Site Specific Orientation

Ottawa OLRT Specific Orientation

COMPANY NAME
WORKER'S NAME
PROJECT SUPERVISOR
ORIENTATION DATE

MonthDayYear
Date
Project Name:
Did you receive a KEV orientation in the last 12 months
If so, Location?
Do you have up-to-date Fall Protection/Working at Heights Training?
If you answered "No" to the question above your tasks must exclude working above 6 feet, working on any form of Elevating Work Platform, working in proximity to edges or anywhere a fall hazard exists.
1. Job Hazards
1.a.) If "Yes" select all Job Hazards that apply:
1.b.) If Other is selected from Job Hazards. Specify:
2. An overview of PCL's policies, practices, and procedures (HSE Policy, Fall protection, Workplace violence and harassment, Environmental)
3. An overview of PCL's firearms, drug and alcohol policies (review drug and alcohol testing)
4. Review of the project site plot plan including location of muster areas, first aid stations, spill kits, etc.
5. Use of a fire extinguisher (Pull, Aim (at base of fire), Squeeze, Sweep)
6. Medical facilities and services on and off the job (KEV nurse, nearest hospital, closest clinic)
7. Responsibility to provide first aid coverage
8. On-site fire prevention, emergency notification, and emergency response plan, report to PCL
9. Project fall protection plan requirements
10. Emergency response for spills
11. Mandatory attendance at HSE Field Meetings, CVIS, JHSC
12. Regular hours of work, lunch breaks, and coffee breaks
13. Project Specific Requirements:
13.a.) If "Yes" select all Project Specific Requirements that apply:
13.b.) If "Other" is selected. Specify:
14. A representative of project management was introduced to you and explained their own commitment to HSE on the project
PRE-JOB SAFETY INSTRUCTION (PSI) PROGRAM & JOB HAZARD ANALYSIS (JHA) PROGRAM
15. Pre-Job Safety Instruction (PSI) and the following steps:
15.a.) recognizing potential hazards?
15.b.) controlling potential hazards?
15.c.) minimizing exposure to potential hazards?
16. The worker should request a PSI and a JHA, if applicable, from his foreman upon leaving this orientation and joining his/her crew. JHA should be part of approved workplan
17. Additional PPE Requirements (KEV PPE Poster Guide)
Workers Signature
Facilitators Name
Facilitators Signature
This form will be retained on file at the project work site location.
Should be Empty:

If you answered "No" to the question above your tasks must exclude working above 6 feet, working on any form of Elevating Work Platform, working in proximity to edges or anywhere a fall hazard exists.