Information
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Foreman's Name
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ATD Job Number
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Job Name
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Name of GC/Customer
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Today's Crew Size
Jobsite Safety
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1) Jobsite binder in gang box?
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Is binder stocked with safety forms, paperwork, and signage?
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2) Do you have the jobsite-specific MSDS's/SDS's?
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3) Did you or a crew member complete and submit a Job Hazard Analysis (JHA)? If YES, please describe:
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4) Crew members fit for duty?
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5) Daily Huddle or pre-task meeting conducted today? If YES, list topic(s) and describe outcomes:
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6) Emergency procedures known & understood?
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7) Does your gang box have a stocked first aid kit?
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8) Fire extinguisher available?
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9) Did you lead a Stretch & Bend session for your crew today?
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10) TBT conducted? (Monday)
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11) PPE, respiratory protection, etc. available/in use as required by OSHA/ATD/GC?
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12) Only properly trained and authorized crew members performing tasks?
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13) Did you personally observe for & correct unsafe behaviors/conditions today? If YES, please describe and include photos:
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Add media
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14) Has your equipment been inspected today? If YES, please describe and include photos:
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Add media
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15) Has your crew reported any near-misses today? If YES, please describe:
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16) ZERO injuries reported today? If NO, please describe what happened:
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17) ZERO misc. incidents today? (ie: property damage, theft, overspray, vehicular/pedestrian accident, etc.). If NO, please describe what happened:
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18) Did you conduct at least one formal joint safety inspection with a crew member this week? If YES, please describe:
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19) Did any crew member report a HAZARD RECOGNITION to you today? If YES, please describe including corrective actions taken:
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20) Equipment secure at end-of-shift?
Additional notes or comments:
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Foreman's Signature
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Select date
