Daily Job Site Safety Briefing Form

A daily safety briefing to record weather conditions, the work environment, protective equipment, and hazards before the crew starts work on site.

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Office Location*

Today's Date*

Time*

Employee #1*

Employee #2

Employee #1 Has All PPE?*

Employee #2 Has All PPE?

Has Hastings Stick Been Properly Inspected and Determined Safe To Use?*

What Job Task is Being Done Today?*

Location of Job Site*

Name and Distance to Closest Medical Facility*

Temperature*

Sky Condition*

Precipitation*

Work Environment Hazard Assessment

What type of environment is your job located in?*

Utilities Next to Road: Vehicular Traffic, Working and Walking, City or Rural*

Vehicular Traffic Working and Walking City Rural

Utilities at Rear of Lot: Fenced or Open, Residential or Commercial, City or Rural*

Fenced Open Residential Commercial City Rural

Environmental: Insects, Foliage & Weather- What do you anticipate encountering?*

Insects Foliage Weather

Utilities, Poles and Spans*

Utilities Poles Spans

What is the posted speed limit in your work area?*

What class safety vest must be worn?*

Final Safety Check

Comments, Notes and Observations

Has your job site been deemed safe to proceed for work?*

Yes No

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