Job Hazard Checklist

/ Form 000.653.F0315
Job Hazard Checklist
Prepared By: / Date:
Project: / Work Location:

Brief Description of Project/Task Order

This Job Hazard Checklist must be issued as part of the bid package to communicate health, safety, and environmental hazards and personal protective equipment to prospective bidders. This checklist contains information obtained during preliminary planning for this project and may not address all hazards. Additional information/details are provided to the subcontractor following contract award. This checklist is intended as a “safety starting point.”

Hazards Identified (for any identified hazard, provide a brief description below)

Abrasive Blasting / Excavation 5ft deep (4 ft in WA) / Noise
Asbestos / Falls 6ft / Operating Rotating Equipment
Coal Tar Pitch Volatiles / Hazardous Materials / Overhead Cranes in Area
Confined Space Entry / Hexavalent Chromium / Overhead Electrical Lines
Dock (around water activity) / High Traffic Area / Railroad Activity
Electrical – High Voltage (1,000volts) / Hot Work / Refractory Ceramic Fiber
Electrical – Low Voltage (<1,000volts) / Lead / Roof Access Required
Electrical – Static / Mobile Equipment (that always has the right-of-way) / Silica
Corrosives (specify the corrosive):
Dust (specify what kind of dust):
Other (specify):
Brief description of all hazards identified above:

Conditions and Permits Anticipated

List conditions particular to the worksite:
Check anticipated work permits/contractor submittals:
Asbestos Work Plan / Energized Electrical Work Permit / Job Safety Analysis
Break-In Permit / Fall Protection Work Plan / Line Break Permit
Confined Space Permit / High Voltage Work Plan / Lockout/Tagout
Critical Lift Permit / Hot Tap Permit / Roof Access Permit
Emergency Plan / Hot Work (Welding/Burning) Permit / Steel Erection Plan
Other (specify):
Specify environmental issues/permits:

Training Anticipated

Subcontractor Training – As required by applicable standards, personnel must be trained, and possibly certified, to do the work they are contracted to do. Proof of training/fitness to do the work must be provided upon request.
Check anticipated training (includes but is not limited to):
Asbestos / Electrical High Voltage / Lead
Bloodborne Pathogens / Equipment Operation / Lockout/Tagout
Confined Space / Fall Protection / PCBs
Crane Operator / Hazard Communication / Respiratory Protection
Dangerous/Hazardous Waste Handler / Hexavalent Chromium / Scaffolding
Electrical (general) / Ladder Use / Lockout/Tagout
Other (specify):

Mandatory Personal Protection and Safety Equipment Requirements

The following 3 items are required on all projects and for construction-type work in office areas:

Long pants and shirt with minimum 1/2 sleeves
“Substantial” footwear — construction work boots/shoes (canvas shoes of any type are not allowed)
Nonconductive frame safety glasses meeting ANSIZ87.1(2003) criteria
Hard hats meeting ANSIZ89.1 criteria

Additional Protective Devices/Controls Anticipated

Check all that apply:
Air Monitor / Gloves / Personal Exposure Monitoring
Barricades/Safety Cones / Goggles / Radiation Clothing
Coveralls / Ground “Spotter” for Lifts/Equipment / Reflective Vests
Disposable Coveralls / High Voltage Escort / Retrieval Tripod
Ear Plugs/Muffs / Lab Coat / Respirator
Face Shield / Lifeline / Safety Shower/Eye Wash
Fall Protection / Local Exhaust / SCBA
Fire Extinguisher / Lockout/Tagout / Silt Fence/Erosion Control
Flame-Retardant (FR) Clothing / MSDSs / Spats (a cloth or leather “gaiter” covering the instep and ankle)
Hazardous Waste Clothing: Level A Level B Level C Level D
100% Cotton Shirts (long sleeve) and 100% Cotton Pants
Other (specify):

General Site Information/Expectations

First Aid, Medical Treatment, and Emergency Medical Response – subcontractor must provide as required by applicable standards; P2Semployees are on site to provide assistance (signing a Hold Harmless clause may be required to use onsite/client-provided services, if available).
Substance Abuse – conformance to onsite/client policy may be required.
Plant-Specific Safety Rules – contained in the HSE Management System.
ProjectSpecific Safety Rules (when subcontractors are expected to comply with requirements that go beyond the HSE Management System)– covered in the pre-task meeting.

Environmental Management – covered in the pre-task meeting.

Housekeeping and other basics:

Subcontractors are expected to maintain a clean, safe jobsite, including ongoing and daily cleanup.
Refuse, cords, cables, etc., are kept clear of walking surfaces.
Subcontractor provides receptacles for trash, welding rod, scrap wire, etc.
Passageways and walkways are kept free of debris.
Cords, plugs, ladders, fall protection equipment, and tools are inspected and marked with contractor identifier. A GFCI is required on all extension cords and power tools.
No riding in the back of pickup trucks.
No live electrical work without a special permit.
The contractor prepares and furnishes a Job Safety Analysis using Form 000.653.F0100 or similar. Depending on the job, other hazard analyses may be required. The JSA is prepared from the information obtained inthis checklist, the site visit, the pre-task meeting, and contractor’s knowledge and experience.
Pre-construction meeting is conducted by the P2S and may be attended by representatives from Contracts and Procurements, Safety, Environmental, Security, and other subject-matter areas.
Plant-specific subcontractor employee orientation may be required.
Sanitary washing facilities.

Unless otherwise identified in writing, P2S does not furnish any equipment for use on this contract; the subcontractor furnishes all lifting, mobile, safety, and other equipment for the job. No work is performed without authorization by a P2S purchase order. Any work performed without an authorized P2S purchase order is at the subcontractor’s risk and expense.

Selection of Safe Subcontractors – subcontractors are to have the attitude, awareness, and capacity to protect their employees and others from injury, and can demonstrate the ability to fulfill their obligations under the contract and under the law.

Subcontractor agrees to bring on site only lowertier contractors that meet P2SHSE requirements including, but not limited to, acceptance by P2S of the safety prequalification for the potential lowertier contractor(s).

Monitoring/Auditing/Inspecting – conducted by P2S and contractor personnel.
Event Notification, Investigation, and Reporting – an Incident Investigation Report (Form 000.653.F0198 or similar) is filed with P2S onanyincident* that occurs at the project worksite. The preliminary report must be completed within 24hours.
*Incident that causes:
–injury (no matter how slight)
–illness (no matter how slight)
–fire/explosion
–property/equipment damage (whether P2Sowned/leased or contractorowned/leased property/equipment)
–release of “stored” energy
–excavation cave-in/collapse
–unearthing/discovery of any “structure” or human remains
–spill, airborne, or waterborne release into the environment
–near miss/near hit with the potential to result in any “incident” listed above

Note:This form is referenced in Practices000.653.1003 and 000.653.1304.