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Safe Work Procedure Template PDF

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DESIGN UPDATED: 2017 3.LE.3.3-3.5.

SWPT(1)

Safe Work Procedure Template

Safe Work Procedure


Name of Safe Work Procedure: Safe Work Procedure #:
Release date: Revision Date:
Date of approval: Management Signature:
This safe work procedure must be reviewed annually or any time the task, equipment or materials change.
DO NOT perform this procedure until you have been appropriately trained and authorized to do so by your supervisor
Required Training: Delete this text and list all training that is required prior to completing this procedure.

Required Personal Protective Equipment and Devices: Delete this text and the Pictograms that do not apply. Add any additional
personal protective equipment required.

Eye Protection Required Approved Dust Mask Required

Long or loose hair must be tied back or


Face-Shield Required contained

CSA Approved Safety Footwear Required No jewelry, watches, rings, necklaces etc.

Gloves must not be worn when operating this


Hearing Protection Required equipment

Define type Gloves Required No loose fitting clothing

Protective Clothing Required

NIOSH Approved Respirator Required

Fall Protection Required


Potential Hazards: Delete this text and enter all potential hazards associated with this procedure.

Pre-Operational Safety Checks: Delete this text and enter Pre-Operational checks that must be completed prior to completing this procedure.
If there are no pre-operational checks to be performed, delete this table.
Safe Work Procedure

Before you Start


1. Inspect required personal protective equipment and replace if required.
2. Put on all required personal protective equipment.
3. Delete this text and continue writing procedure. Enter any caution statements as required.

While you’re Working

1. Delete this text and continue writing procedure. Enter any caution statements as required.
2.

After you Finish

1. Delete this text and enter any housekeeping items that are required after completing the job. For
example: Ensure equipment is off, safe, clean and tidy before you leave it.
2.

If an emergency situation occurs while conducting this task, or there is an equipment malfunction, shut
the equipment off immediately and follow the lock out procedure.

REPORT ANY HAZARDOUS SITUATION TO YOUR SUPERVISOR/MANAGER OR EMPLOYER IMMEDIATELY

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