Select date
Add location
Company Name

General Requirements

Do employees know the location of the MSDS sheets

Are all containers labeled properly?


Is the competent person on site when work is being done?

Are excavations inspected daily

Has a dig permit been filled out prior to the start of work and signed by a Mortenson team member?

Are spoils piles back at least 2' from the edge of the excavation?

Are protective systems in place? (Trench boxes,shoring or sloping)

Is a fall protection system in place on the trench box?

Is there adequate access/ egress to the trench?

Add media
Confined Space

Has a confined space permit been filled out for the day?

Is a tri-pod in place?

Is an air monitor being used?

Are they ventilating the hole?

Is the attendant identifiable?

Is the entrant wearing a harness properly?

Add media
Fire Prevention

Has a Hot Work Permit been filled out for the day and signed by a Mortenson team member?

Have all flammables/combustibles been removed from the area?

Is a 10# fire extinguisher present?

Is a fire watch present?

Add media
Fall Protection

Is the anchorage point cable of supporting 5,000 lbs?

Has the employee been properly trained in how to wear a harness?

Has your harness been inspected prior to each use?

Add media

Have all utilities been located

Spills and Leaks

Do employees know the procedure for containment of spills/leaks.

Is a spill kit on site?

Add media
Equipment Inspections

Inspections done daily

Written log available

Add media

Hard hat being worn

High visibility vest


Safety glasses

Hard soled shoes (boots)

All other necessary PPE being worn

Storm Water

BMPs in place/maintenance

Current site plan with BMPs shown?

Rain gauge/inspection frequency

Add media
Traffic Control

Traffic pattern for haul roads in place?

Traffic control/ road closure plan in place?

Flaggers being used are in place and are CDOT certified?

Traffic control devices set up per plan and checked daily

Add media
Concrete Work

All vertical steel has caps on it

Respirators being worn while doing saw cutting?

Correct PPE being worn (gloves,rubber boots)

Face shield being used while saw cutting

Add media
Pre Shift Start up

Pre task completed

IWP reviewed daily

General observations/other

Add media
Add signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.