Title Page
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Site conducted
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Job Name
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Location
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Inspected by
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Date of Inspection
Ladders & Stairways
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1 Ladders inspected for defects
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2 Ladders extend 3' above landing
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3 Ladders pitched 1' from vertical for every 4' of height from foot of ladder to top support
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4 Ladders secured in place
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5 Stairways equipped with stair rails & handrails
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6 Stairways free of debris & other slip, trip & fall hazards
General Fall Protection
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7 Floor openings covered or guarded
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8 Workers exposed to potential falls of 6' or more protected
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Other fall protection issues on-site?
Scaffolds
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9 Competent Person assigned to supervising erection
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10 Competent Person assigned to supervising disassembly
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11 Working surfaces 10' or higher equipped with guardrails
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12 Working surfaces clear of debris & other slip, trip & fall hazards
Excavations/Trenches
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13 Competent Person assigned to supervise operations
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14 Excavations 5' or deeper equipped with a protective system
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15 Excavations 4' or deeper have ladders or other means of egress within 25' of each worker
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16 Spoil pile is at least 2' from edge of excavation
Electrical
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17 GFCI or Assured Equipment Grounding Conductor Program in place
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18 Outlets checked for proper wiring & GFCI checked where applicable
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19 All tools & equipment inspected for defects in cords & plugs
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20 Extension cords are in good condition
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21 Sources of electricity such as panel boxes & overhead power lines are marked
Personal Protective Equipment
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22 Eye protection provided
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23 Hearing protection provided
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24 Hardhats provided
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25 Protected toe boots or shoes worn by workers
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26 Welding & cutting helmets, properly shaded lens, welding gloves & bibs available
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27 Respirators available where needed & respiratory protection program in place
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Any other issues with PPE?
Cylinders
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28 Oxygen & fuel cylinders properly separated
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29 Compressed gas cylinders labeled
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30 Cylinders turned off & valve caps in place when not in use
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31 Hoses & torches free from defects
Manual Handling of Materials
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32 Materials delivered as close to work area as possible
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33 Materials staged on tables, pallets or racks off the ground close to waist height
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34 Material moving equipment such as carts, mobile pipe racks & wheelbarrows available
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35 Waste containers/bins are on wheels & readily available
Fire Prevention
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36 Flammable & combustible liquids stored away from ignition sources
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37 Portable containers approved & equipped with self-closing lids
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38 Adequate number of properly charged fire extinguishers available
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39 Extinguishers properly located and have current inspection tags attached
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40 Flammable & combustible debris & trash kept away from welding & cutting operations
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41 Oily rags disposed of in approved self-closing waste containers
Tools & Equipment
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42 Tools & equipment in good condition
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43 Defective equipment tagged & removed from work area
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44 Tool & equipment guards in place & in good condition
Confined Space
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45 Air sampling equipment calibrated
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46 Air samples show acceptable oxygen concentration (19.5% to 23.5%)
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47 Air samples show space is free of toxic, flammable & explosive gases
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48 Qualified attendant assigned to keep continuous contact with all workers inside space
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49 Qualified Person assigned to recheck air quality frequently throughout the project
Hazard Communication
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Proper silica controls are in place
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50 Written Hazard Communication Program in place
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51 Written program includes complete list of chemicals workers could be exposed to on site
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52 SDS available for each chemical on the list
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53 Chemical containers properly labeled
First Aid
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54 First aid kits readily accessible to workers
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55 Contents of first aid kits approved by qualified health care provider
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56 First aid kits include medical examination gloves, eye protection & CPR mask
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57 Properly trained first aid provider on site
Housekeeping
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58 Suitable containers/bins available for disposal of trash & debris
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59 Walkways, aisles, hallways & passageways clear of trash, debris & materials
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60 Trash & debris containers/bins empty
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61 Tools not in use stored in job boxes
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62 Equipment not in use properly stored
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63 Pipe & other materials stored neatly
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Any other housekeeping issues?
Other
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67 Potable water readily accessible to workers
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68 Clean, private toilets accessible to workers
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69 OSHA Job Site Safety Poster posted in conspicuous location
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70 Emergency telephone numbers posted at landline telephones & in other conspicuous places
Miscellaneous
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Other