AOC/LBG Safety Check

• Document No.

• Job Site Location

• Description of Work

• Shop(s) Present

• Conducted on

  Date

• Conducted By

Worker Safety

• 1. Is proper PPE being worn?

  Yes

  No

• Select missing PPE.

  Select Eye Hand Foot Hearing Head Respiratory

  • Eye
  • Hand
  • Foot
  • Hearing
  • Head
  • Respiratory

• 2. Is there a clear path, free of trip/slip/fall hazards?

  Safe

  At Risk

  N/A

• Please take photo of hazard.

  Media

• 3. Are tools in proper working condition?

  Safe

  At Risk

  N/A

• Please take photo of hazard.

  Media

• 4. Are workers using proper lifting techniques?

  Safe

  At Risk

  N/A

Job Site Conditions

• 1. Is the job site clean and free of waste and debris?

  Safe

  At Risk

  N/A

• Please take photo of job site.

  Media

• 2. Is the job site clearly marked and secure from unauthorized personnel?

  Safe

  At Risk

  N/A

• 3. Do workers know where to access applicable MSDS?

  Yes

  No

  N/A

• 4. Have applicable permits been obtained? (Hot Work, Confined Space, etc.)

  Yes

  No

  N/A

Additional Information

• Enter any additional comments.

• Signature of Safety Manager

  Sign