Workplace safety assessment forms play an important role in protecting industry workers by ensuring trained professionals consider all potential hazards prior to work commencing. All assessment forms shared here have been provided to STAC by various STAC Members. Additional forms will be posted as they are made available. To submit a form, please contact info@stacouncil.ca

 

COVID-19 Template Checklist

The COVID-19 Template Checklist provides tower companies with information about protecting employees from the spread of COVID-19, and contains individual checklists for a variety of situations tower crews encounter on a near-daily basis, including:

• Accessing Shared Locations
• Tower Site Safety
• Rooftop Site Safety
• Vehicle Safety
• Restaurant Safety
• Public Restroom Safety

This document is also available in French.

 

Pre-Job Survey FormPre-Job Survey

The Pre-Job Survey Form requires crews to identify basic work-site and safety information and includes the following sections:

  • site info
  • emergency contact info
  • project personnel, structural hazard checklist
  • overall hazard checklist
  • job site exposures and hazard identification
  • hazard control measures
  • civil work information
  • tower work information

 

 

Job Hazard Assessment FormJob Hazard Assessment Form

The Job Hazard Assessment Form is a standard industry checklist designed to ensure crews have properly reviewed a wide variety of potential hazards prior to each day of work. Form sections include:

  • site info
  • emergency contact info
  • pre-job check list
  • structural check
  • fall protection and site specific rescue plan
  • job site work, hazard identification and controls
  • last five minutes
  • hazard identification & control job aid

 

Pre-Job EMF Assessment Form

The Pre-Job EMF Assessment Form is designed to help workers ensure that all sources of potential RF and microwave safety hazards are taken into consideration on a job site. This form aids workers in thinking about the potential hazards they could encounter during any given job, and to document that those hazards have been taken into consideration when planning work activities. Form sections include:

  • site transmitter info
  • hazard identification
  • safety controls

 

PPE Inventory Management Form

The PPE Inventory Management Form was designed to help companies manage their PPE and track the expiry date and certification of each PPE item in their inventory.

This customizable form includes instructions on how to ensure your company’s specific PPE items are represented on the form, and allows companies to track each item by:

  • The name of the employee it was issued to
  • The name of the manager who issued it
  • Manufacturer
  • CSA/ANSI standard
  • Model number
  • Serial/Product ID number
  • Manufacturer/Tag date
  • Cost
  • Supplier
  • Department
  • Office/Location
  • Issue date
  • Status
  • Last inspection date
  • Next annual inspection date
  • Expected expiry date
  • Recertification date
  • Retired date