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F7, <br /> Daily Deft teaf °k_ ��- � �SSP <br /> 2870 Gateway Males.Drive,Sum 300 UkS PI'ojt g: Vr;!� 7�4 �� <br /> ' Sacramento,CA 93833 Afe <br /> Cofnpleted by: °' 1 Empla No.: 7lrne: OV30 <br /> Approved by: _ - Employ me talo.. ©am., Time: <br /> �-. Staff work-in under Permit l m I # Si l <br /> G MOWate <br /> S cA t(w` <br /> i : Standard <br /> Ward h lasses,steel tee boots ae sc;or erw cetai — ane, "gift asWa wo erttanin ll l <br /> and ire uislrorto be on tack <br /> Review and sign off on WASP ar orlc IlmFto em or frictions to be corF munkmted to Sh <br /> r 'I'=bs JS SOPs,or SIS <br /> ,I es t7No <br /> a Dyes [_Jiro <br /> Mes ONO <br /> byes Na <br /> FOYes <br /> yes GNd <br /> © es DNO <br /> © YeS ©I�1D <br /> k 0 es MNo <br /> UNo <br /> Questions to cQuWder <br /> Dave this#este{s)prevzsty?If x�o to #ash a�avrar no�discuss with ervir. es ❑No <br /> Has odr URS sMff ese and thm <br /> t (s)be,€are. Discuss with ti�sun and/or aSls iFar asaistanoe. . <br /> Ane you hysirl and unema#ly " ble of ibis tasks}? ©Na <br /> Are you traind or far this 1�r(s)? Yes 11 No <br /> 4 , , <br /> es ©No <br /> Does Buis teak regtasxe a pe ca�fialad bot worts,etc)?C.bapl the s). 11 Yes <br /> o <br /> Is heavy equipment(ftkI t,manta lradthoe,escavafiar,etc)bene used for tts tww l�spectitin and ❑Yes o <br /> docu nma6m eel. i <br /> b excavation required for this task?Have appropriate oncroachnzent permft,USA clearance,BeoPhysical ❑Yes o <br /> clearan and cliieWtmm�am <br /> Are there any Near lasses,Incident Reports,or BBS oirser #a tat should be reviewed prior to <br /> thig tawslc s)7 ❑#do <br /> Dm this work amt any a ffi ar US Pammel or prnjeCU?Review and cue ices to Ym ❑No <br /> Are any power tools being used.for this ftws)?Inspect primo to uta. <br /> ❑Yes o <br /> Does this masks)involve working on systemthat canto start op*mem or mw live cluneal?FoHow ❑Yes No <br /> Ft�Icrcicotrt! r�erk <br /> Does this Task invcylve near live el qx !Cal oil thief cm not be elite or aontrvliaed? ❑Yes No <br /> Is a reWindor remd far this tom?Fit test to daft? r ? ❑Yes 2WO <br /> Is Ads task being performed off read?Ate:there arty residc='W E13 <br /> ues? ❑Yea No <br /> Is the an sod on this twk? era and�� Yes No <br /> Are s aonuadom to be i for this task?Fgllow SMS 46 Q Yes ZINO <br /> Notifications 'r <br /> Clies;t. <br /> Tea�C; <br /> F�eZdll'asknamsm <br /> I'ro ect . <br />