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Y <br /> JOB SITE FALL PROTECTION & SAFETY HAZARD PLAN <br /> 011CHOMEPlan de seguridad y proteccion contra caidas en el lugar de trabajo <br /> Job Name: Job# <br /> Nearest Medical Clinic to job Site: <br /> Hospital/Clinic Name: <br /> Phone Number: Address: <br /> Print driving directions to nearest emergency medical facility and keep with this paperwork onsite. <br /> The Job Site Safety Hazards reviewed for this Project: The Job Site Safety Hazard review Includes: <br /> ❑General Safety(Seguridad General) ❑ Onsite Training/Job Hazard Analysis <br /> ❑Blood Borne (Transmitido por la sangre) ❑ Fall Protection Training <br /> ❑Electrical (Electrico) ❑ Ladder Safety <br /> ❑Fall Protection Plan (Plan de proteccion contra caidas) ❑ Electrical (GFI, Cords, Covers) <br /> ❑Heat Stress (Estres por calor) ❑ Trip Hazards/General Housekeeping <br /> ❑Asbestos/Lead (Amianto/Plomo) ❑ Fire/Flammable Storage/Welding Safety <br /> ❑Ladder (Escalera) ❑ Hazard Communication/MSDS <br /> ❑PPE Requirements (Requisitos de EPP) ❑ PPE Use(Glasses, Hardhat, Boots, Hearing) <br /> ❑Hazardous Chemicals (Productos quimicos peligrosos) ❑ First Aid Requirements <br /> ❑Other ❑ Tool/Machine Guarding <br /> ❑ Asbestos/Lead (awareness, abatement) <br /> Comments: <br /> All employees involved in this project have read and understand this Job Site Fall Protection&Safety Hazard Plan. <br /> Todos los empleados involucrados en este proyecto han leido y entendido este plan de proteccion contra caidas y <br /> riesgos de seguridad en el lugar de trabajo. <br /> Supervisor/Foreman Signature: _ Name <br /> Employee Signatures: <br /> Date Sign Print <br /> THIS JOB SITE FALL PROTECTION&SAFETY HAZARD PLAN MUST REMAIN ON THE JOB SITE AT ALL TIMES!READ <br /> AND UNDERSTAND THIS PLAN.SAFETY IS OUR TOP PRIORITY! <br /> iESTE PLAN DE PROTECCION CONTRA CAIDAS Y RIESGOS DE SEGURIDAD EN EL LUGAR DE TRABAJO <br /> DEBE PERMANECER EN EL LUGAR DE TRABAJO EN TODO MOMENTO! LEA Y COMPRENDA ESTE PLAN. iLA <br /> SEGURIDAD ES NUESTRA MAXIMA PRIORIDAD! <br />