Appendices

Use of these forms is required where applicable to ensure consistency in the implementation and delivery of the Polygon Construction Management Ltd. Health & Safety Program across all Project Sites. Some of these forms will need to be posted in the one or more locations in the workplace.

See the Guidelines for clarifcation and guidance on their use, but please do not hesitate to contact the PCML Safety Manager if you have questions.

PCML Safety Manager
(604) 871-4248
safety@polyhomes.com

Table of Contents

• Site Safety Orientation - All Workers
• Site Safety Orientation - Supervisor
• Site Safety Orientation - Crane Operator
• Site Safety Orientation - Concrete Pump Operator
• Site Safety Orientation - First Aid Attendant
• First Aid Assessment
• After Hours Safety Coverage
• First Aid Record
• Emergency Contacts
• Emergency Procedures - First Aid and Fire Evacuation
• Appendix E1 - Dedicated Emergency Platform (D.E.P.) Critical Lift Plan
• Daily Safety Inspections
• Daily Safety Notes
• Safety Violation Notice
• Incident Investigation - Preliminary
• Incident Investigation - Worker Statement
• Permit - Ground Disturbance (Excavation)
• Permit - Hot Work
• Weekly Record of Site Safety Activity