KINGSVILLE FIRE DEPARTMENT
TRAINING – HAZARDS FORM
Date(s):
South Station – July 6 & 20, 2011
North Station – July 11 & 25, 2011
Completed by: Assistant Chief Jeff Dean
Location: Northeast corner of Kingsville Harbour
PPE REQUIRED – Mark (X) for each piece of PPE required
SCBA (Including Facepiece)
Safety Footwear
Bunker Coat & Pants
Work Pants
Flash Hood
Long Sleeve Shirt
Structural FF Gloves
Coveralls
Fire Helmet (With Eye Protection)
Eye Protection
Fire Boots
Hand Protection
Other : Water shoes
Hearing Protection
Head Protection
5 Point Harness
Wet / Dry / Immersion Suit
Personal Flotation Device
NOTE: Dry suit is only required for instructors if required
HAZARDS CHECKLIST – Mark (X) each hazard that is present or has the potential to be present
Physical Hazards:
Health Hazards:
P1 - Slippery surfaces
H1 - Exposure to hot surfaces / sources
P2 - Fall hazards
H2 - Inhalation – Toxic
P3 - Trip hazards
H3 - Inhalation – Oxygen deficient
P4 - Poor illumination / visibility
H4 - Inhalation – Carbon Monoxide
P5 - Structural integrity of structure
H5 - Flammable liquids
P6 - Limited access & egress
H6 - Dangerous goods present / used
P7 - Other:
H7 - Other:
Environmental Hazards:
E1 - Potential for heat stress
E2 - Cold weather conditions
E3 - Wet weather conditions
E4 - Snakes, insects, rodents, spiders, etc
E5 - Other:
Hazard(s) #:
P1
P3
P4
E1
O1
Other Hazards:
O1 - Traffic (marine included)
O2 - Terrain
O3 - Exposures
O4 - Machinery / Equipment
O5 - Other:
LIST HAZARDS CHECKED ON ABOVE TABLE
Control / Action(s) Required
Personnel will be made aware of this potential hazard
Personnel will be made aware of this hazard
Portable lighting will be set-up if required
Personnel will be monitored by lead instructor and safety officer for heat exhaustion.
Rehab will be used when required. Fluids will be available for rehydration.
Instructor #1 and Safety Officer will monitor the water way for boat traffic. Training
area will be moved to different location within harbour if required.
Training Location Site Plan
Training Area
LEAD INSTRUCTOR SIGNATURE
DATE
SAFETY OFFICER SIGNATURE
DATE
CHIEF OFFICER SIGNATURE
DATE