Title Page
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Conducted on
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Prepared by:
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Weather Conditions:
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Client Representative:
NOTES
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Inspection Information
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PROGRAMS / INFORMATION - SAFETY REPRESENTATIVE
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PROGRAMS / INFORMATION - DAILY PRESHIFT INSPECTION/DAILY RISK ASSESSMENT - JHA FOR TASKS ASSIGNED - FOLLOWED AND SIGNED
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PROGRAMS / INFORMATION - DAILY PRESHIFT INSPECTION - DRA
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PROGRAMS / INFORMATION - WEEKLY SAFETY MEETINGS
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PROGRAMS / INFORMATION - TRAINING
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PROGRAMS / INFORMATION - DAILY EQUIPMENT INSPECTIONS -FORKLIFT - SCISSOR - AERIAL - CRANE
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PPE - HARD HATS - SAFETY VESTS - SAFETY GLASSES - FACE PROTECTION - HEARING PROTECTION
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PPE - RESPIRATORS
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PPE - FALL PROTECTION
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HOUSEKEEPING - EXITS & STAIRS CLEAR - PILING & STACKING - DEBRIS REMOVAL - NAILS BENT
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LADDERS & STAIRS - CONDITION AND USE - LADDER TIED OFF 3' ABOVE LANDING - PROPER USE - CLEAR LANDING
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EXCAVATION / TRENCHING - SLOPE PROTECTION - BARRICADED - SHORING - COMPETENT PERSON - ACCESS EGRESS - WATER ACCUMULATION - DAILY INSPECTION
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RAILINGS / COVERS - FLOOR OPENINGS - STAIRS/RAMPS - WALKWAYS - NAILS FUSH
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SCAFFOLDS - ACCESS - FULLY PLANKED - RAILINGS - GREEN TAGS - QUALIFIED PERSON
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ELECTRICAL - TEMP. POWER BOXES - LIGHTING - CORDS/PLUGS - GFCI - LOTO
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FIRE PROTECTION - FLAMMABLE MAT. STORAGE - EXTINGUISHERS - SIGNAGE - WELDING CUTTING - HOT WORK PERMITS
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TOOLS - CONDITION - GUARDED - HANDLES
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SITE & PUBLIC PROTECTION - FORKLIFTS / CRANES - RIGGING - EARTHMOVING EQUIPMENT - BACK UP ALARMS
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SITE & PUBLIC PROTECTION - FENCES - BARRICADES - SIGNAGE - REBAR COVERS - CLEAR ACCESS - ACCESS ROADS
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FIRST AID - TRAINED PERSONNEL - FIRST AID KITS
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FIRST AID - HEAT ILLNESS PREVENTION - COOL DOWN AREA - COVID-19
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SANITATION - WATER - OUTHOUSES - HAND WASHING STATION
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PROGRAMS / INFORMATION - POSTING REQUIREMENTS / SIGNS
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PROGRAMS / INFORMATION - TRAFFIC CONTROL - CERTIFIED FLAGGER
