Title Page

  • Conducted on

  • Prepared by

  • Location
  • Job #

Personal Protective Equipment

  • Hard Hats Worn At All Times

  • Safety Glasses With Sideshield

  • Face Shields When there Is Potential For Flying Debris

  • Hearing Protection Where Required

  • Full Body Harness With Lanyard Where Needed

Hot Work

  • Fire Protection (Extinguisher / Tarpaulins)

  • Fire Extinguisher Inspected and Tagged

  • Welding Shields In Use

  • Cylinders Secured And Capped When Not In USe

  • Leads And Hoses In Good Condition

Walking/Working Surfaces

  • All Floor Openings And Holes Greater Than 2” Cvered

  • Aisle ways Are Clear Of Hazards Such As: Ext Cords, Welding Leads And Stored Material

  • All Leading Edges With Falls. Greater Than 6’ Protected

  • Welding Rod/All Thread Stubs Are Placed In A Bucket/Trash Container

  • Work Is Properly Illuminated

  • Roof Top Work Has Proper Fall Protection System

  • How Often Is Clean-Up Being Done Per Day

Material fitting/Handling

  • Emmplooyee’s Are Using Proper Lifting Techniques, Etc

  • Slings Are In Good Condition

  • Rigging Is Being Inspected Before Each Use

  • Shackles Are Used On All Multi-Leg Piks

  • Cranes, Chains Falls, Come-Along And Air Tuggers Are Properly Sized And Used In A Safe Manner

  • Porta Powers Are Properly Sized And Used In A Safe Manner

Scaffolds And Manlifts

  • Number Of Scaffolds Your Crew Is Using

  • Handrails And Toe Boards Are In In Place

  • Scaffolds Have Proper Access And Are Tagged , Dated And Inspected By A Competent Person

  • Fall Protection Used In Boomlifts

  • Fall. Protection Requirements For Scissor Lifts Are eying Met

Excavations

  • Excavation Depth Is ____________Feet

  • Designated Competent Person Is

  • 5’ Or More In Depth - Shored Or Benched

  • Spoil Is A Minimum of 2’ From Edge Of Excavation

  • Excavation Are Inspected Daily For Any Changed In Working Conditions

  • Entry Permits Are Filled Out And Posted For Excavations Greater Than 5’

  • Protective Systems For Excavation Over 20’ In Depth Have Been Designed By A Professtional Engineer

  • Proper Access/Egress Is Provided

Ladders

  • All Ladders Free Of Defects

  • Step Ladders Used In Only The Open Position

  • Straight Ladders Are Being Used At Proper Angle

  • Straight Ladders Are Equipped With Safety Feet And Are Secured to Avoid Displacement

  • Access To Ladders Free Of Debris And/Or Obstructions

Power Tools

  • Power Cords In Good Conditon

  • Guards In Place

  • Ground Fault Interruption Protection Is Being Used

Questions For Foreman

  • I Am Working With PM To Resolve Any Of The Above Issues

  • Was A Project Saafety Analysis Performed On this Project

  • Current Safe Behavior By Craftsman

  • Daily Job Hazard Analysis

  • Are We General Contractor or Subcontractor

  • Comments Or Complaints (Explain If Any No’s Aboe)

  • Take A Photo Of Concerns

  • Name Of Safety Committee Mamber Doing Inspection

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.