Focus on Jobs Rarely Done

(Modify the form as needed to have as much room as you need for each question)

1. List the jobs and tasks that are rarely performed, but can be very hazardous when they are performed:

2. For each of the jobs/tasks you listed in #1, when/where are these jobs/tasks usually performed?

3. For each of the jobs/tasks you listed in #1, what are the particular hazards associated with performing that job/task?

4. For each of the jobs/tasks you listed in #1, do you know of any injuries, illnesses or fatalities that have resulted from the performing of that job or task in your workplace? (If yes, give a summary of information that you have about the injury/illness/fatality).

5. For each of the jobs/tasks that you listed in #1, what hazard control measures are currently in place when the job/task is performed to reduce the chances of death or serious physical harm occurring?

6. For each of the jobs/tasks that you listed in #1, add any ideas you may have for additional hazard control measures that should be in place (but are not currently in place when the job/task is performed) that would reduce or eliminate the chance of death or serious physical harm from occurring. (Include here traditional hazard control measures as well as factors such as staffing levels, extended working hours/days,  production pressures, training, etc.)

7. Anything else you would like to add about jobs/tasks that are rarely performed, but carry with them large risk for serious injury, illness or death:

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