ACE Safety Report - duplicate

• Location Of Job
  Address

• Prepared by

• Other Personal Attending Inspection

• Site Supervisor
  Address

Signage

• OSHA Poster

  Yes

  No

  N/A

• Safety Rules Posted

  Yes

  No

  N/A

• Emergency Evacuation Instruction and Emergency Contacts

  Yes

  No

  N/A

Regulatory and/or Company Required Documentaion

• Daily JHA Completed

  Yes

  No

  N/A

• Weekly Tool Box Completed

  Yes

  No

  N/A

• Equipment Inspection Checklist Completed

  Yes

  No

  N/A

• Tailgate Meeting Current

  Yes

  No

  N/A

• Scaffold Permit

  Yes

  No

  N/A

• Demolition Permit

  Yes

  No

  N/A

• Hot Work Permit

  Safe

  At Risk

  N/A

• Annual Trenching Permit and Daily Inspection

  Yes

  No

  N/A

• Confined Space Assessment and/or Permit

  Safe

  At Risk

  N/A

• Heat Illness Prevetion Form

  Safe

  At Risk

  N/A

• Copy Of HSE & SDS Books (Paper or Electronic Copy)

  Safe

  At Risk

  N/A

Ladder Safety - Inspection & Usage

• Ladder Usage

  Safe

  At Risk

  N/A

• Housekeeping

  Yes

  No

  N/A

• Any trip and fall hazards

  Safe

  At Risk

  N/A

• Dust Control

  Safe

  At Risk

  N/A

PPE

• Hard Hats

  Yes

  No

  N/A

• Vests

  Yes

  No

  N/A

• ANZI Z87.1

  Yes

  No

  N/A

• Hand Protection Correct for task

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Silica Exposure

  Safe

  At Risk

  N/A

• Equipment safety

  Yes

  No

  N/A

• Water in compliance with HIPP

  Yes

  No

  N/A

• Machinery equipment tool certifications

  Yes

  No

  N/A

• Safety Non-Compliance

  Safe

  At Risk

  N/A

• Add signature

  Sign