Adams Robinson Jobsite

• Adams Robinson Job-Site

• Adams Robinson

• Location
  Address

• Weather Condition

  Select Sunny Cloudy Rainy Windy Snowy Hot Cold

  • Sunny
  • Cloudy
  • Rainy
  • Windy
  • Snowy
  • Hot
  • Cold

• Temperature

  Select 90*-100* 80*- 90* 70*-80* 60*- 70* 50*- 60* 40*- 50* 32*- 40* 20*- 32* 0*- 20*

  • 90*-100*
  • 80*- 90*
  • 70*-80*
  • 60*- 70*
  • 50*- 60*
  • 40*- 50*
  • 32*- 40*
  • 20*- 32*
  • 0*- 20*

• Today's Date

  Date

• Prepared by

• Signature

  Sign

• Draw / Sketch Here :

  Drawing

• Add : Photo / Video / WebLink

  Media

PRE TASK PLANNING

• Posted / Accessible

  Safe

  Unsafe

  Corrected

  N / A

• Adequate Steps Listed

  Safe

  Unsafe

  Corrected

  N / A

• Hazards Identified

  Safe

  Unsafe

  Corrected

  N / A

• Controls Identified

  Safe

  Unsafe

  Corrected

  N / A

• Crew Participation / Signed

  Safe

  Unsafe

  Corrected

  N / A

PROJECT PLANNING / SPECIAL PERMITS

• Add Photo

  Media

• Description

• Confined Space

  Safe

  Unsafe

  Corrected

  N / A

• Lock Out / Tag Out

  Safe

  Unsafe

  Corrected

  N / A

• Hot Work

  Safe

  Unsafe

  Corrected

  N / A

• Lift Plan / Crane Pick

  Safe

  Unsafe

  Corrected

  N / A

PRE TASK PLANNING

• Posted / Accessible

  Safe

  Unsafe

  Corrected

  N / A

• Adequate Steps Listed

  Safe

  Unsafe

  Corrected

  N / A

• Hazards Identified

  Safe

  Unsafe

  Corrected

  N / A

• Controls Identified

  Safe

  Unsafe

  Corrected

  N / A

• Crew Participation / Signed

  Safe

  Unsafe

  Corrected

  N / A

PROGRAMS / INFORMATION

• Add Photo

  Media

• Description

• Have all employees been indoctrinated with respect to their individual safety responsibilities

  Safe

  Unsafe

  Corrected

  N / A

• Are safety meetings being held once a week?

  Safe

  Unsafe

  Corrected

  N / A

• Are Federal & State OSHA Safety & Health protection posters on the job?

  Safe

  Unsafe

  Corrected

  N / A

• Daily Inspections / Equipment

  Safe

  Unsafe

  Corrected

  N / A

• Safety Meetings

  Safe

  Unsafe

  Corrected

  N / A

• New Employee Orientations

  Safe

  Unsafe

  Corrected

  N / A

• Have all employees been indoctrinated with respect to their individual safety responsibilities

  Safe

  Unsafe

  Corrected

  N / A

FIRST AID

• Kits / Supplies

  Safe

  Unsafe

  Corrected

  N / A

• Visible

  Safe

  Unsafe

  Corrected

  N / A

• Are emergency phone numbers posted? Are first-aid supplies on the job?

  Safe

  Unsafe

  Corrected

  N / A

• Are first-aid trained personnel on the job? Are warning signs and posters adequate?

  Safe

  Unsafe

  Corrected

  N / A

SITE / PUBLIC PROTECTION

• Add Photo

  Media

• Description

• Access / Egress

  Safe

  Unsafe

  Corrected

  N / A

• Sign In Sheet / Visitor Log

  Safe

  Unsafe

  Corrected

  N / A

• Impalement Protection

  Safe

  Unsafe

  Corrected

  N / A

• Exposure Control (Dust,Mud,Ice,Snow)

  Safe

  Unsafe

  Corrected

  N / A

• Signs / Barricades

  Safe

  Unsafe

  Corrected

  N / A

• Adequate Lighting

  Safe

  Unsafe

  Corrected

  N / A

HOUSEKEEPING

• Add Photo

  Media

• Description

• Debris Removal

  Safe

  Unsafe

  Corrected

  N / A

• Exit / Stairs Clear

  Safe

  Unsafe

  Corrected

  N / A

• Cord Management

  Safe

  Unsafe

  Corrected

  N / A

• Nails Bent Over / Removed

  Safe

  Unsafe

  Corrected

  N / A

ELECTRICAL

• Add Photo

  Media

• Description

• Cords Protected from Damage

  Safe

  Unsafe

  Corrected

  N / A

• LockOut / TagOut

  Safe

  Unsafe

  Corrected

  N / A

• Lighting

  Safe

  Unsafe

  Corrected

  N / A

• Temp Power / Spider Boxes

  Safe

  Unsafe

  Corrected

  N / A

EXCAVATION

• Add Photo

  Media

• Description

• Barricades Around

  Safe

  Unsafe

  Corrected

  N / A

• Benching / Shoring / Sloping

  Safe

  Unsafe

  Corrected

  N / A

• Access / Ramps / Ladders

  Safe

  Unsafe

  Corrected

  N / A

• Signs on Tape

  Safe

  Unsafe

  Corrected

  N / A

FIRE PROTECTION

• Add Photo

  Media

• Description

• Extinguishers

  Safe

  Unsafe

  Corrected

  N / A

• Hot Work Permit

  Safe

  Unsafe

  Corrected

  N / A

• Fire Watch

  Safe

  Unsafe

  Corrected

  N / A

• Welding / Cutting Equipment

  Safe

  Unsafe

  Corrected

  N / A

LADDERS / SCAFFOLDS / STAIRS

• Add Photo

  Media

• Description

• Ladder Condition

  Safe

  Unsafe

  Corrected

  N / A

• Proper Set Up / Secured - Tied off

  Safe

  Unsafe

  Corrected

  N / A

• Safe Use / 3 Point Contact / Belt Buckle remains between uprights

  Safe

  Unsafe

  Corrected

  N / A

• Storage

  Safe

  Unsafe

  Corrected

  N / A

MOBILE EQUIPMENT

• Add Photo

  Media

• Description

• Crane

  Safe

  Unsafe

  Corrected

  N / A

• Earth Moving Equipment

  Safe

  Unsafe

  Corrected

  N / A

• Forklift

  Safe

  Unsafe

  Corrected

  N / A

• Scaffold

  Safe

  Unsafe

  Corrected

  N / A

• Scissor Lift

  Safe

  Unsafe

  Corrected

  N / A

• Boom Lift

  Safe

  Unsafe

  Corrected

  N / A

PERSONAL PROTECTION

• Add Photo

  Media

• Description - Using the categories below to check needs for this site: Quantity available, condition, and usage

• Hearing Protection

  Safe

  Unsafe

  Corrected

  N / A

• Glasses / Facesheild

  Safe

  Unsafe

  Corrected

  N / A

• Fall Protection

  Safe

  Unsafe

  Corrected

  N / A

• Foot Protection

  Safe

  Unsafe

  Corrected

  N / A

• Hand / Arm Protection

  Safe

  Unsafe

  Corrected

  N / A

• Hard Hats

  Safe

  Unsafe

  Corrected

  N / A

• Reflective Vest / Hi Viz Shirt

  Safe

  Unsafe

  Corrected

  N / A

• Respiratory Potection

  Safe

  Unsafe

  Corrected

  N / A

HANDRAILS / HOLE COVERS

• Add Photo

  Media

• Description

• Floor Openings / Hole Covers / Signage

  Safe

  Unsafe

  Corrected

  N / A

• Perimeter / Handrails / Warning Line / Barricade / Signage

  Safe

  Unsafe

  Corrected

  N / A

RIGGING

• Add Photo

  Media

• Description

• Daily Inspection / Equipment

  Safe

  Unsafe

  Corrected

  N / A

• Rigging Plan / Set Up

  Safe

  Unsafe

  Corrected

  N / A

TOOLS / MATERIAL

• Add Photo

  Media

• Description

• Proper Use of Tools

  Safe

  Unsafe

  Corrected

  N / A

• Guarded / Secured While Cutting

  Safe

  Unsafe

  Corrected

  N / A

• Stored Orderly

  Safe

  Unsafe

  Corrected

  N / A

CHEMICAL MANAGEMENT

• Add Photo

  Media

• Description

• MSDS / Labeling

  Safe

  Unsafe

  Corrected

  N / A

• Storage / Disposal

  Safe

  Unsafe

  Corrected

  N / A

Behavioral Observations

• Unsafe behaviors observed - Actions taken to correct & prevent reoccurrence

  Safe

  At Risk

  N/A

• Safe behaviors observed - Actions taken to encourage safe behavior

  Safe

  At Risk

  N/A