Component West Pre-Task Inspection

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Job Details

• Job Name

  Camp Pendleton Replacement Hospital: U.C. Davis

• Weather Conditions

  Sunny

  Partly Cloudy

  Cloudy

  Drizzle

  Raining

• Temperature (approximate degrees F)

• Work Location

• Job Activity

  Select Interior Framing Exterior Framing Drywall Installation Drywall Taping Material Moving Housekeeping

  • Interior Framing
  • Exterior Framing
  • Drywall Installation
  • Drywall Taping
  • Material Moving
  • Housekeeping

• Superintendent

  Vinny Nitopi

• Site Foreman

  Mickey Joseph

  Mark Noble

• Safety Contact

  Eric Vogt

  Bob Torrieri

Task Hazards

• #1 Hazard associated with performing this task.

• Steps to be taken to control hazard #2

• #2 Hazard associated with performing this task.

• Steps to be taken to control hazard #3

• #3 Hazard associated with performing this task.

• Steps to be taken to control hazard #3

• #4 Hazard associated with performing this task.

• Steps to be taken to control hazard #4

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Employees Participating in Pre-Task Plan

• Name

• Start Time

  Date

• Finish Time

  Date

• Is Worker injured? ***ALL INJURIES MUST BE REPORTED IMMEDIATELY! NO EXCEPTIONS!***

  Yes

  No

• Workers Signature

  Sign

Supervisor's Verification

• I have verified all workers have the proper PPE and it is in serviceable condition. There are no injuries that have not been reported. I have previously ordered all materials and safety equipment to complete today's work.

  Yes

  No

  N/A

• Name of Supervisor

  Select Jose Contreras Gary Dickens Andrew Joseph Ciro Lagunas Tony Soriano Robert Veague

  • Jose Contreras
  • Gary Dickens
  • Andrew Joseph
  • Ciro Lagunas
  • Tony Soriano
  • Robert Veague

• Supervisor's Signature

  Sign