Cutting Disc Approval Form

PCL HSE OPERATING PROCEDURES

Grinders - HSEOP-25-01
Cutting Disc Approval Form
Project Name:
Your Cell Phone Number
So we can text you when the form has been approved.Format: (000) 000-0000.
Email (copy of final approval will be sent here)
example@example.com
Date

MonthDayYear
Date
Time Issued

Hour Minutes

AM/PM Option
Expiry Time

Hour Minutes

AM/PM Option
Company:
Cutting Disc: Describe in detail the work to be performed and the location/area where the task will be done:
Reasons the work can't be done other than by using a cutting disc: (band saw, reciprocating saw, plasma cutter, chop saw, or other)
Cutting Disc Operation: Does the RPM rating of the disc match the grinder being used?
2. How will the material be cut and secured?
Has the competency of the worker using the grinder been verified?
Years of experience
Trade level (Apprentice, Journeyman, etc.)
Has the worker seen "The Grind" training video?
Submitted by (First and Last Name)
Signature
Date Required

MonthDayYear
Date
Approved by Project Superintendent
Project Superintendent Signature
Superintendent Signature Date

MonthDayYear
Date
Approved by Project HSE
Project HSE Signature
Project HSE Signature Date

MonthDayYear
Date
Should be Empty:

PCL HSE OPERATING PROCEDURES