Title Page

  • Job Number

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Superintendent/Foreman

Atmospheric Monitoring

  • Is a gas monitor required for work being performed?

  • Is the gas monitor calibrated and in good working order?

  • Has a bump test been performed?

Cranes/Critical Lifts

  • Has a lift plan been completed?

  • Is the annual inspection for the crane completed?

  • Does the operator have the valid and applicable certification?

  • Has a daily inspection been completed?

  • Is a spotter/signal person in place?

  • Are alarms working and audible?

  • Has the lifting capacity and work to be performed been verified?

  • Is the proper rigging being utilized and inspected prior to use?

Electrical Hazards

  • Are electrical cords and extension cords in good condition?

  • Overhead electrical lines and cables clearly identified and safety work distances maintained?

  • GFCIs used where required?

Excavation/Trench

  • Competent Person

  • Has the competent person completed a trench/excavation inspection?

  • Properly benched/sloped or shored when exceeding 5 ft. in depth?

  • Is there safe access/egress when exceeding 4 ft. in depth?

  • Access/Egress within 25ft.?

  • Spoil material at least 2 ft. from edge of the excavation?

  • Have underground utility installations been identified and safely excavated?

  • Are open excavations protected when necessary?

Fire Prevention

  • Is the fire extinguisher inspected for the current month?

  • Is the fire extinguisher annual inspection current?

  • Does the fire extinguisher appear to be in good working order, charged and free of damage?

  • Are fire extinguishers properly located and mounted?

  • Compressed gas cylinders separated & secured?

  • Proper storage of flammable materials? Approved Containers?

  • Are fuel tanks properly grounded?

Hand & Power Tools

  • Condition of hand tools and power.

  • Are all tools being used for their intended use?

  • Guards on tools & equipment?

Hoisting/Rigging Equipment

  • Is the correct rigging system used?

  • Is there a permanently affixed and legible identification to indicate SWL?

  • Condition of rigging hardware

Hot Work/Welding

  • Is proper PPE being worn for welding, cutting, grinding, etc. activities?

  • Are all employees wearing FR Clothing?

  • Condition of welding leads

  • Is a Hot Work Permit completed?

  • Is a dedicated Fire Watch in Place?

  • Area free of combustibles?

Housekeeping

  • Good appearance?

  • Proper trash disposal?

  • Prevention of slips/trips/ falls?

Ladders

  • Is the ladder appropriate for the task?

  • Is the ladder set at proper angle?

  • Is the ladder extending 3' beyond the work surface or leading edge?

  • Is the ladder adequately secured to prevent movement?

  • Condition of the ladder

Mobile Equipment/Vehicle Safety

  • Operation of equipment and vehicles.

  • Condition of equipment.

  • Seat belts being worn while operating equipment?

  • Are vehicles/equipment left running and unattended?

  • Is equipment properly secured when not in use? (Attachments grounded, brake engaged, parked in safe location, etc.)

  • Proximity to employees. Are spotters in place?

  • Has the operator performed a daily inspection?

  • Back-up alarms operational?

  • Are vehicle wheels chocked when parked on grade?

  • Are vehicles in good condition or free from creating additional hazards?

  • Are vehicles or equipment being loaded beyond their capacity?

  • Load Securement

PPE

  • PPE used for task

  • Are all employees wearing appropriate PPE required for the task and work location?

  • Is all PPE in good condition and being worn properly?

Traffic Control

  • Is traffic control being performed by a subcontractor?

  • Are approach signs in place and adequate for work activities?

  • Is proper communication being utilized?

  • Is a transition area and work zone delineation properly set up?

  • Are appropriate traffic control devices being utilized?

  • Are the appropriate measures being taken for night time flagging operations?

Jobsite (General)

  • Is the JSA onsite and complete?

  • Are other applicable permits completed (Confined Space, Critical Lift, Hot Work, Excavation, Lift Plan, etc.)?

  • Were there any incidents reported (Injury, Property Damage, Line Strike, Near Miss, Etc.)?

  • Are first aid kits available and stocked?

  • Are all employees trained for the tasks being performed (Competent Person, Confined Space, Aerial Lifts, HAZWOPER, Fire Watch, etc.)?

Efficiencies

  • Adequate staging of materials.

  • Employee emergency access/egress maintained.

  • Utilization of equipment.

  • Other areas for improvement.

Observations to Initiate Improvement

  • Pre-Job Plan/Inspect.

  • Proper Tool for the Job.

  • Line of Fire.

  • Eyes on Path.

  • Protective Equipment/PPE.

  • Housekeeping.

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.