Information
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Project/Job
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Conducted on
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Prepared by
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Location
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Personnel
PPE
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Safety glasses
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Face shield
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Appropriate Gloves
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Others
Right tools for the task
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Right tools for assinged task
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Inspected/Color Coded
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D. Other:
FIRE SAFETY
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A. Hot Work Permit (if required)
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B. Fire Watch Assigned (Competent Person)
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C. Fire Extinguisher/Inspected
Working at height
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Bodyharness in place
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Lifeline in place
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Scaffolding checklist completed
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Appropriate a frame ladder
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Tools tied and secured
WORK AREAS
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Appropriate barricade in place
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Warning signs in place
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Work information available (contact person, type of work)
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Access way clearly identified
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Tools and materials at right place
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Work areas are clean and tidy
Comments/Recommendations
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Enter any corrective actions that will be undertaken
Sign Off
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Safety Representative
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Site Incharge
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Construction Supervisor
