Information
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Job / Crew
Superintendent
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- Zach Geuy
- Scott Stayton
- Mark Barnes
- Nelson Hickey
- Earl Payne
- Mike Haney
- Scott Weeks
- Dave Latham
- Tim Woods
- Jeff Finley
- Jay Shawver
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Conducted on
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Prepared by:
- Forrest Cash
- Gary Coffey
- Donald Cash
- Jeremy Sleve
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Location
PPE
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All workers wearing class 3 safety vest?
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All workers wearing hard hats?
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Appropriate footwear being worn?
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Face shields for chipping / grinding operations ?
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Safety glasses in environments where hazards are present (dust, debris, etc)
Trucks / Equipment
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Strobes / Flashers operational & in use?
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Operators wearing seat belts?
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Daily inspections / Zonar complete?
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Back up alarms operational?
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Mirrors / backup cameras in good condition
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Fire extinguishers on all trucks / equipment?
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Cab clean of trash & debris?
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Placards in place and readable on required loads?
Traffic Control
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Warning signs properly posted?
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Signs clean and in good condition?
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Barrels / cones properly set?
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Flaggers using stop / slow paddles?
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Flaggers positioned in safe location?
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Pedestrian traffic protected?
Misc. Tools & Equipment
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Hand tools in good condition? (No damaged handles/parts, proper for job)
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Fuels stored in labeled safety cans?
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Chemical containers labeled?
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MSDS / SDS available?
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Lifting equipment adequate? Load rating tags in place & legible?
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Extension cords in good condition
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GFCI in use?
Excavations
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Daily inspection completed?
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Trench box / benching / sloping where needed?
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Ladder or ramp where required?
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Spoils at least 2 feet from edge?
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Unattended excavation guarded?
Misc.
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Foreman / Superintendent Signature