This form should be completed before beginning any non-routine task.
What is a "Take 5 Form"
This is the name of the Model Program that ensures all energy sources are at a zero-state before any work begins.
What is the "LOTO Model Program"
This is defined as "A space which by design has limited openings for entry and exit, unfavorable natural ventilation, and is not intended for continuous employee occupancy."
What is a "Confined Space"
Fall Protection is required anytime this cannot be maintained while working from a ladder.
What is "3-Points of Contact"
This is what "GHS" stands for.
What is "Globally Harmonized System"
USG defines this as "A task that is done less than once a week or if you have never completed the task before."
What is a "Non-Routine Task"
This is the first step in the LOTO process.
Prepare for shutdown by notifying affected employees and reviewing the LOTO procedures of the particular equipment.
A confined Space Entry occurs anytime this happens.
What is "When the plane of entry into a confined space is broken by any part of your body."
Fill in the blank " ________ _______ must withstand 5,000 pounds of force and be independent of anchorage to support or suspend platforms."
What is "Anchor Points"
This is the name of the form that details the contents, hazards, proper-use directives, and emergency protocols.
What is an "SDS"
This is defined as "A source of Danger"
What is a "hazard"
This is the second step of the LOTO steps.
What is "Prepare for Shutdown"
Besides filling out a Confined Space Permit this also needs to be conducted prior and during any confined space entry.
What is "Air Monitoring"
Fall protection is required at this height.
What is 4ft or higher.
This is the name of the online company that handles and documents our SDS's and can be found on USG Connections under the Safety heading.
What is "3E"
This form accompanies the Take 5 form and helps evaluate and examine the plan.
What is the "Risk Meter"
This is the third step in LOTO
Identify, isolate and release all energy sources.
All confined spaces must have these two items to ensure unauthorized access does not occur.
What is signage and a lock.
Fill in the blank "MSHA requires mine operators to provide a fall protection harness and _______ to each miner who may work at unprotected heights."
What is "Lanyard"
This is how many Pictograms the GHS uses for labeling purposes.
What is "9"
This needs to be completed by a "Competent Person" at the beginning of each shift before workers are allowed to enter the work area.
What is "Workplace Examinations"
This is the 4th, 5th and 6th step to LOTO
4. Apply LOTO locks
5. Release any energy or block.
6. Try to turn it on.
This is defined as an "Atmosphere that contains a substance or mixture that displaces oxygen in the ambient atmosphere and can cause oxygen deprivation those who are exposed."
What is an "Asphyxiating Atmosphere"
Fill in the blank "Fall Protection is the __ most cited violation from MSHA."
What is "3rd"
This is the number of sections contained within an SDS.
What is "16"