Title Page
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Name of Job
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Conducted on
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Location
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Supervisor
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Prepared by
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Hard hats work by workers on-site?
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Eye protection worn by workers on-site?
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Appropriate footwear being worn by workers?
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Hearing protection needed?
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Hearing protection adequate for noise exposure?
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Hearing protection worn correctly?
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Charge fire extinguishers available on-site?
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Complete first aid kits in job trailer?
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Good housekeeping on job site?
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Proper fall protection being used?
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Are tools and equipment being use as intended?
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Are tools serviceable and in good condition?
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Scaffolding properly assembled and wheels locked?
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Workers out from under suspended loads?
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Seat belts being used in all vehicles and equipment?
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Blanton procedures and guidelines being followed?
Footer
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Inspector Signature
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Supervisor Signature
