Wind Energy – Risk Assessment and Mitigation Form

Making the right choice – Work Safely

Work Task:Date:

Tailboard Participants: (names, use back if needed)

Conduct a new Safety Tailboard meting if the personnel or work scope changes.

(A)Emergency Procedure: (Safety, Medical, Environmental or Security)

Emergency – radio call to leader, see emergency response procedure, have emergency numbers

(B)Work Procedures: Procedure Name

Discuss the procedure and/or the work scope as well as the safety risk. What equipment, systems and hazards are involved in this job? What other work in this area could affect the safety on this job?

(C)Work Procedures: * * check and discuss all that apply * *

Behavior discussion: (Hazard Recognition and Response includes ROUTINE Task)

 / Climbing /  / Walking/Working Surfaces
 / Stretch before working /  / Eyes on Path
 / Pushing/Pulling /  / Eyes on Task
 / Lifting//Lowering material (____lbs)* /  / Pinch Points
 / Repeitive motion /  / Line of fire
 / Correct body position /  / Ascending/Descending (3 pt contact)
 / Twisting /  / Housekeeping (dirt, trash,etc.)
 / Assistance when needed /  / Stay to right
 / Overextended/Cramped /  / Have the Skills/Knowledge needed

*Note: Back sprains and strains are a leading cause of injuries. If lifting more than 50 lbs. Request assistance.

Other Risks/Hazards associated with the job::

WeatherNormalHotColdRainSnowIceLightening

 / Falls /  / Confined spaces
 / Ladders /  / Excavations
 / Tools, Hoses, Cords /  / Scaffolds
 / Energized Parts /  / Material Handling
 / Driving Vehicle (wear seat belt) /  / Grounding
 / Chemicals, Oils, Flammables, etc. /  / Environmental Spills
 / Industrical Hygiene (air quality) /  / Rotating Equipment
 / Pest (wasp, spiders, bees, etc) /  / Other work in area
 / Fiberglass materials /  / Powered Vehicles (fork-lift, crane)
 / Sharp objects /  / Additional Lighting Required

(D)Energy Source Controls:

Identify and discuss the energy sources that need to be isolated and verified.

 / Electrical / Verification Method:
 / Mechanical / Verification Method:
 / Pressure/hydraulic / Verification Method:
 / Chemical / Verification Method:
 / Potential Energy / Verification Method:
 / Other / Verification Method:

Clearances and Boundaries: Clearance needed to do this job? YesNo

Verify:

Correct Unit?Correct Equipment?Correct System?Correct Boundary?

(E)Special Precautions: Identify and discuss the following items:

 / Fire Extinguisher /  / First Aid Kit
 / Eye Wash Station/Shower /  / AED
 / Bloodborne pathogens kit /  / Drinking Water
 / Muster Point /  / MSDS
 / Spill Containment Kit /  / Storm Drains, Wetlands
 / Other Precautions

(F)Risk/Hazard Mitigation:

Personal Protective Equipment: (Hazard Recognition and Response includes ROUTINE Task)

Head /  / Hard Hat / Administrative
Eyes /  / Safety Glasses /  / Hot Work Permit
 / Googles /  / Caution/Danger Tags/Cones
 / Face Shield /  / Warning Signs
Hands /  / Work Gloves /  / Rescue Plan (fall protection)
 / Chemical Resistant Gloves /  / Communication (radio channel____)
Feet /  / Steel Toe Shoes /  / Tool Inspection Before USE
Ears /  / Ear Muffs /  / Rigging Inspection
Body /  / Fall Protection Harness /  / Waste Material Management
 / Dual Y Lanyards / Engineering
 / Coveralls /  / Ground Fault Interrupter
 / Cold Weather Gear /  / Hole covers
 / Rescue Equipment Available /  / Tie Off for Fall Protection
 / Waste Containment

List other mitigation methods required:

Participants: Print NameSignature

Use back of page for additional names and signatures if needed.