Y	N	NA	Pre-Work			Y	N	NA
			Tailgate AOCs		MSDS Sheets Available
			Locates		Evacuation Route & Assembly Point
			Training/OQ		Other
			Workers Physically Rady To Work
			Vehicle Safety
			Pre-trip Inspection		Fire Extinguisher
			Chock Blocks		First Aid Kit
			Personal Protective Equipment
			Hardhat w/ Bill Forward		Welding Hood & Gloves
			Reflective Vest		Face Shield
			Steeltoe Boots		Googles
			Safety Glasses w/ Side Shields		Respiratory/Dust Mask
			Work Gloves		Fire Suit
			Hearing Protection		Other
			100% Cotton Clothing
			Hazard Evaluation
			Moving Object/Equipment		Lock Out/Tag Out
			Excavations		Extreme Noise
			Confined Space		Flammable/Combustible Gasses or Liquids
			Traffic Control		Lifting/Pulling/Pushing
			Pedestrian Foot Traffic		Asbestos/Lead Exposure
			Fall Protection (6' or greater)		Contacting ElectricalCurrent
			Extreme Heat/Cold		Other
			Hazard Control Tips
			Eliminate Hazard		Good Work Practices
			Isolate Worder from Hazard		Proper PPE
			Substitute Hazard w/Less Severe		Ventilation of Area
			Change Work PlanorMethod		Other
			Safety Equipment
			Signs		Air Monitoring Equipemnt
			Cones/Barrells		Slings/Chokers Inspected
			Fall Protection Equipment		Electrical Cords Inspected
			Ladder		GCFI Working
			*In ditch over 4ft deep, must extend 3ft over top edge		Safety Pins in Airhoses
			*No further than 25ft from anyemployee		Other

Sequence of Basic Job Steps	Identify All Hazards/AOCs Found	How Will You El