Information

  • Contractor

  • Foreman

  • Conducted on

  • Location
  • Personnel

  • Prepared by

Fall Protection

  • Body Harness & Lanyards with Shock Absorbers properly inspected & in use.

  • Independant safety lines in place; installed & anchored properly.

  • 100% Tie-off when working in unprotected areas above 6ft.

Scaffolding

  • Exterior Scaffolding - Platforms / Picks have Handrails & Independent Lifelines in place.

  • Suspended scaffold anchor points & rigging sufficient?

  • Interior Scaffolding/Painter's Boom in good repair.

  • Scaffold & Painter's Boom anchor points & rigging sufficient?

Housekeeping

  • Walkways & Access Points free of debris and storage.

  • Trash & Debris properly disposed of.

  • Handwashing Station on site.

  • Damaged / Defective equipment removed and tagged "Out Of Service."

Tools

  • Hand tools are in good repair. (No damaged handles, no mushroomed heads.)

  • Power tools have proper guards in place.

  • Electric cords / tools are in good condition.

  • Fire Extinguisher accessible & fully charged.

  • Ladders in good repair, have three rung clearance & secured.

Personal Protective Equipment (PPE)

  • Hard Hats

  • Safety Glasses

  • Gloves

  • Face Shields / Welding Hoods

  • Protective Clothing

  • Proper Attire

  • Respiratory Protection

Environmental

  • Environmental Hazards Observed

  • Paint Storage Area designated?

  • Mixing Area designated & ground protected from spills.

Lead

  • Is this a lead project/is there lead paint on this tank?

  • Has the Action Zone been established & Lead Hazards signs in place?

  • Has personal air monitoring been done to set Action Levels?

  • Is a proper decontamination station set up? i.e.: hand-wash station, decontamination trailer with shower, changing area.

  • Has lead waste been tested/TCLP?

  • Lead waste storage area designated?

  • Is lead waste properly stored? i.e.: dumpster lined, covered at night, ground cover, hazardous waste storage drum.

  • Are crew members decontaminating before smoking, eating and/or drinking?

  • Is there a HEPA vacuum being used before exiting containment?

Containment

  • Is a containment system set up on this site?

  • Is the air tugger/ containment hoist properly mounted?

  • Is the hoist cable properly secured?

  • Is the cable in good condition?

  • Are the anchors in good condition? i.e.: not pulling loose

  • Correct number of cable clamps installed and properly torqued?

  • Is the rigging tree properly secured?

  • Is the rigging tree loaded evenly & properly?

  • Is the bonnet tight and secure? No low hanging/entanglement hazards.

  • Are the tarps/sided properly sealed & in good condition?

General

  • Job site properly marked, including barricades & construction signs.

  • First-aid & Bloodbourne Pathogens kit fully stocked & accessable

Signatures

  • Subcontractor Foreman

  • Auditor

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.