Title Page
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Site Foreman
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Tract/ Lot #
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Conducted on
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Prepared by
PPE
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Use of safety glasses
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Use of hard hat
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Other
Ladders
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Extension ladder in good condition with proper labeling
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Use of Extension ladder
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A Frame Ladder in good condition
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Use of A frame ladder
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Other
SWPPS
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Compressor containment
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Generator containment
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Site conditions
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Other
Tools
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Nail guns
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Power tools
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Hilti
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Hilti Properly stored
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Hilti Warning Signs Available
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Skill saw
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Other
House keeping
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Trash cleaned up
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Lumber cleaned up
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Hardware cleaned up
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Nails bent
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Clear path
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Other
Fall protection
Floor level
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Guard rails installed per plan
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Leading edge lines
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Equipment used per plan
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2nd floor windows guarded
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Other
Roof level
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Bracket scaffold installed per plan
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Harness used per plan
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Net installed per plan
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Other
Safety Requirements
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Foreman Binder
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First Aid Kit
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Fire Extinguisher
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Shade Tent
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Water Jug / cups
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Other comments
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Immediate corrective action implemented
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Follow up steps required
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Follow up required?
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Supervisor signature
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Inspector Signature
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Superintendent Signature
Employee receiving action notice
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Employee Receiving Action Notice