Information

  • Project Number

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

  • Location

General

  • Weekly tool box talk available for review?

  • Weekly safety inspection available for review?

  • Daily AHA forms for each crew available for review?

  • Drinking water and cups available?

  • Adequate temporary lighting in work areas?

  • First aid kit stocked?

Housekeeping

  • Adequate number of toilets available and clean?

  • Projecting nails or screws bent over or removed?

  • Walkways and passages clear to walk?

  • Rebar ends protected by caps or 2x4?

Personal Protective Equipment

  • Employees wearing safety glasses at all times?

  • Employees wearing hard hats?

  • Employees wearing gloves when exposed to cut/chemical hazards?

  • Hearing / Respiratory Protection worn by employees when required?

Electrical

  • GFCI protection in use on all temporary power sources?

  • Electrical panels and devices labeled and secured?

  • Extension cords in good condition?

Hand and Power Tools

  • Power Tools free from damage (switches, cords, and guards)?

  • Hand tools free from damage ( shaft, head, splinters, etc.)?

  • PAT operator have training card available for review.

Excavations

  • Have utilities been located and protected?

  • Adequately sloped or shored if below 5' in depth?

  • Means of egress every 25 feet?

  • Spoil pile and equipment back at least 2 feet from edge?

  • Water being pumped out if present?

  • Documented daily inspection available for review?

Fall Protection

  • Employees using anchor capable of supporting 5,000 lbs?

  • Elevated work levels have guardrails or cables at 21" and 42"?

  • Employees working above 6 feet using fall protection?

  • All holes covered and labeled?

Fire Protection

  • Only NFPA approved containers used for fuel?

  • Flammable materials removed from job site properly?

  • Adequate number of fire extinguishers in place?

Ladders

  • Do extension or job built ladders extend 36 inches above laning?

  • Are spreader bars locked on step ladders?

Powered Industrial Equipment

  • All equipment have ROPS installed?

  • Back up alarm working on on equipment?

  • Operator wearing seatbelt?

  • Operator have training card available (forklift)?

  • Employees wearing fall protection when using aerial lift?

Cranes

  • Does crane have annual inspection available for review?

  • Does operator have training card available for review?

  • Does operator have daily/weekly inspection available for review?

  • Is swing radius of crane barricaded?

  • Are outriggers in use (if equipped and needed)?

Scaffolding

  • Mudsill, base plate, and Screwjack in place?

  • Guardrails, Midrails and Toeboards installed?

  • Ladder access provided for employees on all working levels?

  • Rolling scaffold wheels locked?

Hot Work

  • Fire extinguisher available and inspected?

  • Flashback arresters in place on torch heads?

  • Gas cylinders separated when not in use?

Review

Comments

  • Pictures

  • Superintendent Signature

  • Safety Engineer Signature

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