BHA Cutting Disc Approval Form

Cutting Disc Approval Form

PCL HSE OPERATING PROCEDURES (Procedure HSEOP-25-01)
Project #*
Project Name*
Submitted by*
Your Name
Work Area*
Note: This field determines who your request will be sent to. Please ensure that this Area lines up with your approving PCL authority.
Work Area*
Note: This field determines who your request will be sent to. Please ensure that this Area lines up with your approving PCL authority.
Email*
your_email@example.com
Date*

MonthDayYear
Date Required*

MonthDayYear
IMPORTANT: Once approved, you will receive a watermarked PDF of this form to be used as a permit. The permit will be valid for 24h from the Date Required.
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
1. Does the RPM rating of disc match the grinder being used?*

YesNo
2. How will the material be cut and secured.*
3. Has the competency of the worker using the grinder been verified?*

YesNo
Years of Experience*
Trade level*
4. Has the worker seen the “The Grind” training video?*

YesNo
Approved by:*
Project Superintendent
Signature:*
Date Approved:*

MonthDayYear
Date
Should be Empty:

Cutting Disc Approval Form