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
Does your scope of work require you to wear a full body harness in travel restraint/fall arrest? If yes, a valid copy of the Working at Heights certificate training MUST be attached.
Does your scope of work require you to wear a full body harness in travel restraint/fall arrest? If yes, a valid copy of the Working at Heights certificate training MUST be attached.
I will be...
Take a photo of your certificate to upload right away
Upload your file

If you already have a copy of your Working at Heights Certificate training, you can upload it here
Cancelof
Upload your file
PART 1: THE GENERAL HSE ORIENTATION
Have the following been reviewed with the short duration worker?
1.Working safely is a condition of access and of the disciplinary procedures associated with failure to adhere to this or other project site requirements.
Error. Please Select Yes
2.Legislative jurisdictional HSE requirements.
Error. Please Select Yes
3. An overview of PCL's policies, practices and procedures.
Error. Please Select Yes
4. The Project Site Plot Plan.
Error. Please Select Yes
5. Regular hours of work, lunch breaks and coffee breaks.
Error. Please Select Yes
6. The Pre Job Safety Instruction (PSI) program and the following steps have been explained and reviewed:
7. The proper selection, care and use of the following PPE:
7a. Required PPE
7a. Required PPE
7b. Additional PPE

Other
8. HSE signs and compliance.
Error. Please Select Yes
9. Housekeeping requirements.
Error. Please Select Yes
10. Have the following site-specific job hazards been reviewed; they are subject, but not limited to:

Other
If applicable:
11. Scaffold requirements.
12. Ladder requirements.
13. Guardrail requirements.
14. Project fall protection plan requirements.
Error. Please Select Yes
15. Intoxicating beverages and drugs prohibited on the worksite.
Error. Please Select Yes
16. Have the following items been reviewed ?
PART 2: INCIDENT MANAGEMENT

Have the following been reviewed with the short duration worker ?
17. The emergency response/evacuation procedures.
Error. Please Select Yes
Ramtech WES3 Systems
18. The incident reporting procedures.
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
19. Does your work involve connection or exposure to any building services ?
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 Sign-in (JSA)
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