PHYSICAL PLANT – Dept Name

Safe Job Procedure #

Edited by: names required here / Approved by: names required here
M - Manager
W - Worker / Created by: names required here
M - Manager
W - Worker / Last revision date:
Date require
Hazards Present:
  1. Delete this text and enter all potential hazards associated with this procedure eg…below
  2. Slips, Trips
  3. Fall (over 8’)
  4. Pedestrian Traffic
  5. Working alone
  6. Communication
  7. Crushing / Pinch Points
  8. Hoisting Equipment / Loads
  9. Procedure itself
/ Personal Protective Equipment or Devices may be Required:
Delete this text and add any additional personal protective equipment required and devices such as;
  1. Non- slip CSA boots
  2. Hard hats
  3. Safety Glasses
  4. Fall Protection System (inspected)
  5. Hi-Vis Vest
2 person job
Communication (radios) / Additional Training Requirements: Delete this text and list all training that is required prior to completing this procedure.
  1. Review of Safe Work Procedure
  2. Fall Protection
  3. Rigging & hoisting
Prior Experience and/or Supervision
Supportive Information: Add any..such as
To be reviewed with Crew prior to task with JHA completion
Authorised personnel only to complete task
Housekeeping
Delete this text and enter any housekeeping items that are required after completing the job.
For Example:
  • Ensure equipment is off.
  • Place all materials in their proper storage areas.
  • Ensure the equipment is safe, clean and tidy before you leave it.

Pre-Operational Safety Checks
  • Delete this text and enter Pre-Operational checks that must be completed prior to completing this procedure. If there are no pre-operational checks to be performed, Delete this table.

SAFE JOB PROCEDURE
Image of steps / Completed
Insert pictures here
Insert picture
here /
  1. Inspect required personal protective equipment and replace if required.
  2. Put on all required personal protective equipment.
  3. Delete this text and continue writing procedure. Enter any caution statements as required.

Additional notes;
Supervisor
It is the responsibility of the Supervisor to ensure:
All employees know, understand and comply with the safe work procedure.
The safe work procedure is reviewed annually and amended, if required.
Any changes that have been made to the safe work procedure must be immediately communicated to all employees. This
includes a posted bulletin and verbal notification.
Employees
It is the responsibility of the Employee to:
Read, understand and comply with the safe
job procedure.
If an emergency situation occurs while conducting this task, or there is an equipment malfunction, shut the equipment off immediately and follow the lock out procedure.
REPORT ANY HAZARDOUS SITUATION TO YOUR SUPERVISOR IMMEDIATELY
Guidance Documents/Standards/Applicable Legislation:
Enter all documents that apply to this Procedure/Task. Eg below
Guidance Documents:
  • Operator’s Manual
CSA Standards:
Manitoba Regulation:
Part 02 – General Duties
Part 04 - General Workplace Requirements
Part 06 - Personal Protective Equipment - General
Part 09 – Working Alone
Part 14 - Fall Protection
Part 20 - Vehicular and Pedestrian Traffic
Part 23 – Crane and Hoists / NOTE: Add any additional note…such as This task will be monitored periodically to ensure compliance and safety

EMPLOYEE SIGNATURE: ______MANAGEMENT SIGNATURE______

REVIEWED BY PPLASH yes / no DATE: ______