Fill in the job. Load trade-specific hazards. Print — you're SSSP-compliant.
—
| Owner / responsible party | — |
|---|---|
| Competent person | — · |
| First-aid / CPR responder | — |
| Emergency phone | 911 |
|---|---|
| Nearest hospital | — · |
| Muster point | — |
| Fire extinguisher location | — |
| MIOSHA reporting | Fatal ≤ 8h · Hospitalization ≤ 24h · 1-800-858-0397 |
| Task | Hazard | Control | PPE | Responsible |
|---|---|---|---|---|
| No hazards documented. | ||||
Hard hat, safety glasses, hi-vis vest, ANSI-rated boots. Task-specific PPE per JHA.
OSHA 10-hour Construction minimum for all workers. Competent person training for supervisor.
Standards prefix: MIOSHA Part
All workers assigned to this project have reviewed this SSSP and agree to comply with the controls, PPE, and emergency procedures documented above.
| # | Print Name | Signature | Date |
|---|---|---|---|
| 1 | |||
| 2 | |||
| 3 | |||
| 4 | |||
| 5 | |||
| 6 |