Information

  • Document No.

  • MBIC Project

  • Conducted on

  • Prepared by

  • Location
  • Brief Description of Work

Housekeeping and Sanitation

  • Project work areas are clean, orderly, and free of excess trash and debris

  • Trash Receptacles provided and maintained

  • Aisles and Stairs Clear of Debris

  • Material and Equipment Clean, Properly Stored, and Orderly

  • Proper number of maintained portable toilets

  • Scrap material free of protruding nails or other puncture hazards

Fall Protection and Perimeter Protection

  • Fall prevention / protection methods reviewed prior to work start

  • Personal fall arrest systems used properly when needed

  • Controlled access zones are established with physical barriers and proper signage

  • Fall arrest system installed and inspected properly by a competent person

Ladders/Stair in Placed and Maintained

  • Ladders properly used and maintained / inspected

  • All access and egress to ladders and stairs clear and free of debris

Scaffolds Constructed Properly and Maintained

  • Scaffold tags in place and inspected daily by a competent person<br>

  • Proper access and egress provided

Floor Openings/Penetrations

  • All holes greater than 2" in diameter covered, marked, and secured

Adequate Lighting Provided

  • Lights provided throughout the project for access / egress routes

  • Adequate task lighting is provided for each employee

  • Temporary lighting properly protected

Electrical Power (GFCI / Electrical Cords / Power Lines)

  • Electrical cords are inspected on a daily basis

  • Lock out tag out / labeled breakers

  • GFCI used and inspected on a daily basis

  • All electrical splices are properly protected

  • Electrical rooms (temporary and permanent) are kept clean and are free of excess materials and debris

  • All temporary electric inspected monthly

Environmental Issues

  • Hazardous materials are stored and/or diposed properly

  • Dust Control

Fire Protection

  • Fire extinguishers provided for every 3,000 sq. ft. of building space, not to exceed 75' travel

  • Fire extinguishers inspected, tagged, logged monthly and serviced annually

  • Emergency plan practiced and egress routes maintained

  • Hot work permits are utilized for all hot work operations and fire watch provided

  • Evacuation routes posted and all employees are informed of gathering point

  • Have Fire Alarms Been Deactivated

  • 36" unobstructed access maintained in front of fire exits, fire extinguishers, and electrical panels/disconnects

Personal Protective Equipment Utilization

  • Proper eye protection worn at all times and face protection when needed

  • Hard hats worn at all times

  • Gloves worn at all times

  • Hearing protection used around high noise sources above 90 dB

  • Respiratory protection worn when necessary

  • Proper footwear worn at all times

Pedestrian Protection

  • Jobsite temporary partitions / fence installed, inspected, and maintained around perimeter of project

  • Proper signage secured at access points / pedestrian walkways

Hand and Power Tools

  • Hand and power tools inspected and maintained

  • Proper guards in place and maintained

  • Power tools are grounded or double insulated

  • Whip lines and/or pins are provided for at all air compressor connections

Flammable and Combustible Substances

  • Flammable / combustible liquids are stored and handled properly

  • All containers are properly labeled / protected where required

  • Fire extinguisher provided within 50' of storage area(s)

  • No smoking / open flame signage secured near storage area(s)

  • Flammable / combustible liquids are not stored within 10' from stairwells, elevators, and exits

Signage

  • OSHA posters posted on jobsite bulletin board

  • Exit signs posted and safety awareness / training signs posted throughout the project

  • Warning signs posted at temporary partitions or perimeter fence near access points

  • Federal posters and anti-harassment signs posted on jobsite bulletin board

  • Proper PPE Signage Displayed

  • First Aid Kit Readily Available and Inspected Monthly

  • Daily Paperwork Completed (JSA, Contractor Safety Checklist, Toolbox Talk, Permits)

Mobile Equipment

  • Daily inspection conducted on all mobile equipment and documentation maintained

  • Fire extinguishers in all mobile equipment

  • Owner's manual secured in all mobile equipment

  • Seat belts functional and worn on mobile equipment (as required)

  • Proper attachments used on all mobile equipment

  • Crane Lift Plan Approved Prior to Hoisting Activities

  • Annual Crane Inspection Completed

  • Crane Operator Certification Verified

Ergonomics

  • Proper lifting techniques used

Additional Comments

  • Additional Comments

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.