Commercial Safety Inspection

• Inspector Name:

  Select Zac Kyle Levi Schrock Josh Spink

  • Zac Kyle
  • Levi Schrock
  • Josh Spink

• Date of Inspection:

  Date

• GC:

• Name of foreman:

  Select Justin Henry Otis Hensler Raymundo Lopez Dior Washington Devon Heck Alex Lemus Mauricio Ochoa Chad Lewis

  • Justin Henry
  • Otis Hensler
  • Raymundo Lopez
  • Dior Washington
  • Devon Heck
  • Alex Lemus
  • Mauricio Ochoa
  • Chad Lewis

• Project Number:

• Type of Job:

  Select Footing Stem Wall Wall Excavation Backfill Prep/Stone Base Pour Sidewalk Curb Concrete Paving Slab on Grade Slab on Deck

  • Footing
  • Stem Wall
  • Wall
  • Excavation
  • Backfill
  • Prep/Stone Base
  • Pour
  • Sidewalk
  • Curb
  • Concrete Paving
  • Slab on Grade
  • Slab on Deck

Safety:

PPE

• Is sufficient PPE being used?

  Yes

  No

  N/A

• PPE being used:

  Select Hard Hat Shirt Pants Boots Gloves Safety Glasses High-Vis Vest Respirator Ear protection Face Shield

  • Hard Hat
  • Shirt
  • Pants
  • Boots
  • Gloves
  • Safety Glasses
  • High-Vis Vest
  • Respirator
  • Ear protection
  • Face Shield

• PPE not used:

  Select Hard Hat Shirt Pants Boots Gloves Safety Glasses High-Vis Vest Respirator Ear protection Face Shield

  • Hard Hat
  • Shirt
  • Pants
  • Boots
  • Gloves
  • Safety Glasses
  • High-Vis Vest
  • Respirator
  • Ear protection
  • Face Shield

• Names of those without proper PPE:

Fall Protection

• Is guardrail or PFAS present?

  Select Guardrail PFAS N/A

  • Guardrail
  • PFAS
  • N/A

• Is top rail at 42" (+/- 3")?

  Yes

  No

  N/A

• Is mid rail at 20" - 35"?

  Yes

  No

  N/A

• Is guardrail sturdy (200lbs of applied pressure)?

  Yes

  No

  N/A

• Is PFAS attached to an approved anchor?

  Yes

  No

  N/A

• Is lanyard in good condition?

  Yes

  No

  N/A

• Is harness worn properly?

  Yes

  No

  N/A

• Is PFAS in overall good condition?

  Yes

  No

  N/A

Misc. Safety Items

• Are stakes capped?

  Yes

  No

  N/A

• Is vac being used a HEPA Vac?

  Yes

  No

  N/A

• Any unique hazards on jobsite?

EPA:

• Are all EPA guidelines being followed?

  Yes

  No

• Is street dirty from job?

  Yes

  No

  N/A

• Is there a wash pit onsite?

  Yes

  No

  N/A

• Is wash pit close?

  Yes

  No

  N/A

• Is wash easily accessible?

  Yes

  No

  N/A

Housekeeping

• Is jobsite cleared of excessive trash?

  Yes

  No

• Are Custom Concrete trucks clean of trash?

  Yes

  No

  N/A

• Does equipment have excessive mud or concrete on them?

  Yes

  No

  N/A

Sanitation

• Is there a portable toilet onsite?

  Yes

  No

• Is portable toilet onsite close?

  Yes

  No

Excavation

• Proper sloping/benching?

  Yes

  No

  N/A

• How wide is path between wall and excavation?

  Yes

  No

  N/A

• Any potential cave-offs?

  Yes

  No

  N/A

• Name of person/subcontractor who dug site:

• Is construction entrance good enough for all equipment and/or vehicles?

  Yes

  No

  N/A

• Is jobsite congested with traffic and/or not enough working space?

  Yes

  No

  N/A

• Picture of jobsite:

  Media

Vehicle

• Vehicle ID number(s)?

• Is pre-trip inspection filled out?

  Yes

  No

  N/A

• Name of driver:

• Are cones being used?

  Yes

  No

  N/A

• Does truck(s) show any new damage?

  Yes

  No

  N/A

• Is skid steer emergency exit accessible?

  Yes

  No

  N/A

Tools & Equipment

• Are all tools, cords, & equipment in good condition?

  Yes

  No

  N/A

• Are all hand tools in safe and usable condition?

  Yes

  No

  N/A

• Are all power tools in safe and usable condition (all guards in place and no modifications)?

  Yes

  No

  N/A

• Are all cords in good condition (excluding power tools)?

  Yes

  No

  N/A

Storage

• Are all fuel cans being stored in safe location and properly labeled?

  Yes

  No

  N/A

• Are all high valued tools stored in a safe location while not in use?

  Yes

  No

  N/A

• Are all storage containers properly labeled?

  Yes

  No

  N/A

• Anything else needing to be noted about jobsite?

• Photo?

  Media

• Anything else needing to be noted about jobsite?

• Photo?

  Media

• Anything else needing to be noted about jobsite?

• Photo?

  Media

• Anything else needing to be noted about jobsite?

• Photo?

  Media

• Anything else needing to be noted about jobsite?

• Photo?

  Media