Site Specific Orientation ChecklistSubmitted by:(Required)Select a NameRobert JohnsenRobert JohnsonAaron JacquesAhmed Lindseyandrewowen21Anthony LightawesomecompanyBenjamin MecklenburgBenson NdunguBilly JohnsonBrandon BennettBrett ChalcraftBrock RobinsonBryan RogersBunnason Khuncandice3455Casey EnfieldChris LaneChris JenkinsChristopher ClarkChristopher KunnenCody MorrisCraig CollinsCreole Enrico-JohnsonCynthia PowerDakota PottsDale StoutDaniel HillikerDaniel FletcherDaniel SmithDaniel StonerDan MeadDanny PattersonDarryl BoyerDavid KelloggDavid MaddenAndrew OwenDennis BlakleyDiego OsorioDominic SmithDouglas SkagenDustin IveyDustin DavisDustin JonesElliot GarciaEric MoeEric ParisErik GladsjoFoushee123Garrett CollomGary ParshallgoodfellowbrosGregory SmithHenry LuceroAlejandro HernandezIntegrity SafetyAARON WRIGHTIrma ZamoraJacob McCrayJames CullumJames HardyJennifer MoreauJesse ButtsJessica BarendregtJoel CovingtonJohn NoldJonathan BeckJonathon MontanoJoseph ChastainJosephus PinoteJoshua CraigJoshua MoreauJsaac CullumJohn SchuhJuan LuevanoKelly FrankKent KrahmerKyle DamonlastLee JonesMarcos HerreraMario LuevanoMatthew BibbyMax JewettMichael DaravongMitchell BohnNate JuenNewestNghia NguyenNorm HooklandNW CascadePapeGroupPaul CoddePaul HamiltonPhilip DoveRamon ContrerasDick BeithRobert BatesRobert ChaconRobert WrightRobinson ConstructionRon FlemingRob VirtueSean CoulterSeav SourStacie RogersStephen BowdishStephen JohnsonStephen SmithTimothy BrownTobias LoeffelbeinTom BertramJaime TorresTraining AccountTravis GibbsTravis WenrickRandy CarltonTupufia FaleagafuluMatt PerhatchZachary StewartJames AndersonTrevor FitzgeraldJames OrrStepehen LeachWalter BurkhartAubrey Quinn-WardPaul NewellJacob TroutDylan UtleyEric HendersonLandon WayneAllan Copeland Jr.Anthony Graham IIIMichael WetzelSeth HammondJoe SmothLuke WilsonSpencer CarlsonTaylor ClarnoDonte DavisAdrian NunezAustin FrickelGleidi CastellanosJose Sanchez GaribayAlex CulleyGilberto EsquivelJustin CimorelliLoren PetersenJon SandersKevin GreeneDuane LyphardtCody LawsCamacho Gutierrez SantiagoDalton SmithHunter WesselMariano MejiaRyan CampbellSteven BidlemanAldo Atonal RoblesTaylor CollierDylan MosesSteffani MaddenEric ElleryAlejandro PeredaChristopher GloverJose CisnerosHenry SantiagoEdwin OrtegaAndrew HallPhuc ThoiColin ClarkCarlos MunozRod BuscaBrad AndersonJohn ZimbureanJeff McClurgRiley TrogdonMarshall PrattRoman YunikovRaul PalaciosMark WrightJoshua WilsonKenneth EdgmandKyle WilliamsJoel HendricksonMichael WhiteCregg WhiteKyle WellsEulalio GalvanGavin VowellFatu VaimaaEthan StarkDavid TurcotteTanner TeeplesJose CorreaDavid SparkesMarco CastilloTaylor SimonJose Cuevas TelloLoren MaberryJarred SimmonsDaniella MoalemBrad SheaPaul RussellTony RomeroRichard BlanchetteRiley RichardsonJuan PulidoEric TranJeremy PriceScott PraterJesse PraterTyler MaherBernard ShawJohn PortreyAaron OlsonManuel PeredaBryan MyersDale MurphyChad SizemoreTsibxwm MouaPhuc NguyenMacol MolinaAaron KnappJesse MarkowskiJason LuckovichJoshua LawrenceKasey KrauseChristopher KirchnerColton JoryJared JohnsonAdam JetteFred HolguinMalcolm HensleyDonald HenkinsSovedan HatSean GrealishDmitriy GorelovMichael GoeTravis GauseColtin FosbergJames FinneyMark FelsmanJoseph EstradaJarrad DodsonCarl DepoorterJoel Craig Sr.Eriberto Contreras-SierraLincoln CaldwellMichael CaudleLeshawn BoykinCuong BangAn BangGuillermo Avina-MarmolejoGeorge HarrisPhy SunMatt GeorgeAmandy DavisTerrence LebeauPbeng MouaNoah BosAlex BremmeyerTammy DenningDemarious DukeRoberto MartinezAlden YaleBryon YatesTandy AdamsBlake HodgeMoises MojicaCharles SimmonsRoberts UncleSkyler AndersonRobert SchroyerThomas AchtenHolt MaddenEmily StonecypherCorcoran DarrenAntonio CoronaErnest HumeJohnny WetzelMatt RandIan ThomasHector Trujillo-AguileraJordan BrushBethany WhitlockBrandon WilhiteAngel PerezMatthew BrownJimmy RaineyMelinda RaineyWalt DaquilaFabian EstevesTatjana WilliamsMegan GibbMichael GibbJames CrowJamie GalvezFeras NahiaCheyenne BurchetteIrelys FernandezMichael SwanAaron DaytonAbigail MorrisZachary WynegarHector ChaconAlexander FavierHumble AndrewFredy Rodriguez FloresJolene BrooksStipsky JamesJoseph BethmannMichael Aguirre Jr.Christopher OlivoPratt PhillipRichard RomoJose Sanchez CequeidaJerron StinerRyan FisherDesmond DiamondKyra HolmanAdam BakerDavid Salazar FloresRobert TumlinAlberto BoneEric PacknettJuan PenadoDan LongJennifer Ellsworth-BoeslJesse MatthewsDaren SchermerhornCorban PruittAnthony MasonJacob PhillipsMichael MillsTaylor HamakerMandi MendozaPhillip Pritchard Sr.charles EdwardsHans HaydalMelisa PenderMurvin Wolfe Jr.Gerardo AltamiranoJose Herrera AguilarJames WilsonMyles Youngtest testEricka BeckwithCristobal AguilarJames JonathanGustavo Madrid LeyvaArmando Madrid OlivasBenigno Madrid LeyvaConnor CookAlexander VujovichElijah ZonMartin Gonzalez EspinozaBrian KronaOlivia BryantAaron JacobsonAdam Yzaguirre Jr.Nicholes MaceOdilon PadillaEdgar TabafundaConner LedetKaleb BurkhartWilliam McDougallMichael ThomasRyan KrahmerShane AndersonJayden BucherTuese MaoAngelina LomberaRobert HoustonAaron CordesThomas DaughertyCesar Lopez MolinaAnton PeroErik TinajeroCameron SeatonJames CarlsonJeremiah Van OrmanLangston PattersonIsaiah MabryTravis HoeyClint HaydenColton FlomJoshua LeerDaniel FreemanCassandra PerkinsSteven CantrellJacob ScottJonathan BrawnJoel ChavezChristian EagleJeb CuminKurtis AdamsChristopher HarrisBreckin RaszlerColeton RaszlerJacob MurbachMichael FunderburkJustin BreierJose HughesNick SalvatierraChristopher GiffordDevon BrownDavid McSwainAlvince RoppulZachary SeysAaron LittlepageAngelo BelsitoCurtis MurbachJacob DobsonSeth LochridgeSteve WarnerBob SmithSteven ClarkDominin HernandezTrevon HumesRobert WilsonPatrick KernDanielle NormanRobert KnickerbockerCesar Rivera DavilaKyle NesslyMatther WoodTyler CaseTristan GanAndrewTest OwensLucas OliverJerry HaskewJoy LakotaRicardo Laboy AvilesPat CampbellJoseph HanGabriel MarkowskiDevin BassJonathan LopezLidia MotaBoris LuisOdiel CastilloWilbart Hernandez De JesusMarbin Flores SanchezBrian MantheyLucas BainDillon SteinErick CedilloJustin HowardTauni PowellChristopher MorganSalwan Al-OgailiJeremy KratinaAngel CanoJohn WarrenRene GibbsJeremy HammScott BonhamVincent AbellEthan CrandallJose Santanajaime SantanaJake KimHarold McMichaelRonaldo Negrete-NolascoHector PerezJeff McPhersonJerime WillourRichard WestMichael SonierProject(Required)Select a ProjectNew TestTest Before TransferJob#Date(Required) MM slash DD slash YYYY This field is hidden when viewing the formSubmitted By Email Project Information Employee Orientation – Site Specific Tab 16G Employee NameSelect NameRobert JohnsenRobert JohnsonChris BorodenkoAaron JacquesAhmed Lindseyandrewowen21Anthony LightawesomecompanyBenjamin MecklenburgBenson NdunguBilly JohnsonBrandon BennettBrett ChalcraftBrock RobinsonBryan RogersBunnason Khuncandice3455Casey EnfieldChris LaneChris JenkinsChristopher ClarkChristopher KunnenCody MorrisCraig CollinsCreole Enrico-JohnsonCynthia PowerDakota PottsDale StoutDaniel HillikerDaniel FletcherDaniel SmithDaniel StonerDan MeadDanny PattersonDarryl BoyerDavid KelloggDavid MaddenAndrew OwenDennis BlakleyDiego OsorioDominic SmithDouglas SkagenDustin IveyDustin DavisDustin JonesElliot GarciaEric MoeEric ParisErik GladsjoFoushee123Garrett CollomGary ParshallgoodfellowbrosGregory SmithHenry LuceroAlejandro HernandezIntegrity SafetyAARON WRIGHTIrma ZamoraJacob McCrayJames CraigJames CullumJames HardyJames HerringJennifer MoreauJesse ButtsJessica BarendregtJoel CovingtonJohn NoldJonathan BeckJonathon MontanoJoseph ChastainJosephus PinoteJoshua CraigJoshua MoreauJsaac CullumJohn SchuhJuan LuevanoKelly FrankKent KrahmerKyle DamonKyle MyerslastLee JonesMarcos HerreraMario LuevanoMatthew BibbyMax JewettMichael DaravongMitchell BohnNate JuenNewestNghia NguyenNorm HooklandNW CascadePapeGroupPaul CoddePaul HamiltonPeter BethmannPhilip DoveRamon ContrerasDick BeithRobert BatesRobert ChaconRobert WrightRobinson ConstructionRon FlemingRob VirtueRyan ClarkRyan ManevalSean CoulterSeav SourStacie RogersStephen BowdishStephen JohnsonStephen SmithTimothy BrownTobias LoeffelbeinTom BertramJaime TorresTraining AccountTravis GibbsTravis WenrickTrent LeachRandy CarltonTupufia FaleagafuluMatt PerhatchZachary StewartJames AndersonTrevor FitzgeraldJames OrrStepehen LeachWalter BurkhartAubrey Quinn-WardPaul NewellJacob TroutDylan UtleyEric HendersonLandon WayneAllan Copeland Jr.Anthony Graham IIIMichael WetzelSeth HammondJoe SmothLuke WilsonSpencer CarlsonTaylor ClarnoDonte DavisAdrian NunezAustin FrickelGleidi CastellanosJose Sanchez GaribayAlex CulleyGilberto EsquivelJustin CimorelliLoren PetersenJon SandersKevin GreeneDuane LyphardtCody LawsCamacho Gutierrez SantiagoDalton SmithHunter WesselMariano MejiaRyan CampbellSteven BidlemanAldo Atonal RoblesTaylor CollierDylan MosesCrystal LoeffelbeinSteffani MaddenEric ElleryAlejandro PeredaChristopher GloverJose CisnerosHenry SantiagoEdwin OrtegaAndrew HallPhuc ThoiColin ClarkCarlos MunozRod BuscaBrad AndersonZach HanoldJohn ZimbureanJeff McClurgRiley TrogdonMarshall PrattRoman YunikovRaul PalaciosMark WrightJoshua WilsonKenneth EdgmandKyle WilliamsJoel HendricksonMichael WhiteCregg WhiteKyle WellsEulalio GalvanGavin VowellFatu VaimaaEthan StarkDavid TurcotteTanner TeeplesJose CorreaDavid SparkesMarco CastilloTaylor SimonJose Cuevas TelloLoren MaberryJarred SimmonsDaniella MoalemBrad SheaPaul RussellTony RomeroRichard BlanchetteRiley RichardsonJuan PulidoEric TranJeremy PriceScott PraterJesse PraterTyler MaherLynsey PotterBernard ShawJohn PortreyAaron OlsonManuel PeredaBryan MyersDale MurphyChad SizemoreTsibxwm MouaPhuc NguyenMacol MolinaAaron KnappJesse MarkowskiJason LuckovichJoshua LawrenceKasey KrauseChristopher KirchnerColton JoryJared JohnsonAdam JetteFred HolguinMalcolm HensleyDonald HenkinsSovedan HatSean GrealishDmitriy GorelovMichael GoeTravis GauseColtin FosbergJames FinneyMark FelsmanJoseph EstradaJarrad DodsonCarl DepoorterJoel Craig Jr.Joel Craig Sr.Eriberto Contreras-SierraLincoln CaldwellMichael CaudleLeshawn BoykinCuong BangAn BangGuillermo Avina-MarmolejoGeorge HarrisPhy SunMatt GeorgeAmandy DavisTerrence LebeauPbeng MouaNoah BosAlex BremmeyerTammy DenningDemarious DukeRoberto MartinezAlden YaleBryon YatesTandy AdamsBlake HodgeMoises MojicaCharles SimmonsRoberts UncleSkyler AndersonRobert SchroyerThomas AchtenHolt MaddenEmily StonecypherCorcoran DarrenAntonio CoronaErnest HumeJohnny WetzelMatt RandIan ThomasHector Trujillo-AguileraJordan BrushBethany WhitlockBrandon WilhiteAngel PerezMatthew BrownJimmy RaineyMelinda RaineyWalt DaquilaFabian EstevesTatjana WilliamsMegan GibbMichael GibbJames CrowJamie GalvezFeras NahiaCheyenne BurchetteIrelys FernandezMichael SwanAaron DaytonAbigail MorrisZachary WynegarHector ChaconAlexander FavierHumble AndrewFredy Rodriguez FloresJolene BrooksStipsky JamesJoseph BethmannMichael Aguirre Jr.Christopher OlivoPratt PhillipRichard RomoJose Sanchez CequeidaJerron StinerRyan FisherDesmond DiamondKyra HolmanAdam BakerDavid Salazar FloresColin SearsRobert TumlinAlberto BoneEric PacknettJuan PenadoDan LongJennifer Ellsworth-BoeslJesse MatthewsDaren SchermerhornCorban PruittAnthony MasonJacob PhillipsMichael MillsTaylor HamakerMandi MendozaPhillip Pritchard Sr.charles EdwardsStephen SwanHans HaydalMelisa PenderMurvin Wolfe Jr.Gerardo AltamiranoJose Herrera AguilarJames WilsonMyles Youngtest testEricka BeckwithCristobal AguilarJames JonathanGustavo Madrid LeyvaArmando Madrid OlivasBenigno Madrid LeyvaConnor CookAlexander VujovichElijah ZonMartin Gonzalez EspinozaBrian KronaOlivia BryantAaron JacobsonAdam Yzaguirre Jr.Nicholes MaceOdilon PadillaEdgar TabafundaConner LedetKaleb BurkhartWilliam McDougallMichael ThomasRyan KrahmerShane AndersonJayden BucherTuese MaoAngelina LomberaRobert HoustonAaron CordesThomas DaughertyCesar Lopez MolinaAnton PeroErik TinajeroCameron SeatonJames CarlsonJeremiah Van OrmanLangston PattersonIsaiah MabryTravis HoeyClint HaydenColton FlomJoshua LeerDaniel FreemanCassandra PerkinsSteven CantrellBrandon RussellJacob ScottJonathan BrawnJoel ChavezChristian EagleJeb CuminBrandon ViceKurtis AdamsChristopher HarrisBreckin RaszlerColeton RaszlerJacob MurbachMichael FunderburkJustin BreierSydney BrownJose HughesWill ColbyNick SalvatierraChristopher GiffordDevon BrownDavid McSwainAlvince RoppulZachary SeysAaron LittlepageAngelo BelsitoCurtis MurbachJacob DobsonSeth LochridgeSteve WarnerBrent KratinaBob SmithSteven ClarkDominin HernandezTrevon HumesRobert WilsonPatrick KernDanielle NormanRobert KnickerbockerCesar Rivera DavilaKyle NesslyMatther WoodTyler CaseTristan GanAndrewTest OwensLucas OliverJerry HaskewJoy LakotaRicardo Laboy AvilesPat CampbellJoseph HanGabriel MarkowskiDevin BassBrent MorrealeJonathan LopezLidia MotaBoris LuisOdiel CastilloWilbart Hernandez De JesusMarbin Flores SanchezBrian MantheyLucas BainDillon SteinErick CedilloJustin HowardTauni PowellChristopher MorganSalwan Al-OgailiEmployee Email This Check list is a guideline for conducting employee safety orientations for employees new to this project. Once signed by both the Safety Representative and the Employee, it serves as documentation that the orientation has taken place.Place a check in the box to indicate that the subject was discussed:Explain the company safety program including: Overview of the Site Specific Safety Manual Safety Meetings Safety Committees (if required) Substance Abuse Policy Review General Safety Rules Disciplinary Procedures – Serious consequences for horseplay / Fighting / Drug & Alcohol Use. – Smoking Policy – Good Housekeeping PracticesDiscuss Personal Protective Equipment Required Proper attire Hard Hats and Safety Glasses Orange Vests or Bright Colored Clothing Lines of Communication and Responsibility for Immediately Reporting Accidents When to report an injury To whom an injury should be reported Filing of accident report forms First Aid Supplies, Equipment and Training Location of all First Aid Stations Obtaining Treatment Proper Lifting Techniques Proper Lifting Techniques Description By placing a signature below, the employee acknowledges that they will abide by the Guidelines contained within the Site Specific Safety Plan and report any condition or activity perceived to be unsafe to my immediate supervisor or the Site Safety Representative.Employee Signature:Safety Supervisor Signature:Date MM slash DD slash YYYY
