Lineman Job Briefing DATE MM slash DD slash YYYY Address(Required)Job Description / Work Order #(Required)Crew Leader(Required) First Last Identify The Following:Hazard(s): Electrical Contact / Flash Weather Suspended Load/ Falling Objects Traffic Tripping / Falling Insects OTHER Select AllWork Procedures To Be Used:Special Work Precautions:Energy Control Sources:PPE Requirements:PPE Used: FR Clothing / Proper Footwear Hard Hat Safety Glasses Leather Gloves Rubber Gloves Safety Harness / Fall Restraint Rubber Sleeves Chaps Hearing Protection Rubber Line Hoses Rubber Blankets Rubber Hood Covers Pole Covers Was the Job Briefing Effectively Communicated and Understood by all Involved Employees YES NO The One Call Underground Utilities Center has been Located for any Digging that is Required? YES NO Changes Made on Staking or Material Sheets Should be Noted and Proper Personnel Should be Notified. I agreeAppropriate Items Must Be Checked Direction of Feed Non-Reclose Operation De-Energize Location Rubber Gloves / Sleeve UG Facilities Located Guarding of Work Site Material Sheets Body Belt, Safety Straps / Climbers Traffic Warning Devices De-Energize Lines / Test & Ground Rubber Cover-Up Goods Check Poles and Structures Safety Check on Vehicles Select AllConsent(Required) I have discussed the job or procedure with the crew foreman or the designated employee in charge and we are prepared to complete the job or procedure. It is our opinion that the job or procedure can be completed in a safe and efficient manner. It is agreed between all employees involved that the job or procedure will be completed using all rules, regulations, and guidelines set forth by Gallatin Department of Electricity and / or OSHA.Supervisor(Required)DATE MM slash DD slash YYYY Crew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew MemberCrew Member
