Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Job Number

  • Superintendent:

  • Project Manager(s):

PERSONAL PROTECTIVE EQUIPMENT

  • Grade

  • Proper job site clothing

  • Steel tiped (if required) , hard soled boots

  • Head protection

  • Eye protection

  • Fall protection

  • Hearing protection

  • Proper/Maintained PPE in use

HOUSEKEEPING

  • Grade:

  • Immediate work area clean <br>

  • Overall jobsite clean

  • Proper storage of materials

  • MSDS on jobsite

  • Proper record keeping Ex: Job tool box docs. Etc.

  • Proper posting-Comp. Poster/OSHA Logs

  • First Aid Kit on jobsite & stocked

  • Clinic & Hospital maps accessible

  • Employees aware of the injury procedures

  • Employees aware of the injury procedures

  • Water Keg, water bottles on jobsite

TOOLS

  • Grade:

  • All shields, hoods, & guards in place

  • Trained employees using tools

  • Licensed employees using tools

  • Correct use of tools

  • Damaged tools not on site or being used

  • Properly maintained tools

  • Tools properly stored when not in use

  • Signs up when using powder actuated tools

  • Actuated tools unloaded when not in use

LADDERS

  • Grade:

  • All rungs and steps in place

  • Proper base

  • No debris build up on rungs or steps

  • Ladders tied, blocked or secured

  • Barricades in use while in passageways

  • No one climbing with materials/equipment

  • No one standing on top 2 steps

  • Approved ladders on jobsite

  • No damaged ladders in use

  • Proper use of ladders, not to be used as planks, scaffolding

GAURDRAILS & OPENING PROTECTION

  • Grade:

  • Holes covered & marked

  • Wall openings protected 39" a.f.f.

  • Guardrails at building edges 6' or greater fall

  • Guardrails on scaffolding 6' or greater fall

  • Proper materials used for guardrails

  • Maintained guardrails

  • Impalement hazards protected

  • Tie off system in place when installing guardrails

  • Fall protection executed where applicable

  • Compliance of safety monitoring system when in use

ELECTRICAL

  • Grade:

  • Extension cords compliant with OSHA standards

  • Lockout/Tagout when applicable

  • Electrical line hazards

  • Power tools are being used in dry conditions

  • Knowledge of underground utilities

  • Plugged into OSHA approved jobsite power (circuits/breakers)

  • No cutting or drilling in energized walls

  • No overloading of circuits

  • No homemade electrical devices such as cords, receptacles

MATERIAL STOCKING/STAGING

  • Grade:

  • No materials stocked 10' from slab edge

  • Drywall not stocked more than 4' high

  • No strapped/bundled materials over 4' high

  • No overloading of materials on scaffolds

  • Materials stocked on suitable platform

  • Employees trained on how to handle mtls.

  • Workers aware of stocking and staging zones

  • Drywall leaned up against studs marked

SCAFFOLDING

  • Grade:

  • Competent person on jobsite

  • Employees are trained on erect/dismantle <br>

  • Proper erection or dismantling of scaffold

  • Proper equipment

  • Safety rails when working above 6'

  • Wheels locked on scaffolding when in use

  • Out riggers on scaffold above 1 set

  • Scaffolding set up on suitable terrain

  • Ladders to elevated platforms

  • When 4 to 1 height to base, (tie off)

  • Toe boards where applicable

  • Separate towers tied together

  • Working platforms are completely planked

  • Cross brace in place

  • Mud sills in place

  • Awareness of electrical overhead hazards

MOBILE EQUIPMENT

  • Grade:

  • Seatbelts or restraint system in use

  • Proper use of cranes, forklifts, & lifts

  • Licensed operators

  • Equipment inspection with inspection records

  • Overhead hazards identified

  • Working in adequate illumination

  • Proper guards/shields in place

  • Equipment maintained

  • Construction barricades in traffic areas

  • Shift inspection records available if applicable

  • Operable working reverse alarm

PRESENCE OF SAFETY SUMMARY

  • Project Manager Signature:

  • Superintendent Signature:

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.