Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Is all Personal protective equipment required for the task available?

  • Has hand and power tools been inspected for frayed cords, missing ground plugs and overall serviceability?

  • Does work require the control of hazardous energy?

  • Has lockout/tagout procedures been implemented?

  • Will this work require traffic or pedestrians disruptions?

  • Are signs/flagmen posted?

  • Are employees wearing hi vis vest?

  • Will work require cutting into, chip into, or making any penetrations into floors deeper than 1 5/8 inch?

  • Are holes in floors covered to prevent falls?

  • Will elevated work platforms (scaffold, aerial lift, scissor lift, baker scaffold) be used?

  • Has work platform been inspected for the shift?

  • Are all employees on jobsites aware of location of fire extinguishers?

  • Have extinguishers received monthly inspection?

  • Will hazardous chemicals be used?

  • Are employees aware of SDS (MSDS) locations for hazardous chemicals they use?

  • Are there eyewash units available?

  • Has fall protection required for this job been inspected before use?

  • Are cords and hoses strung to prevent tripping?

  • Is job site clean and free of debris?

  • Will work involve welding or hot work?

  • Has hot work permit been obtained and copy sent to safety specialist?

  • Are respirators required for this job?

  • Are employees authorized to wear a respirator (medical surveillance, respirator training, fit test)

  • Will this operations require the demolition of concrete, or working with dry motar?

  • Are employees in respirators?

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.