CSM008
Contractor Safety Orientation
Contractor Name:
Location & Project:
Transwestern Representative:
Field Start Date:
Attention Contractor: You must provide an interpreter for this presentation for your non-English
speaking personnel.
The Transwestern representative reviews topics below that are relevant to the project and
marks each item number that is discussed.
1.
2.
3.
4.
5.
6.
Self introduction of Company Representative
Contractor Safety Orientation Video presentation
Answer questions about the video
Special PPE requirements
Requirement to sign-in and sign-out every day including where and how it is to be done.
Requirement to report work injuries and property damage accidents verbally as soon as possible
and to provide written accident investigation reports within 5 working days.
7. Areas where smoking is permitted.
8. Areas where hearing protection is required and high noise levels are encountered.
9. The process for obtaining General Work permits and Hot work Permits.
10. The process to obtain permission to enter a confined space.
11. The sound of an emergency alarm and the place to go in case of an emergency.
12. The lockout / tagout procedures for the facility.
13. Hazardous chemicals the contractor will encounter and where they are located. Provide an MSDS
if needed.
14. Obtain a list of chemicals the contractor will bring to the project. Obtain an MSDS if needed.
15. Areas where asbestos will be encountered by the contractor.
16. Areas where lead will be encountered by the contractor.
17. Explain the labeling system on tanks and containers that contain hazardous materials.
18. Tools and equipment the contractor may use as stated in the contract or written agreement.
19. Housekeeping requirements: Cleanup is required at the end of each day and throughout the day
as needed. Clutter must be managed so that operations personnel are not endangered by it.
20. Speed limits.
21. Restricted areas that contractors may not enter.
22. Only supervisors may carry a cell phone. In their absence, a crew leader may carry one.
23. No one may carry a cell phone in gaseous areas or while operating mobile equipment such as
back hoes, cranes, dozers, etc.
24. Conduct a job site walk-through to identify and correct potential hazards that should be addressed
before the job starts.
The contractor supervisor and his personnel sign this document in the appropriate spaces
provided below.
Contractor Supervisor Statement:
I understand and agree to follow the safety practices and policies explained in the Contractor Safety
Orientation Program that I attended today. I will ensure that workers under my supervision, including
those who do not speak English and any subcontractor's workers who have not attended the
Contractor Safety Orientation program also understand and follow the safety practices and policies.
Print Name
Sign Name
Date
Contractor Employee Statement:
I understand and agree to follow the safety practices and policies explained in the Contractor Safety
Orientation Program that I attended today.
Print Name
Sign Name
Retention: Send an electronic copy of the completed form to the Safety Operations Analyst.
Date