Installer Jobsite Hazard

Case Number: 00718521 Author: Alexander Artherton Date/Time: 3/24/2023 7:02 PM
Address: 36.53135-120.435451 Customer Name: Jesus Rivera Job Number:
Roof Pitch: Supervisor Name: Damon Paz Supervisor Number: null
Expected Temperature: Expected Weather Conditions: Workscope:
All sites upon leaving MUST be cleaner than when we arrived. No unWired Broadband property shall be left onsite.
Emergency Action Plan
Make sure your site diagram is uploaded to Schedulo. This needs to be an overhead shot of the jobsites that includes:
An X for the jobsite safe meeting area where all parties will meet in case of emergency
A drawn route of the emergency escape route from the jobsite to the safe meeting area in case of emergency. The nearest first responders contact information is located in the job.
Personal Protective Equipment
Drinking WaterSafety BootsBody Harness
Hazard Assessment
Falling From HeightAwkward LifitingSlips Trips or Falls
Hazard Assessment Mitigations
Falling From Height Mitigations:
Awkward Lifting Mitigations:
Installation Work
Vehicle maintenance up to date
Pre use inspection has been completed
Tools inspected
Extension cords inspected
Personnel trained or qualified to use tools on site
Fall protection is needed
Fall protection has been inspected prior to use
Ladder has been inspected prior to use
Ladder placement will be in a position where the 4 to 1 ratio will be used
Oxygen Level
Hydrogen Sulfide Level
Carbon Monoxide Level
Combustable Gas Level
Our Anchor point will be which we have deemed to be capable of 5,000lbs per person attached. If no anchor point can be used, engineered fall protection must be used such as handrails, scaffolding, ect...
Onsite Names

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Signature Certificate
Document name: ja-{{ninja-field-id-90}}
lock iconUnique Document ID: 240561034029b7e7cec6b23bbb06ee79d9a660e5
Timestamp Audit
July 7, 2020 2:33 pm PDTja-{{ninja-field-id-90}} Uploaded by James Kinler - jkinler@getunwired.com IP