Chandos Safety Contact Report

• Job # & Site Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• 1. Emergency Procedures

  Correct

  Action Required

  N/A

• 2. Site Signage

  Correct

  Action Required

  N/A

• 3. Chemicals and Material Storage

  Correct

  Action Required

  N/A

• 4. Documentation and Permits

  Correct

  Action Required

  N/A

• 5. Site Personnel

  Correct

  Action Required

  N/A

• 6. The Work Area

  Correct

  Action Required

  N/A

• 7. Equipment and Tools

  Correct

  Action Required

  N/A

• 8. Working at Heights

  Correct

  Action Required

  N/A

• 9. Trenches / Excavation / Confined Space

  Correct

  Action Required

  N/A

Inspection Comments:

• Corrective actions to be completed:

  Yes

  No

  N/A

• Select date

  Date

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign