Organization Name:

[Your Company Name]

Department/Work Area:

[Welding and Fabrication]

Date of Assessment:

[Month Day, Year]

Assessor's Name:

[Your Name]

Position/Title:

[Your Position]

Location/Address:

[Your Company Address]

Type of Work/Activity:

[Welding and Fabrication of Metal Structures]

Weather Conditions:

[Temperature: 25°F, Wind Speed: 15 mph, Humidity: 40%]

Date and Time of Work:

[Month Day, Year]; [Time]

Current Temperature:

[25°F]

Wind Chill :

[18°F]

Historical Data:

[No significant temperature fluctuations]

Current Wind Speed:

[15 mph]

Gusts:

[Occasional gusts up to 20 mph]

Wind Direction: 

[North-Northwest]

Current Humidity Levels 

[40%]

Impact on Perceived Temperature

[Minimal impact observed]

Description of Tasks:

[Welding metal components, fabricating structures]

Duration of Exposure to Cold:

[6 hours]

Physical Exertion Level:

[Moderate to High]

Type of Clothing Worn:

[Insulated coveralls, gloves, thermal hats]

Adequacy of PPE:

[All employees equipped with appropriate cold-weather PPE]

Availability of Spare Clothing:

[Spare coveralls available]

Frequency and Duration:

[15-minute breaks every 2 hours]

Location of Breaks:

[Designated break area with windbreaks]

Warm-up Activities during Breaks:

[Hot beverages available, stretching exercises]

Availability of Heated Rest Areas:

[Heated trailer provided]

Access to Warm Shelter: 

[Yes, indoors break room available]

Employee Health Checks:

[Regular health assessments conducted]

Medical History Review:

[No known cold-sensitive conditions reported]

Accommodations for Health Conditions:

[None reported]

Signs of Cold Stress:

[No signs reported, regular monitoring by supervisors ]

Emergency Response Procedures:

[Employees trained in recognizing cold stress, emergency numbers posted]

First Aid Availability:

First aid kits stationed in multiple locations

Engineering Controls:

[Windbreaks installed around welding stations and fabrication areas to reduce the impact of cold winds on workers.]

Administrative Controls:

[Job rotation implemented to minimize prolonged exposure; regular safety training conducted to enhance awareness and preparedness for cold weather conditions.]

Personal Protective Equipment (PPE):

[All employees equipped with insulated coveralls, thermal gloves, and head protection to ensure adequate warmth and protection against cold temperatures.]

Protocols for Cold Stress Emergencies:

[Evacuation to heated shelter, emergency contact procedures]

Communication Plan:

[Two-way radios provided to all employees]

Evacuation Routes:

[Posted in prominent locations]

Location of First Aid Kits:

[Designated first aid stations at welding stations]

Training for First Aid Responders:

[Designated employees trained in first aid]

Frequency of Reviews:

[Quarterly]

Process for Updating Assessment:

[Updates after incidents or changes in work processes]

Documentation of Incidents and Near Misses:

[Incident reports filed and reviewed]

Assessor:

[Your Name]

Supervisor/Manager

[Supervisor's Name]

Employee

[Employee's Name]