Permit Management

Workers badged appropriately?

ICRA Permit Posted - not expired

ILSM Assessment Posted

Emergency Contact Listing Posted

Hospital Codes/Orientation Information Posted

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ICRA Requirements Maintained

Project Secured From Public

Work Area Clean & Orderly

Construction Debris Under Control

Clear Paths of Egress

Dumpster Maintained

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Personal Protective Equipment

Appropriate PPE in use

Fire Prevention & Protection

Fire Extinguishers

No Smoking Enforced

Housekeeping (fire hazard related)

Material Storage

Fire Sprinkler Systems

Compressed Gas Cylinders

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Temporary Wiring & Lighting

Extension Cords


Equipment Condition

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Hand & Power Tools

Correct Tools

Equipment Condition (e.g. Frayed cords, lack of guards)

Operator Safety Manuals

Knowledge of Use

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Object Hazards

Protrusions & Catch Hazards

Unsafe Work Methods

Tool/Material Placement

Debris Piles

Additional Photos
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Photo Comments:

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Photo Comments:

Overall Rating

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Other Comments

ICRA/ILSM/Safety Team Representative Signature
Contractor/Project Representative Signature (optional)
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.