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Berkeley Lab

Forms

Job Safety Plan and Job Briefing Forms

QEW 1 Job Safety Plan Click HERE   New!
 Download and fill with Adobe Fill & Sign!

QEW 2 / 3 Job Safety Plan Click HERE   
Extra Task Risk Assessment Worksheet
QEW 2 / 3 Job Safety Plan Google Form   
New!

QEW 2 / 3 Job Safety Plan Short Form Click HERE

Job Safety Briefing Form Click HERE

LBNL QEW 1 / 2 / 3 Online JSP Form – for use by LBNL QEWs. Contractors may use this form only with approval from their ESO.

(Downloading of these forms is strongly recommended, as they may not display/print properly in Google Docs)

QEW Field Assessment Forms

QEW 1 Field AssessmentQEW 2 Field Assessment

Electrical Injury Notification Form

This form has been migrated to an online Google Form. Click  HERE

See the Emergency Response page for more information.

 

 

 

Red Lock Keyed Alike

LOTO Procedure Template

A LOTO procedure is a formal document detailing all the steps required to establish the lockout. It is specific both to the equipment or system and to the scope of work. A LOTO procedure is required for all complex LOTOs.

View the complete process HERE.

LOTO Procedure Templatebolt cutters

Absent Person LOTO Lock Removal Form

Pub-3000, Chapter 18, Work Process O addresses Special Condition LOTO Lock Removal.

View the complete process and requirements HERE.

Absent Person Removal of LOTO Devices Form

 

Printable Barricade Signs

For use on indoor-only danger, warning, and notice barricades. Signs should be printed in color.