Company Name * Input the full name of your company. Trade * Input your company trade. Foreman or Supervisor * Input the first and last name of your company on-site foreman or supervisor. First Name Last Name Work Activity * Describe your work task. (Example: framing, steel erection, masonry, etc.) Site Conditions & Hazards * Provide information relating to the work area conditions, or specific hazards present on the particular site where the work is being performed (example: overhead powerlines, equipment or vehicular traffic, fall hazards). Project Address * Input the full address of the work site. Project General Contractor * Input the full company name of the project general contractor. Project Name * Input the full project name. Project Site Supervisor * Input the name of the general contractor site supervisor. First Name Last Name Email * Name First Name Last Name Equipment * Indicate the equipment that will be used for your task, or select "No Equipment to be Used". Power Elevating Work Platform (Scissor Lift) Rough Terrain Telehandler In-Door Forklift Mini-Excavator Excavator Skid Steer Backhoe Loader Front Loader Mobile Crane No Equipment to be Used Equipment Not Listed If the equipment to perform your tasks isn't listed above, please write it below. Thank you!
