CompTrust AGC MCIC Loss Prevention Report SV

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety Management

• Written Safety Program at Site

  Yes

  No

  N/A

• Hazard Communication and SDS Available

  Yes

  No

  N/A

• Tool -box Safety Meetings Conducted

  Yes

  No

  N/A

• Site Posters / WC Panel of Physicians at Site

  Yes

  No

  N/A

• Report for Safety Van Training Visit

• Meeting Topic

Work in Progress

• Work

Jobsite Conditions

• Housekeeping

  Safe

  At Risk

  N/A

• Lighting / Illumination

  Safe

  At Risk

  N/A

• Personal Protective Equipment

  Safe

  At Risk

  N/A

• Health Hazards

  Safe

  At Risk

  N/A

• Fire Protection / Prevention

  Safe

  At Risk

  N/A

• Material Handling / Storage

  Safe

  At Risk

  N/A

• Rigging - Slings

  Safe

  At Risk

  N/A

• Power Tools

  Safe

  At Risk

  N/A

• Welding / Cutting

  Safe

  At Risk

  N/A

• Fall Protection

  Safe

  At Risk

  N/A

• Scaffolds

  Safe

  At Risk

  N/A

• Scissor Lifts

  Safe

  At Risk

  N/A

• Electrical

  Safe

  At Risk

  N/A

• Ladders

  Safe

  At Risk

  N/A

• Stairways

  Safe

  At Risk

  N/A

• Aerial Lifts

  Safe

  At Risk

  N/A

• Cranes

  Safe

  At Risk

  N/A

• Forklifts - Operation, Training

  Safe

  At Risk

  N/A

• Excavation / Trenching

  Safe

  At Risk

  N/A

• Mechanical Equipment - Dirt Moving / Hauling

  Safe

  At Risk

  N/A

• Steel Erection

  Safe

  At Risk

  N/A

• Concrete Slabs / Formwork

  Safe

  At Risk

  N/A

• Masonry Construction -

  Safe

  At Risk

  N/A

• Demolition

  Safe

  At Risk

  N/A

Additional Comments

• Comments

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• Affinity Service Group Consultant

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• Member Superintendent / Foreman

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