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Sub – Contractor: employee count confirmation
BC CONSTRUCTION SITE
*Require Fields
Company Name
*
Number of workers on site
*
Count completed by
*
Phone
*
Date
*
MM slash DD slash YYYY
Job Site
*
Latimer Heights 313
Latimer Heights 7.3
Harrison Highlands
Pre-shift Hazard Assessment
Task
Task location
Crew foreman
Break down the task into steps, Identify and Analyze the related hazards, the associated risk level from the matrix below, then identify the plans to eliminate or control the risk
Pre‐use Inspection done for:
PPE (basic & specialized)
Yes
No
Tools & Equipment for the job at hand
Yes
No
Fall Pro. Equipment
Yes
No
Respirator
Yes
No
After Job done/End shift
Area cleaned‐up / Housekeeping done
Yes
No
Any new hazards introduced as a result
Yes
No
Such Hazards controlled/communicated
Yes
No
Any need to update/review related SJPs
Yes
No
Applicable SWP/SJP Reviewed for the job?
Yes
No
If yes, SIP name:
Work at heights
Workers trained
Yes
No
Equipment available and suitable
Yes
No
Fall Pro Plan prepared if above 25 ft
Yes
No
Protecting surrounding trades / public
Surrounding trades notified of work
Yes
No
Public protected? (if affected by work)
Yes
No
Risk of dropped objects controlled?
Yes
No
Work involving Silica Dust
Exposure Control Plan applicable/followed
Yes
No
Workers Fit tested
Yes
No
Workers clean shaven
Yes
No
Use of Vacuum/Wetting prioritized
Yes
No
Consent
*
By signing on this page, I acknowledge that I have reviewed this hazard assessment, and the procedures to control the hazards with my supervisor and understand my responsibilities
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