14.2 Health, Safety & Environmental Forms (Blank)

Safety Shoe/Boot Purchase Authorization Form

  • Safety Footwear Purchase Authorization Form M004s00900

Crane, Hoist & Rigging

  • M1 Primary Mirror Crane Pre-Fly Checklist M004s00030
  • Load Test Template for Lifting Fixtures & Platforms M004s00041
  • Critical Lift Plan (CLP) Template M004s00039

Lockout Tagout (LOTO)

  • Log (Blank) Telescope, Level 5 Control Room M004s00405
  • Log (Blank) Upper Right Treehouse M004s00404
  • Log (Blank) Level 4 MCC M004s00403
  • Log (Blank) Level 9 Catwalk & Upper Roof M004s00406
  • LOTO Procedure Template UA Document (.doc) (.pdf)
  • Alternative Means to LOTO Evaluation Form M004s00051

Lifts (Scissor/Boom) & Fork Truck

  • JLG Scissor Lift Pre-Use Inspection Log (Blank) M004s90040
  • Genie Scissor Lift Pre-Use Inspection Log (Blank) M004s90041
  • Genie Boom Lift Pre-Use Inspection Log (Blank) M004s90042
  • Fork Truck Pre-Use Inspection Log (Blank) M004s90043

Hazmat Transportation

  • Hazmat Shipping Papers Template M004s00581 PDF or MS Word

Machine Shop

  • 3-Lower Machine Shop Training Form & Equipment List M004s00252: GENERAL
  • 3-Lower Machine Shop Training Form & Equipment List M004s00253: MILL & LATHE ONLY
  • Machine-Specific Staff Training Matrix for 3L Shop Google Drive Link

Confined Space

Freon Refrigerant Compliance

  • 1-Time Refrigerant Activity Report (RAR) M004s00561
  • Ongoing Refrigerant Master Log (Blank) M004s00562

Hazard & Risk Assessment (HSE Manual Chapter 4.13)

  • System Hazard Identification & Risk Assessment Worksheet M004s00805
  • Job Safety Analysis (JSA) Tool M004s00801
  • Pre-Task Plan (PTP) Tool M004s00021
  • Personal Protective Equipment (PPE) Evaluation Form M004s00902
  • Personnel Hazard Identification & Risk Assessment Worksheet M004s00802
  • Safety Inspection Walkthrough Checklist M004s00803
  • Failure Mode, Effects & Criticality Analysis (FMECA) Tool M004s00804

Planning

  • M1 Primary Mirror Crane Pre-Fly Checklist M004s00030
  • Fall Rescue Plan Template M004s00702
  • Drop Prevention Tool & Personnel Tethering Checklist M004s00031
  • Restricted Access/Communications to Observatory Planning Tool M004s00323
  • Also see "Hazard & Risk Assessment" Section above, which includes:

Emergency Response

Equipment Sign-Off

Training

  • New Employee/Visitor Walkthrough Checklist for Site Safety Orientation M004s00063
  • Acknowledgement of Safety Requirements Form M004s00060

Lessons Learned for Continual Improvement

-- DavidCarroll - 13 Oct 2020
Topic revision: r10 - 05 Apr 2024, DavidCarroll
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