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Short Duration Worker HSE Orientation Checklist
Company
*
Email
example@example.com
Date
*
-
Month
-
Day
Year
Date
Name
*
Project Name:
*
Please Select
CF_RC_GALLERIA_UPGRADE
OC FOOD WINE & TOURISM CENTRE
BCH LMS TruckStorage
CF PC Dunsmuir Upgrades
CF PC Ceiling Replacement
BCH EDMONDS OPS CENTRE
BCH_GANGES_BLDG
Pacific Center Anchor Repositioning Project
Fibreco Silos
New St. Paul's Hospital
Lions Gate Hospital (ACF)
Capstan Way Station
Brentwood SkyTrain Station
NSWWTP
Teck EVO AMC
CSRC
Air Canada YVR Simulator PH2
Project #:
*
Please Select
2222396
2270012
2222287
2222405
2222411
2222298
2222395
2220085
2226016
2220059
2220061
2226017
2226023
2226024
2226026
2220074
2222398
Test
1. Working safely is a condition of access, and of the disciplinary procedures associated with failure to this or other project site requirements?
*
Yes
No
N/A
CL
2. Legislative jurisdictional HSE requirements?
*
Yes
No
N/A
CL
3. An overview of PCL's policies, practices and procedures?
*
Yes
No
N/A
CL
4. The Project Site Plot Plan?
*
Yes
No
N/A
CL
5. Regular hours of work, lunch breaks, and coffee breaks?
*
Yes
No
N/A
CL
6. The Pre-Job Safety Instruction (PSI) program and the following steps been explained and reviewed?
*
Yes
No
N/A
CL
7. The proper selection, care and use of the following PPE? Hard hats, gloves, monogoggles, hearing protection, face shields, dust masks, safety glasses, safety footwear.
*
Yes
No
N/A
CL
8. HSE signs and compliance?
*
Yes
No
N/A
CL
9. Housekeeping requirements?
*
Yes
No
N/A
CL
10. Have the following site specific hazards been reviewed? They are subject to but no limited to: Demolition, Heavy Lifts, Water Service Lines, Restricted Work Areas, Gas Lines, Personal Radios, Congested Work Areas, Harmful Gases and others.
*
Yes
No
N/A
CL
11. Scaffold requirements?
*
Yes
No
N/A
CL
12. Ladder requirements?
*
Yes
No
N/A
CL
13. Guardrail requirements?
*
Yes
No
N/A
CL
14. Project fall protection plan requirements?
*
Yes
No
N/A
CL
15. Intoxicating beverages and drugs prohibited on the worksite?
*
Yes
No
N/A
CL
16. Worker's Right to Refuse Work and Workplace Violence/Harrassment Policies been reviewed?
*
Yes
No
N/A
CL
17. The emergency response/evacuation procedures?
*
Yes
No
N/A
CL
18. The incident reporting procedures?
*
Yes
No
N/A
CL
Worker's Name
*
Worker's Signature
*
*STOP: Give phone/tablet to a PCL representative to complete below
Facilitator's Name
*
Facilitator's Signature
*
Legend:
N/A = Not Applicable
CL = Client
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