PDM Pre-Task Plan

5. Is there a Pre-Task Plan Board on site reflecting today's date that details ongoing tasks and a detailed plan to accomplish each task while prioritizing safety?
If yes, you will be asked to upload a photo of the board. If no, you will be asked to submit the plan digitally. *This question is required.

• Yes
• No

6. Please consider the work to be performed and check 'Yes' or 'No' *This question is required.

Space Cell	Yes	No
Does every crew member know how to use assigned tools & equipment?	Does every crew member know how to use assigned tools & equipment?: Yes	Does every crew member know how to use assigned tools & equipment?: No
Does this work require special training?	Does this work require special training?: Yes	Does this work require special training?: No
Do you need additional or special personnel to complete this task?	Do you need additional or special personnel to complete this task?: Yes	Do you need additional or special personnel to complete this task?: No
Do you need additional or special materials and tools to do the job?	Do you need additional or special materials and tools to do the job?: Yes	Do you need additional or special materials and tools to do the job?: No
Do you need to review an MSDS to proceed with this work?	Do you need to review an MSDS to proceed with this work?: Yes	Do you need to review an MSDS to proceed with this work?: No
Is there adequate lighting and access?	Is there adequate lighting and access?: Yes	Is there adequate lighting and access?: No
Will weather conditions affect the safety or quality of this work?	Will weather conditions affect the safety or quality of this work?: Yes	Will weather conditions affect the safety or quality of this work?: No
Does this task require shutdown of systems or equipment?	Does this task require shutdown of systems or equipment?: Yes	Does this task require shutdown of systems or equipment?: No
Is there any potential to impact existing Owner or Construction activities?	Is there any potential to impact existing Owner or Construction activities?: Yes	Is there any potential to impact existing Owner or Construction activities?: No
Are there occupied spaces adjacent or below?	Are there occupied spaces adjacent or below?: Yes	Are there occupied spaces adjacent or below?: No
Have shop drawings, contract drawings, and As-builts been reviewed?	Have shop drawings, contract drawings, and As-builts been reviewed?: Yes	Have shop drawings, contract drawings, and As-builts been reviewed?: No
Will there be any discharge of fluids?	Will there be any discharge of fluids?: Yes	Will there be any discharge of fluids?: No
Do other subs need to be involved?	Do other subs need to be involved?: Yes	Do other subs need to be involved?: No
Does this task require any special permits or procedures?	Does this task require any special permits or procedures?: Yes	Does this task require any special permits or procedures?: No
Employees are assigned a "buddy?"	Employees are assigned a "buddy?": Yes	Employees are assigned a "buddy?": No
Crew knows the location of fire extinguishers, eye washes, and phones?	Crew knows the location of fire extinguishers, eye washes, and phones?: Yes	Crew knows the location of fire extinguishers, eye washes, and phones?: No
Work involves awkward positions, heavy or repetitive lifting?	Work involves awkward positions, heavy or repetitive lifting?: Yes	Work involves awkward positions, heavy or repetitive lifting?: No
Do you know where the nearest Worknet location is?	Do you know where the nearest Worknet location is?: Yes	Do you know where the nearest Worknet location is?: No
Do you have a rescue plan?	Do you have a rescue plan?: Yes	Do you have a rescue plan?: No

6. Check if any of the following apply: *This question is required.

• Public Interface
• Traffic Control
• Barricades/Signs
• Confined Space
• Chemical Exposure
• Ventilation
• Electrical Hazards
• Lock-out/Tag-out
• Open Flame Welding
• Critical Lifting Plan
• MSDS/HazCom
• Fall Protection/PPE
• Hand/Arm PPE
• Full Body PPE
• Respirator PPE
• Hearing PPE
• Eye/Face PPE
• Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.