Project-Specific HSE Orientation Checklist

Project-Specific HSE Orientation Checklist

PROJECT-SPECIFIC HSE ORIENTATION CHECKLIST

TORONTO DISTRICT
Worker Name:

First NameLast Name
Project Name
Project Number
Time

Hour Minutes

AM/PM Option
Company Name
CN_PDF
Orientation Date

MonthDayYear
Date of Orientation
PCL HSE Online Orientation Date

MonthDayYear
Date of Online Orientation performed on PCL Learning Portal (FOR PCL OFFICE USE)
Project Supervisor

First NameLast Name
Project Supervisor
Signee Email
Please enter your email if you wish to receive a copy of this form.
How will you be uploading your Learning Certificate from the PCL Orientation?
Upload your file
Take a Photo to upload your certificate
Does your scope of work require you to wear a full body harness in travel restraint/fall arrest ?
I will be...
Take a Photo to upload your certificate
Upload your file
I understand that workers who are required to use fall protection methods including a travel restraint system, fall restricting system or fall arrest system must be trained in Working at Heights.
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I understand that tools and materials must be tethered/secured when working from heights and/or within 1.8 metres (6 feet) of any leading edge.
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PLEASE CONFIRM THAT THE FOLLOWING HAS BEEN REVIEWED WITH YOU ALONGSIDE PCL PERSONNEL
1. Introduction of PCL project team members and office locations.
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2. Summary of Project HSE Committee (JHSC/WTC)
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3. Project hours of operation and local by-law considerations, (if applicable)
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4. Incident Reporting: All incidents must immediately be reported to your direct supervisor.
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5. Personal protection equipment (PPE); check all that apply
5a. Required Personal Protection Equipment (PPE)
5a. Required Personal Protection Equipment (PPE)
5b. Additional Personal Protection Equipment (PPE); check all that apply

Other
5. Additional Personal Protection Equipment (PPE); check all that apply

Other
6. Project access and egress requirements.
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7. Subcontractor parking.
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8. Worker amenities
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9. Project HSE Bulletin Board location(s) and content review.
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10. Location of Material Safety Data Sheets (MSDS) and Safety Data Sheets (SDS).
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11. Designated smoking area(s) and general fire prevention.
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12. Designated storage, laydown and waste disposal area(s).
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13. Site services including emergency shut-off location(s).
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14. Emergency response protocols and emergency assembly area(muster point)
WES3 Emergency Systems
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15. Location of first-aid, eyewash, spill kit, fire extinguisher and AED stations.
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16. Name and location of nearest hospital.
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17. Temporary traffic control considerations and concerns.
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18. Coordination of deliveries and materials.
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19. Pre-Job Safety Instruction (PSI) program review. (to be completed at the start of any shift, updated when tasks or conditions change and reviewed/signed-off upon return from each break).
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20. Job Hazard Analysis (JHA) and/or Safe Work Procedure (SWP) requirements (high risk activities).
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21.a Project and/or client-specific requirements and considerations.
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21.b Please state requirements and considerations below.
21.b Please state requirements and considerations below.
Any Additional Relevant Training (i.e. Hoisting and Rigging, Mobile Crane Operator, Vertical Drilling Rig Operator, Confined Space)
Worker's Signature
Please Select the Name of PCL Facilitator from the dropdown List below and Receive Said Facilitator's Signature
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Name:
Facilitator's Signature:
PCL Reference Number
Facilitator's Email
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Secondary Email
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Shared Mailbox Email
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Shared Mailbox Email (2)
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MXHERO Email
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ALL SUBMISSIONS
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Should be Empty: