Title Page
-
Project Name
-
Brief Summary of Tasks and Crew (number of carpenters, finishers, etc)
-
Construction Management/General Contractor/Owner Representative
-
Circle B Subcontractors on-site
-
Report Date
-
Prepared by
-
Assisted by
Safety Documentation, Emergency Action Plan, First Aid Kits
-
Weekly TBT, Daily JHA/PTP, Equipment Inspections, & Other Reports/Documents
-
First Aid Kits: Location, Adequately Stocked, Trained Provider
-
Emergency Action Plan is Posted: Nearest Approved Medical Facility, Emergency Signals, Evacuation or Shelter Map/Locations
Housekeeping/Organization (related to Circle B tasks, except item for 'other')
-
General Site Conditions (clear walkways, work areas, and access to entry/exits)
-
Material Storage: Stable, Organized, Accessible
-
Trash/Waste Removal (dump/trash carts available, accessible dumpsters, trash removal schedule)
-
Hazard Communication (containers labeled, stored correctly, used properly, chemical list available, SDS available)
-
Other Site Hazard Awareness (other trade & owner activities, site conditions, site visitors/public access)
Fire Prevention and Protection
-
Site Provided Fire Extinguishers: Location & Condition of Extinguishers
-
Task Specific Area: (dedicated fire extinguisher, protected & clear of combustible/flammable materials, hot work permits when required)
-
Flammable Fuels/Chemicals (proper container, storage, labels, use)
Personal Protective Equipment
-
General: Hard Hat, Safety Glasses (with side shields), Sturdy Work Boots (safety toe per task/project requirement)
-
Gloves: Cut Resistant, Task Specific, Project/Site Required
-
Face Shield: Use with Chop Saws, Grinders, Circular Saws, as required by tool manufacturer, other tasks that create similar flying object potential.
-
Respiratory Protection: Task Specific Dust Mask, N95, or other type
-
Hearing Protection: Ear Plugs or Ear Muffs as required by Noise Level of Task or Equipment
-
Hi-Visibility Clothing: Site/Task Required
Fall Prevention and Protection
-
Guardrails: Wood or Cable (toprail, midrail, and toeboard, properly secured)
-
Barricades/Warning Lines: Red/Yellow Tape with Signs (restricted access, overhead hazards, leading/open edges, limited access areas)
-
Personal Fall Arrest Systems (Full Body Harness, Lanyard/SRL, Anchor Point): Inspected, Proper Installation and Use of Equipment
Electrical, Temporary Lighting, Hand/Power Tools
-
Temporary Electrical Power: Outlets Provided, GFCI's, Protected from Damage
-
Extension Cords, Battery Chargers, Tool Cords: Condition, GFCI or Double Insulated, Protected from Damage
-
Hand & Power Tools: correct selected, inspected, in good condition, used as designed, stored/protected from damage
-
Temporary Lighting: Provided, Adequate, Protected, Portable Lights available as needed
Elevated Work Tasks: Ladders, Benches, Stilts, Scaffolds, MEWPs
-
Ladders: Step/Extension (correct type, inspected, proper set-up & use)
-
Carts (finishers), Drywall Benches, Stilts (inspected, proper set-up, & use)
-
Scaffolds (correct type, proper assembly, height/base ratio stable, inspection)
-
Mobile Scaffolds (proper assembly, locked wheels)
-
Scaffolds: Fall Protection (guardrails when platform at/above 4 feet, personal fall protection systems)
-
MEWP: Boom/Scissor Lifts (correct type & use, inspected, fall protection as required)
-
Suspended Scaffold System (inspected pre-use/post-break/post-lunch, proper set-up, competent person, personal fall protection system)
Material Handling / Heavy Equipment
-
Manual Material Handling (proper lifting form, team lifts, lift plan and clear path)
-
Lifting/Rigging Equipment (competent person, inspection, condition, proper selection, rigging plan)
-
Forklift/Lull/Telehandler (trained operator, inspection, proper selection, correct use)
-
Cranes: Certified Operator, Stable Set-Up, Inspected
-
Trained/Qualified Signal Person, Standard Signal Chart Posted
General Notes/Comments
-
Note / Comments
-
Foreman signature