Tell us about one job.

1. Who this is for

Document needed Other document

2. Job

Job location (street, city, state — building / area if you have it) GC / host / owner (if different from the company requesting the document)

3. Work

Scope of work in detail, including tools and equipment Work this crew will NOT do on this job Chemicals to be used (names / products; write “none” if none) Special processes (welding, cutting, coating, concrete, steel, demolition, live plant, etc.)

4. Controls that change the write

LOTO required? No Yes If yes — energy to isolate Confined space None Non-permit Permit-required Where / why Work at height No Yes If yes — how high and what they stand on Hot work No Yes If yes — where Excavation / trench No Yes If yes — depth / soil if known Energized electrical No Yes If yes — voltage if known Host PPE / site rules you already know

5. People and emergency

Nearest medical facility Muster / emergency number on site First aid / CPR on this crew? Unknown Yes No Language(s) the crew uses

6. Attachments

Attach what you have (checklist, manual pages, SDS, blank form, photos, logo). Max size depends on your email path — if upload fails, email the files to intake@offsitesafety.com with your company name in the subject.

Upload files (optional, multiple) What you’re sending

7. Delivery

Who should receive the files (name / email) File format

Acknowledgment

Answers are about this company and this job. We are the employer. Buying documents does not transfer site responsibility and is not an OSHA or KY OSH approval. Offsite Safety will write from this intake and the attachments. They will not invent host rules we did not send. We will train the crew and update the files if the work changes.

Date I agree to the acknowledgment above. Typed name stands as signature.