Visitor Safety Briefing and Instructions

Site Name

SunVest/Rethink/PEEC Employee Name

First NameLast Name

Date/Time

Date

24-hour Format Minutes

Does the visitor(s) have the site name and address for calling 911?

Does the visitor(s) have the name and phone number of one employee?

Has the visitor(s) been informed of the work being performed on site during their time on site?

Has the visitor(s) been informed of the high energy hazards of the work being performed?

Has the visitor(s) been informed of the exclusion areas?

Does the visitor need fall protection (PFAS)?

Does the visitor(s) need to perform any work on site other than observation or photographs? If yes, complete a JHA Process Form. If no, sign below:

I have provided the visitor(s) with the information required above and verified that they understand the site specific hazards, the exclusion areas, and the need for an escort while on site.

SunVest/Rethink/PEEC Employee Name

First NameLast Name

Employee Signature

Name

First NameLast Name

I have received sufficient information to comply with the rules and expectations for conduct on the site, have contact and location information, and agree to comply with site rules and instructions of host personnel.

Visitor Name

First NameLast Name

Visitor Signature