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It also asks for confirmation that each employee inspected their PPE and then records GAR verbal status and approvals in the chart.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},307373,1790182596,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":8,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},137455076865,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Pre-Job Briefing/  \nJob Safety Analysis (JSA) Form  \n05132024-01  \nDate:   Person Completing Form:   Supervisor:    \nWork Location/Address:   City/Town:   Time:    AM  PM GPS Coordinates:    \nNearest Intersection:   Landmark:   Temperature for applicable conditions:   Weather Conditions:  Sunny  Cloudy  Rain  Snow  Ice  Wind Are weather conditions appropriate for the work to be conducted?  Yes  No If No, find appropriate job site or task or suspend operations.  \nEmergency Action Plan  \nArea 911:  Yes  No If No, EMS/Fire phone number:   Aerial Rescue Person:   911 Caller:   CPR and First Aid Trained crew members available?  Yes  No First Aid/CPR Provider:   First Aid Supplies Onsite:   Closest Medical Facility (Name):   Contact \\#:   Address:    \nWork or Training Task  \n Training  Work Related (select one)  \nJob Tasks:  Driving  Inspection/Auditing  Traffic Control  Bucket Trim  Ground Cutting  Climbing  Brush Chipping  Tree Removal  Stump Grinding  Crane  Heavy Equipment Operation  \nIdentify any Heavy Equipment used:   Other Tasks (describe):    \nElectrical Safety  \nAre electric utilities present in or near your work area?  Yes  No Are the students/attendees QLCA Trained?  Yes  No Is the work taking place for a utility contractor or subcontractor?  Yes  No  \nUtility Company:   Pole or Structure \\#:   Utility & Contact Number:   Line kV:   MAD:    \nIncidental Line Clearance MAD Chart Minimum Approach Distances from Energized Conductors  \nVoltage Range (Phase-to-Phase) kV 0.300 and less  \nMinimum Approach Distance (MAD)  \nft-in m  \nAvoid Contact  \n 0.301 to 0.750 1-06 0.457   \nVoltage Range  \nAltitude Correction Factor Sea Level to  \n5,000 ft  \nAltitude Correction 5,000 to 10,000 ft  \nAltitude Correction 10,000 to 14,000 ft  \n kV ft-in m ft-in m ft-in m   \n0.300 and less Avoid Contact Avoid Contact Avoid Contact  \nVerification of Di-Electric test date (MM/YY): Insulated Tool  \nInsulated Pole Saw (Solid Core Only):   Insulated Boom:   Insulated Pole Pruner (Solid Core Only):   Other:    \nTopics of Discussion (Hazards, Risks and Potential Impacts)  \nHazard Control Measures  \nLeast Effective Most Effective  \nHierarchy of Controls  \nElimination  \nSubstitution  \nEngineering Controls  \nPhysically remove the hazard  \nReplace the hazard  \nIsolate people from the hazard  \nChange the way people work  \nProtect the worker with  \nPersonal Protective Equipment  \nSource: NIOSH  \nIdentify type & \\# of Signs & Cones:  \nSign type:   \\#:    \nCone type:   \\#:    \nIs Drop zone sufficient to drop debris away from obstacles?  Yes  No If no, select other means of controlling debris/drop zone.  \nJob Site Hazard Control (describe how you are going to control hazards, risks, and potential impacts):  \nTraffic Control Flagger Initials  \nPersonal Protective Equipment Required  \nHas every employee inspected their Personal Protective Equipment?  \nHead Protection  \nHard Hat/ Helmet (ANSI Z89)  \nFace Shield  \n(When Required)  \nEye Protection  \nSafety Glasses or Eye shield (ANSI Z87 . 1)  \nEar Protection  \n Hearing Protection  \nFoot Protection  \n Boots OR  \n Cut-Resistant Boots  \n Yes  \n No  \nLeg Protection Fall Protection  \n Chainsaw Pants OR  \n Chainsaw Chaps  \nVisibility  \n Class 2 Hi-Vis Shirt/Vest  \n Fall Restraint  Work Position  \n Fall Suspension  \n Fall Arrest  \nHand Protection  \nGloves/Cut-resistant gloves (ANSI 105)  \nPlease designate one person on your crew to capture all required information. Through verbal responses from crew members, the transcriber will report all opinions and positions utilizing the GAR model and will document each individual’s response in the chart above next to the appropriate name.  \n\n| Employee \\# | Name | Verbal Status (GAR) |\n| --- | --- | --- |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n\nThe Green, Amber, Red (GAR) Model  \nThe Green, Amber, Red or (G.A.R.) Model is a work risk management model that includes and values the opinions and positions of all workers involved on a work project/site. There is ","cbCaiiikyvtNKM23","https://ap.wps.com/l/cbCaiiikyvtNKM23","pdf",349038,"English","# Pre-Job Briefing / Job Safety Analysis (JSA) Form\n## Emergency Action Plan\n## Work or Training Task\n## Electrical Safety\n## Topics of Discussion, Hazard Control Measures\n## Personal Protective Equipment Required\n## GAR Model and Job Site Visit","[{\"question\":\"What information does the form collect during the pre-job briefing?\",\"answer\":\"It records date, person completing the form, supervisor, work location, nearest intersection/landmark, time, GPS coordinates, applicable temperature and weather conditions, and whether conditions are appropriate for the work.\"},{\"question\":\"How does the form handle emergencies and first aid readiness?\",\"answer\":\"It provides fields for the emergency action plan, including whether Area 911 is required, the EMS/fire phone number, aerial rescue person, 911 caller, availability of CPR and first-aid trained crew members, first-aid provider and supplies onsite, plus the closest medical facility and contact details.\"},{\"question\":\"What safety controls and PPE documentation are required?\",\"answer\":\"The form requires hazard control measures using the hierarchy of controls, including elimination through personal protective equipment, and it lists required PPE types. It also asks for confirmation that each employee inspected their PPE and then records GAR verbal status and approvals in the chart.\"}]","Pre-Job Briefing - Job Safety Analysis (JSA) Form - 05-2 | PDF",1789848513]