Name,

Surname

2.Compa
ny Name

3.Email
Address
and
Contact
Number

4.Accredi
ted DOLE
Safety
Practition
er

Yes
No

5.With
COSH/B
OSH
Training?

Yes
No
6.Total
Years of
Safety
Experien
ce
Minimu
m6
Months
More
Than 6
Months
but Less
Than 1
year

More
than 1
Year but
not
greater
than 2
Years

More
Than 2
years but
Less
Than 5
Years

More
Than 5
Years
7.What
are the 3
other
activities
are
covered
by Work
Authoriz
ation
aside
from
Excavatio
n Works,
Hot
Works,
Working
with the
use of
Heavy
Equipme
nt and
other
hazardou
s
activity?
(3
Answers)
(1 Point)
1.
Confined
Space

2.
Installati
on works

3.
Electrical
Works
4.
Commiss
ioning
5.
Working
at
heights
6. LOTO
8.Who
accompli
sh the
Work
Permit?
(1 Point)
Contract
ors
Safety
Officer
Authoriz
ed
represent
atives

All of the
above

9.Who
approves
the
Permit?
(1 Point)
Construc
tion
manager
only
Authoriz
ed
Personne
l
10.Worke
rs who
are
physicall
y and
mentally
deficient
shall not
allowed
to work?

(1 Point)
1
0

11.Worke
rs are
allowed
to work
alone
specially
at
confined
space or
at
heights

(1 Point)
1
0

12.What
are the
inspectio
ns
needed
before
working
at
heights?

(1 Point)
Stability
and
integrity
of ladder
or
scaffolds
only

 Checked
and
verify
capacity
of ladder
and
scaffolds

Complet
e fall
protectio
n system

All of the
above

13.What
are the 6
Hazards
associate
d
working
at
heights
(6
Answers)

(1 Point)

Fall from
heights
Contact
with
overhead
powerlin
es

Bad
weather
condition

Use of
incorrect
ladder or
scaffold

Insufficie
nt access

No fall
protectio
n system

Asphyxia
tion

14.Ladde
r Safety
requires
4:1 Rule
and 3
Point
Contact?

(1 Point)
Yes
No
15.What
are the 2
fall
protectio
n
system?
(1 Point)
Horizont
al and
Vertical 
Anchora
ge and
Positioni
ng

All of the
above

16.Do
you need
NCII
certified
to install
scaffold? 

(1 Point)
Yes
No

17..   Do
you need
structural
engineer
for
scaffolds
lower
than  6
meters?

(1 Point)
1
0

18.The
walls of
excavatio
n________
___shall
be
supporte
d by
adequate
shoring.

(1 Point)

Over 1 m

Less than
1m
Depends
on
methodo
logy
None of
the
Above

19.An
excavatio
n, may
also be
consider
ed as a
__________
_.

(1 Point)
Working
Platform
Confined
Space

Long
Open
Manhole
None of
the
Above

20.“A
person
must be
complete
ly buried
on soil to
be
seriously
injured/k
illed.”

(1 Point)
1
0
Can’t be
determin
ed
None of
the
Above

21.For
63mm
Pipelayin
g and
above,
__________
__________
_ of the
work
area
must be
strictly
impleme
nted

(1 Point)
Full
board-up
enclosur
e

Full
bollard
Enclosur
e
Traffic
Cone
None of
the
Above

22.. Every
excavatio
n over
1m shall
be kept
free of
water
__________
_.

(1 Point)
every
hour
at all
times
daily

all of the
above
23.Meth
ods of
Excavatio
n
Protectio
n from
cave-ins:
Benching
, Sloping,
Shielding
,_________
___?

(1 Point)
Shoring
Concreti
ng
Piling

24.What
is the
standard
distance
of
excavate
d
materials
from
excavatio
n?

(1 Point)
1/3
Height
1/3
Meter
1/3 Feet
25.What
is the
standard
distance
of tools
and
materials
from
excavatio
n?

(1 Point)
1/3
Height
1/3
Meter
1/3 Feet
1 Meter
Min

26.What
is the
standard
distance
of
machine
and
Vehicles
from
excavatio
n?

(1 Point)
1/3
Height
1/3
Meter
1/3 Feet
1 Meter
Min
27.2
Types of
Traffic
Signages

(1 Point)
Road
Works
Signage
Regulato
ry
Signage
Safety
Signage
28.Types
of
channeli
ng
devices?
(1 Point)
Board-
ups

 Bollards

Warning
signages

 Informat
ive
signages

All of the
above

29.Types
of
lighting
devices?
(1 Point)
Flash
Arrow
Boards
and
Yellow
warning
lights

Flood
Lights
and LED

30.Is a
Traffic
Manage
ment
Plan
Necessar
y for
working
near
road?

(1 Point)
No
Yes
Maybe

31.To
whom
are you
going to
Report
an
accident?

(1 Point)
Construc
tion
Manager
Only
Project
Manager
Only
Safety
Officers
Only

All of the
above

32.What
is the
lead time
to notify
a major
or fatal
accident
?

(1 Point)
1 Hour
30
Minutes
15
Minutes
Immedia
tely

33.What
is the
lead time
to
submit
Full
Accident
and
Investiga
tion
Report
for Major
or Fatal
Accident
?

(1 Point)
3 Hours
6 Hours

12 Hours

34.Only
person
who has
undergo
ne
compete
ncy
training
on use of
heavy
 equipme
nt from
DOLE
accredite
d
training
organizat
ion

(1 Point)
1
0

35.Which
of the
following
is not
consider
ed Heavy
Equipme
nt

(1 Point)
Crane
Boom
Truck
Backhoe
Pallet
Truck
All of the
above

36.Do
you need
lifting
plan
when
using
mobile
crane
when
lifting
heavy
objects?

(1 Point)
1
0
Maybe

37.Who
is
authorize
d person
to
perform
Electrical
Works?

(1 Point)

Electricia
n/
Electrical
Engineer

Anybody

None of
the
Above
38. All
equipme
nt must
be
placed in
a de-
energize
d state
prior to
any
maintena
nce or
repair
work?

(1 Point)
1
0
Maybe

39.All
electrical
tools
shall be
in good
working
condition
s,
including
protectiv
e
insulatio
n

(1 Point)
1
0
Maybe
40.Overl
oading
of power
outlets
are
permitte
d?

(1 Point)
1
0
Maybe

41.De-
energizin
g
electrical
equipme
nt should
always
be your
first
option
when
working
on
electrical
equipme
nt or
near it

(1 Point)
1
0
Not All
the time
42.What
is PPE?
(1 Point)
Personal
Protectiv
e
Equipme
nt

Personal
Pressure
Equipme
nt
Personal
Protectiv
e
Estimate
None of
the
above

43.What
are the 5
basic
PPE? (5
Answers)

(1 Point)
Helmet
Spectacle
s/
Googles
Safety
Vest
Earmuff
Safety
Shoes
SCBA
44.What
are the 6
Safety
Equipme
nt/
Devices
required
in
performi
ng
Confined
Space
activity?
6
Answers)

(1 Point)
Gas
Monitor
Electric
Fan
Tripod
with
Winch
Blower
and
Ducting
Lighting
System
Fire
Extinguis
her
Commun
ication
System
LOTO
45. Rapid
oxidation
of
combusti
ble
materials
with the
help of
energy in
the form
of heat
and light

(1 Point)
Smoke
Heat
Fire
None of
the
above

46.Triang
le of
Fire-
Fuel,
Heat,
__________
?
(1 Point)
Smoke
Oxygen

Combust
ible
Materials
47.Com
monly
used fire
protectio
n
(1 Point)
FM200
CO2
Suppress
ion
Hydrant
System
Fire
Extinguis
her

48.Class
of Fire
for
Wood,
Paper,
Rubber
(1 Point)
Class A
Class B
Class C
Class K

49.Class
of Fire
for
Electrical
Equipme
nt

(1 Point)
Class A
Class B
Class C
Class K
50.Class
of Fire
for
Liquid,
Grease,
Oil and
Tar
(1 Point)
Class A
Class B
Class C
Class K

51. Emer
gency
lights
shall be
able to
provide  
illuminati
on for 1
½ hours
after the
power
failure at
a level

 sufficien
tly bright
enough
to allow
person
to see
their way
to exits

(1 Point)
1
0
52.Manil
a Water
Penalty
System is
aligned
with D.O
198 of
DOLE?

(1 Point)
1
0
Maybe
53.Main
Contract
ors are
responsi
ble for
the
health
and
safety
performa
nce of
their
sub-
contracto
r. 

Any
violation
of the
subcontr
actor
shall be
deemed
violation
of the
Main
Contract
or/Vend
or?

(1 Point)
1
0

Depends

54.What
are the 3
Phases of
Project
Life
Cycle?
__________
__?,Execu
tion,
Project
Closeout

(1 Point)
Commiss
ioning
Procure
ment
Planning
None of
the
Above

55.What
Type of
Plan is
required
prior to
Construc
tion
Work?

(1 Point)
Construc
tion
Health
and
Safety
Program
Construc
tion
Health
and
Safety
Progress

Construc
tive
Health
and
Safety
Program

Construc
tive
Health
and
Safety
Progress

56.Execut
ion
Phase
Stages. 1.
Critical
Process
Review 2.
Impleme
ntation
of PTW.
What is
PTW?

(1 Point)
Permit
To Wait
Permit
To Work
Purpose
to Work
None of
the
Above