Short Duration Worker Orientation

SHORT DURATION WORKER HSE ORIENTATION CHECKLIST

(valid only for 24 hrs.)
TORONTO DISTRICT
Project Name*
Project Number
Orientation Date*

MonthDayYear
Name*
Signee Email
This email address will be used to send a copy of this completed document (Optional)
Company Name*
Company Name*
Company Name*
Company Name*
Company Name*
Company Name*
Company Name*
Company Name*
Company Name*
CN_PDF
YESNO
YESNO
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PART 1: THE GENERAL HSE ORIENTATION
Have the following been reviewed with the short duration worker?
YESNON/A
Error. Please Select Yes
YESNON/A
Error. Please Select Yes
YESNON/A
Error. Please Select Yes
YESNON/A
Error. Please Select Yes
YESNON/A
Error. Please Select Yes
Recognizing potential hazardsControlling potential hazardsEliminating potential hazardsMinimizing exposure to potential hazards
7. The proper selection, care and use of the following PPE:
Hard HatsSafety GlassesGlovesSafety Footwear
Hard HatsSafety GlassesGlovesSafety FootwearReflective Vests
Mono-gogglesFace ShieldsHearing ProtectionDust MasksRespiratory EquipmentFall ProtectionOther
YESNON/A
Error. Please Select Yes
YESNON/A
Error. Please Select Yes
DemolitionWater Service LinesGas LinesCongested Work AreasHeavy LiftsRestricted Work AreasPersonal RadiosHarmful GasesOther
If applicable:
YESNON/A
YESNON/A
YESNON/A
YESNON/A
Error. Please Select Yes
YESNON/A
Error. Please Select Yes
Workers Right to Refuse WorkWorkplace Violence/Harassment Policies
PART 2: INCIDENT MANAGEMENT

Have the following been reviewed with the short duration worker ?
YESNON/A
Error. Please Select Yes
Ramtech WES3 Systems
YESNON/A
Workers are to keep in mind they are working in an active Hotel and must keep their voices down and be respectful while in common Corridors.

Workers are to utilize dedicated freight elevators for vertical access. Passenger / guest elevators are not permitted to be used at any time.

Workers are required to wear reflective vests while accepting a delivery / working around traffic. Reflective vests are not to be worn while in common Corridors of the Hotel.
PART 3: DESCRIPTION OF WORK
ElectricalWaterSprinklerSteamGasCommunication/Security/Controls
Short Duration Worker’s Name*
Short Duration Worker's Signature*
Any Additional Relevant Training (i.e. Hoisting and Rigging, Mobile Crane Operator, Vertical Drilling Rig Operator, Confined Space)
Please Select the Name of PCL Facililtator from the dropdown List below and receive said Facilitator's Signautre
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:*
TRILLIUM
Facilitator's Name:*
Facilitator's Name:*
Facilitator's Name:*
Facilitator's Name:*
Facilitator's Name:*
Facilitator's Email
example@example.com
Shared Mailbox Email
example@example.com
Shared Mailbox Email (2)
example@example.com
MXHERO Email
example@example.com
ALL SUBMISSIONS
example@example.com
Facilitator's Signature*
PCL Review Number
Visitor Valet Link
NOTE: ALL SHORT DURATION WORKERS MUST SIGN IN AND OUT AT THE PROJECT OFFICE EACH DAY. NON-COMPLIANCE TO THIS SITE REQUIREMENT WILL RESULT IN THE USE OF PCL’S DISCIPLINARY POLICY.
Should be Empty:

SHORT DURATION WORKER HSE ORIENTATION CHECKLIST

TORONTO DISTRICT

PART 1: THE GENERAL HSE ORIENTATION

7. The proper selection, care and use of the following PPE:

If applicable:

PART 2: INCIDENT MANAGEMENT