CCSC - Open Hole Tracking Template

• Conducted on

  Date

• Prepared by

Lower Level

L1H1

• Is Elevator/Escalator Erected?

  Yes

  No

  N/A

• Is Red Danger Tape Present and in Good Condition?

  Yes

  No

  N/A

L1H2

• Is Elevator/Escalator Erected?

  Yes

  No

  N/A

• Is Red Danger Tape Present and in Good Condition?

  Yes

  No

  N/A

Upper Level

L2H1

• Is Elevator/Escalator Erected?

  Yes

  No

  N/A

• Are Guardrails Present and OSHA Compliant?

  Yes

  No

  N/A

• Is Toe Board in Place?

  Yes

  No

  N/A

• Is Orange Screen in Place?

  Yes

  No

  N/A

• Is Proper Signage in Place?

  Yes

  No

  N/A

L2H2

• Is Elevator/Escalator Erected?

  Yes

  No

  N/A

• Are Guardrails Present and OSHA Compliant?

  Yes

  No

  N/A

• Is Toe Board in Place?

  Yes

  No

  N/A

• Is Orange Screen in Place?

  Yes

  No

  N/A

• Is Proper Signage in Place?

  Yes

  No

  N/A

Sleeves

• Is Hole Filled? (Pipe/Conduit/HVAC)

  Yes

  No

  N/A

• Is Hole Cover Present and Secure?

  Yes

  No

  N/A