APPENDIX A Activity Hazard Analysis

← Back to document page

APPENDIX A Activity Hazard Analysis Note: Activity Hazard Analysis will be prepared and inserted prior to the start of work APPENDIX B Forms Risk Mitigation Two-Week Look-Ahead Form Safety plan for week ending: Project/ Location: Plan Prepared by: Next Two Weeks Scope of Work: Contractor: Meeting date: Dated: Identified Risks/Exposures/ hazards : Control Measures: Additional Activity hazards Analysis Required: Subcontractors Mobilizing/Demobilizing: Audit/Inspections Scheduled: Competent Person Changes:Planned Orientation/Training : Recommendations/Comments/Concerns: Note: This information should be incorporated into the meeting minutes. __________________ _________________________________ __________________________ ________________________________________ ________________________________ ______ _______________________ ________________________________________ ________________________________ ______ ________________________________________ __________ ________________________________________ ________________________________ ______ ________________________________________ ________________________________ ______ ________________________________________ __________________ ________________________________________ ________________________________ ______ ________________________________________ ________________________________ ______ __________________ ________________________________________ ________________________________ ______ _____

Critical Lift Required clearance distance = _____Ft. Safe work zone marked Hot Work Crane or other Signalman assigned Tag lines in use Area around crane barricaded ... Ear Plugs/Ear Muffs Barricades provided Access/egress provided Protection from accumulated water ... Trips Falls Inspect for trip hazards Hazards marked Tools & material properly ...

  Fall, Critical, Analysis, Activity, Access, Hazards, Activity hazard analysis