or protect against the hazard. ## STEPS FOR COMPLETING A JHA In accordance with WAC 296-800-[redacted postal code] - Hazard Assessment for PPE, a hazard assessment must be conducted to identify hazards or potential hazards and determine if PPE necessary on the job. Additionally, this hazard assessment must be documented according to WAC 296-800-[redacted postal code]. The steps required for completing a quality hazard assessment are as follows: is • Involve the Right People in the Process: Employees who do the job know the job best at the frontline level, and their knowledge is valuable in identifying hazards and coming up with solutions to mitigate hazards. - Define the core tasks and Break the Hazard Analysis into Steps: In the first step, separate each job into all the individual segments of the job. The simplest way to do it is observe the worker doing the task and list the individual steps. to - Observe the work: Watch employees perform the task in question. • Record steps: Break down tasks into a reasonable number of steps. • • - Review your findings: Review your task lists with the employees you observe. Are you missing any necessary steps? - Identify specific hazards in Each Step: With all the steps outlined, identify each hazard associated with each step. Some hazards will be obvious (risk of laceration, fall, struck by, caught in or between, etc.…
[10] HAZARD ALERT: Fatal Aerial Injuries
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# HAZ ALERT (cont.) ## Fatal Aerial Lift Injuries (cont.) FACE the Facts Haz Alert Page 2 A "pre-job safety plan" should be devel- oped for each job site and reviewed prior to each day on the job. site. Each company should write down work procedures for the following day's tasks to be performed and review with employees. A job hazard analysis should be conducted to recognize unsafe work practices and hazardous work conditions. Supervisors should ensure that all employers follow all standard operating procedures (SOP) and remove workers from the site if the SOP is not followed. Mechanical checks should be performed on all equipment at each job site prior to each use. Equipment users/owners should have the owners manual for the piece of equipment to develop a pre-operation safety inspection checklist. Checklists should document the required inspection points and identify the equipment make and model. The checklist should also have a section for required cor- rective actions when there's a defect. Re- move any malfunctioning equipment from service immediately. There should be communication between the worker in the elevated lift and ground control crew. Communication between workers should be clear and precise when interacting with other workers on the job site. Radio or sig- nal communication should be established between the ground crew and aerial lift crew to perform work tasks and to pre- vent miscommunications. Supervisors should establish a communication proto- col. The KY Fatality Assessment and Control Evaluation (FACE) and Occupational Safety and Health Surveillance (KOSHS) programs are funded by the National Insti- tute for Occupational Safety and Health (NIOSH) (Cooperative Agreement No: 1U600H008483-01). Ensure that appropriate fall protection equip- ment is available and correctly used when working from elevations, and safety training should be provided. Employers have a responsibility to provide a safe working environment for all their employe…
[11] Hazard and Risk - Sample Risk Assessment Form
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# What is a sample risk assessment form? (cont.) ## Sample Risk Assessment Form (cont.) <table><tr><th>Step or task</th><th>Hazard</th><th>Consequences or harm</th><th>Risk</th><th>Priority</th><th>Hazard Controls</th></tr><tr><td>EXAMPLE: Working at heights while on a ladder</td><td>Safety hazard: falling from heights</td><td>Serious injury due to a fall</td><td>High risk</td><td>1</td><td>Follow the hierarchy of controls for working at heights Elimination: when possible, perform work from the ground. Engineering controls: use an elevating work platform when appropriate. Administrative controls:</td></tr><tr><td></td><td></td><td></td><td></td><td></td><td>development of fall protection plans, safe work procedures, emergency response plans for working at heights, and adequate training (including working heights and fall protection training, elevating work platform training, ladder safety, training on safe work procedures and emergency response, etc.). Personal protective equipment: fall arrest system and equipment, head protection, high-visibility. clothing, protective footwear, face and eye protection, emergency response equipment, and other appropriate equipment for the job.</td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td></tr></table> Hazard and Risk - Sample Risk Assessment Form CCOHS
[12] Energized Electrical Work Permit
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# ENERGIZED ELECTRICAL WORK PERMIT ## PART I: TO BE COMPLETED BY THE REQUESTER: Job/Work Order Number: <empty> 1) Description of circuit/equipment/job location: <empty> 2) Description of work to be done: <empty> 3) Justification of why the circuit/equipment cannot be de-energized or the work deferred until the next scheduled outage: <empty> Requester/Title: <empty> Date: <empty> ## PART II: TO BE COMPLETED BY THE ELECTRICALLY QUALIFIED PERSONS DOING THE WORK: <table><tr><th>1)</th><th>Detailed job description procedure to be used in performing the above described work:</th><th>Check when Complete</th></tr><tr><td></td><td></td><td></td></tr><tr><td>2)</td><td>Description of the Safe Work Practices to be employed:</td><td></td></tr><tr><td>3)</td><td>Results of the Shock Hazard Analysis:</td><td></td></tr><tr><td>4)</td><td>Determination of Shock Protection Boundaries:</td><td></td></tr><tr><td>5)</td><td>Results of the Flash Hazard Analysis:</td><td></td></tr><tr><td>6)</td><td>Determination of the Flash Protection Boundary:</td><td></td></tr><tr><td>7)</td><td>Necessary personal protective equipment to safely perform the assigned task:</td><td></td></tr><tr><td>8)</td><td>Means employed to restrict the access of unqualified persons from the work area:</td><td></td></tr><tr><td>9)</td><td>Evidence of completion of a Job Briefing including discussion of any job-specific hazards:</td><td></td></tr></table> 10) Do you agree the above described work can be done safely? Yes "No (If no, return to requester) Electrically Qualified Person(s) Date Electrically Qualified Person(s) Date ## PART III: APPROVAL(s) TO PERFORM THE WORK WHILE ELECTRICALLY ENERGIZED: Manufacturing Manager Maintenance/Engineering Manager Safety Manager Electrically Knowledgeable Person General Manager Date Note: Once the work is complete, foreword this form to the site Safety Department for review and retention. -1-
[13] Confined Space - Program
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# Confined Space - Program (cont.) ## What is a Confined Space Hazard Assessment and Control Program? (cont.) - Development of an emergency plan complete with training and equipment in case an unforeseen situation occurs. - An emergency response system. - Reporting and investigating incidents related to work in confined spaces. - Record and documentation control. - Program review whenever there is a change in circumstances or at least annually, to identify program weaknesses and make any necessary changes to the program. More information about confined spaces is located in the OSH Answers documents Confined Spaces - Introduction and Confined Space - Atmospheric Testing. ## What is an Entry Permit System? An entry permit is an administrative tool used to document the completion of a hazard and risk assessment for each confined space entry. Someone fully trained and experienced in confined space work should complete the entry permit. Some jurisdictions require a permit for all confined space entries. An entry permit is required for confined spaces where the hazard and risk assessment determined that the measures to control the risk involve the following: - atmospheric monitoring, - isolation, - lockout, - ventilation, - safeguarding devices, - respiratory protection, or - any other control that needs to be verified and documented in the permit as required by the assessment. Before entering a confined space, an entry permit should be completed. It should contain at least the following information: - The length of time the permit is valid for. - The name(s) of the worker(s) that are authorized to enter the confined space. - The name(s) of the attendant(s) (safety watch). - The name of the supervisor responsible for the work. - The location and description of the confined space. Confined Space - Program CCOHS
[14] Fall Protection - Fall Protection Plan (General)
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# Fall Protection - Fall Protection Plan (General) (cont.) ## What is working at heights? (cont.) - elevated work platforms, - fixed suspended work platforms, - swing staging, - boatswain's chairs, - aerial devices, - suspended equipment, or - personnel carrying equipment (e.g., personnel lifting units raised by cranes or hoists) Occupational health and safety laws generally require action when a worker has the potential to fall about 3 metres (10 feet). Check with your jurisdiction as exact requirements do vary. Note that most jurisdictions require the use of specific fall protection measures before, or in addition to, personal protective equipment (PPE). These measures generally include the use of some of the following: - fixed barriers (e.g., handrails, guardrails) - surface opening protection (e.g., covers, guardrails, etc.) - warning barriers or control zones - fall or travel restraint systems (i.e., a system to prevent a worker from falling from a work position, or from travelling to an unguarded edge from which the worker could fall) - fall containment system (e.g., safety nets) - fall arrest systems (ie., a system that will stop a worker's fall before the worker hits the surface below) There may also be specific legal requirements around use of equipment like ladders and scaffolding. ## What are fall protection plans and why are they important? A fall protection plan is a general term for the policy and procedures used to identify fall hazards, and the measures taken to prevent injury. Included in this plan is selecting, assembling, maintaining, inspecting, using, and dismantling equipment such as ladders, scaffolds, or platforms used for working at heights as well as any fall protection equipment. Emergency procedures for rescuing fallen workers (including those who are hanging in midair by their harness) are also needed. Fall protection plans must be specific to each site where workers are at heights. There is "no one size fits all" plan.…
[15] Personal Protective Equipment (PPE) Hazard Assessment Tool
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Open source documentSource excerpt
## PPE required at this workplace includes (check all that apply): (cont.) OSHA Oregon OSHA Department of Consumer and Business Services Hazard assessment worksheet: Fall protection Salem Central Office [redacted street address]. NE Salem, OR [redacted postal code] Phone: [redacted phone] Toll-free: [redacted phone] osha.oregon.gov Work task: Date ## Potential hazards No hazards requiring fall protection Unguarded surfaces more than 6 or 4 feet above a lower level or any height above dangerous equipment Other hazard: ## PPE required None required Personal fall arrest system Personal fall restraint system Other PPE: 440-5871 (07/23/COM)
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