Information

  • Client/Project Name

  • Job Number

  • Region

  • Conducted on

  • Prepared by

  • Superintendent

  • Project Manager

  • Location
  • Current Job Status

  • Current Manpower Levels

  • Largest Current/Upcoming Risk(s)

  • Current Job Photos

Project Planning and Education

  • Grade

  • B&G Job Specific Safety Plan, HazCom, & SDS present?

  • Safety Orientations being done and up to date?

  • Bi-Weekly PM/Supt Safety Walks up to date?

  • Daily Crew Work Plans completed? Quality? Entire crew attending?

  • Weekly Safety Meetings held/documented?

  • Training - OSHA 10/30 hour and specific equipment

  • Safety as a main topic in Schedule/Coordination meetings?

  • Safety Notebook current?

  • New employees identified & coach/mentor assigned?

  • Foreman- performance in required level of supervision

  • Foreman- Superintendent expectations communicated?

  • Comments:

  • Attachments

  • Attachments

Subcontractor Management

  • Grade

  • Startup meetings completed and documented?

  • Safety documents current?

  • Participation in regular safety walks as required?

  • Sub supervision showing accountability for personnel in field?

  • B&G holding sub supervision accountable?

  • Following up on safety issues? Increasing accountability for repeat items?

  • Training - Adequate for scope of work being performed, including specific equipment?

  • Competent person, OSHA 10/30 for supervision is required?

  • Comments:

  • Attachments

  • Attachments

Injury/Accident/Incident Management

  • Grade:

  • Reported in a timely manner?

  • Accident/Incident report(s) complete?

  • Root cause reports complete?

  • Corrective actions implemented

  • Actively managing employee return to work, modified duty provided

  • Injury diary maintained for injured employee(s)

  • Injury log maintained job wide

  • Current Stats

  • # of recordables

  • # of lost time days

  • # of first aids

  • Comments:

  • Attachments

  • Attachments

Current Site Conditions/Behaviors

  • Grade:

  • Jobsite Postings & Documentations

  • Housekeeping/Sanitation/Material Storage

  • Personal Protective Equipment

  • Fall Protection

  • Aerial Lifts

  • Scaffolding

  • Stairways/Ladders

  • Trenches/Excavations

  • Fire Protection/Prevention

  • Fuel Storage

  • Welding/Cutting/Hot Work

  • Mobile/Heavy Equipment

  • Concrete/Masonry

  • Electrical (including weekly GFCI inspections)

  • Hand/Power/Powder Actuated Tools

  • Cranes/Rigging/Signaling

  • Confined Spaces

  • Traffic Control

  • Public Protection

  • Other

  • Comments:

  • Attachment

Presence of Safety Summary:

  • Overall Grade:

  • Project Manager Signature:

  • Superintendent Signature:

  • Safety Manager Signature:

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.