Example Pre Task Plan Worksheet Harvard University

Summary

EXAMPLE PRE-TASK PLAN WORKSHEET
A Pre- Task Plan is required for every activity at Harvard
Contractor Name: ________________________ Start Date: _____/_____/_____ Finish Date: _____/_____/_____
Work Plan Author: _______________________ Phone No. __________________ DirectConnect #: _____________
Project Supt. ____________________________ Phone No. __________________ DirectConnect #: _____________
Safety Rep. Name: ________________________ Phone No. __________________ DirectConnect #: _____________
Location of Work: ______________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
ANSWER THE FOLLOWING QUESTIONS. ADDRESS ‘YES’ ANSWERS IN THE WORK PLAN
YES NO N/A
Will task require working on or around live systems or equipment?
Does the task require any emergency equipment to be available or on standby?
Fire Extinguishers, Eye Wash Stations/ Showers, Phones? Circle Each Needed
Has the work been coordinated with other crafts in the area?
Are the shop drawings, panel schedules, or as-builts needed to complete this task?
Does this task require special permits/procedures?
Are additional personnel needed to complete this task safely?
Does this task require special training (40-Hour HAZWOPER, etc)?
Do you need to review an MSDS to proceed with this task?
Will weather or other working conditions affect the safe completion of this task?
Will you need additional materials, tools or equipment to perform the task safely
Will workers need PPE training to complete task? Will this task generate hazardous waste or material?
Will this task impact any pollution prevention systems? (Wastewater, Stormwater system)
Will the task introduce live chemical into the system?
Will the task produce significant amounts of dust/fumes/noise/vibration/odors? Circle Each
Will the work be conducted above six (6) feet?
Will the task cause any interruptions to Harvard Properties?
Will any work use clean steam or hot water?
Will lifting equipment be used? ( Lulls, Cranes, Backhoes, etc.)
Will mobile elevated work platforms (MEWPs) be used?
Will the task create hazards to people working below?
Will the task affect perimeter security, or security equipment?
Will the task require the addition or deletion of security equipment?
Has Lock Out/Tag Out (LO/TO) of all Hazardous Energy been preformed?
Are any of the following permits or forms required? (Mark all that apply. Permits must be attached to PTP)
[ ] Hot Work Permit [ ] Confined Space Entry [ ] Excavation Permit [ ] Lock Out/Tag Out
[ ] Fuel Storage Permit [ ] Road Closure Permit [ ] Critical Lift Plan [ ] Sidewalk Closure
Which of the following Personal Protective Equipment will be required during this task (Mark all that apply)
[ ] Safety Glasses [ ] Hard Hat [ ] Leather Gloves [ ] Kevlar Gloves
[ ] Safety Goggles [ ] Hearing Protection [ ] Chemical Gloves [ ] Rain Gear
[ ] Face Shield [ ] Steel Toed Boots [ ] Electrical Gloves [ ] Tyvek Suit
[ ] Cutting Goggles [ ] Meta Tarsal Protect. [ ] Fingerless Gloves [ ] Poly-Coated Tyvek
[ ] Welding Shield [ ] Welding Screen [ ] Welding Gloves [ ] Chaps
[ ] 1/2 Face Respirator [ ] Full Face Resp. [ ] Tripod/Winch [ ] Reflective Vest
Pre-Task Plans must be submitted to Contractor Safety Officer 24-hours in advance of the Start of the Task

Approval Signatures:
Work Plan Author: _____________________________________________________________________________
(Print Name) (Signature) (Date)
Area Superintendent: ____________________________________________________________________________
(Print Name) (Signature) (Date)
Project Safety Manager: __________________________________________________________________________
(Print Name) (Signature) (Date)
02/2019 Page 1 of 2
Copyrighted © 2019 President and Fellows of Harvard College
EXAMPLE PRE-TASK PLAN WORKSHEET
WORK PLAN
A Pre- Task Plan is required for every activity at Harvard
STEPS REQUIRED TO ASSOCIATED ACTIONS TO ELIMINATE OR RESPONSIBLE
# COMPLETE TASK HAZARDS CONTROL THE HAZARDS PERSON
Signature (Supervisor): Date:
_____________________________________________________________________________________________
Signatures (Crew): Date:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
02/2019 Page 2 of 2
Copyrighted © 2019 President and Fellows of Harvard College

ADDRESS ‘YES’ ANSWERS IN THE WORK PLAN . YES NO N/A Will task require working on or around live systems or equipment? Does the task require any emergency equipment to be …

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Frequently Asked Questions

What is a pre task plan?

EXAMPLE PRE-TASK PLAN WORKSHEET WORK PLAN A Pre- Task Plan is required for every activity at Harvard STEPS REQUIRED TO COMPLETE TASK ASSOCIATED HAZARDS ACTIONS TO ELIMINATE OR CONTROL THE HAZARDS RESPONSIBLE PERSON Signature (Supervisor): Date: Signatures (Crew): Date: Title APPENDIX A – PROJECT SUBMITTAL LIST Author Administrator

What is an example of a project task?

For example, let’s say the project task is to flat saw a six inch thick slab of concrete. One of the first things that need to be done is for the supervisor or person in charge of the project, to walk the site with the customer (and walk the site solo) to identify potential hazards, such as:

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