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APPENDIX A Activity Hazard Analysis

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. _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ SAFETY MEETING SIGN-IN SHEET Safety Meeting Presenter: _____ Date: Current Weather Conditions: Temperature (oF) = _____ Wind Direction = _____ Wind Speed = _____ Clear - Sunny Cloudy Rain - Snow Forecast = Current Site Conditions (circle as appropriate):Dry - Wet - Muddy - Frozen - Snow Covered - Other (describe) 1.

Hot Work Crane or other Signalman assigned Tag lines in use Area around crane barricaded Lock Out/Tag Out Lifting Equipment Lifting equipment inspected Personnel protected from overhead load ... Fire Hazard Hot Work Permit Fire Extinguishers Fire watch ... Fire Extinguisher Oil Level (Full/ No Leaks) Operator=s Area Clear of Extra Materials

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  Analysis, Activity, Fire, Hazards, Extinguisher, Fire extinguisher, Activity hazard analysis

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