Information

  • MarketOne Builders

  • Job Site Name
  • Job Number

  • Conducted on

  • SUPERINTENDENT/FOREMAN:

  • Number of M1B Employees / Number of Subcontractor Companies

  • Prepared by

Postings

  • 300A Posted Feb.1 to April 30?<br>

  • Emergency Phone#?

  • Cal/OSHA/CSO/Code Safe Practices/Clinic/Hospital Info?

  • SDS/Labeling?<br>

  • Excavation Notification/Project/Permits/USA?

  • Door or Gate Signage/Wall Map

Lighting

  • Lighting/String Lights/Cages/Securing?

  • Task/Area lighting sufficient/Flashlights?

SWPPP

  • Inspections/Weather Reports?

  • Rain Gauge Readings/Spill Kit/Waste Handling?

  • BMP's Maintained?

  • Porta-can Secured In Place?

TRAINING

  • Training Cards/Safety Meetings/Special Tailgates?

  • Safety Audit Conducted/Documented/JHA?

ELECTRICAL

  • Temp Boxes/GFCI?

  • Cords/Plugs/Properly Placed/Protected/Inspected?

  • Overhead Power Lines/Signage?

  • Grounded/Bonded/LOTO/NFPA70E?

FIRE PROTECTION

  • Fire Extinguishers/Monthly Inspection Tag/Trailer/Exit Sign?

  • Fire Extinguisher/Accessible<75'/Hung?

  • Safety Cans/Flammable Storage Cabinets/Signage No Smoking 50'?

FALL PROTECTION

  • Caps/Trough/Lanyards/SRL?

  • Perimeter Rail/Cable/Openings/Holes Covered

  • Scaffolded/ Inspected/Tied/Ladder/Tagged/ToeBoard?

GENERAL

  • Ladder/Use/Access/Secured/Guarded/Labels?

  • Access/Temporary Job Built Stair or Ramp<br>

  • Excavation/25' to Stair/Ladder/Ramp/Trench

  • Forms/Falsework/Rebar/Bracing/Cap?

  • Traffic/Paddle/Signs/Barricades?

  • Water Supply/Cups/Bottles/Covered Disposal?

  • Ventilated/Shade/100% Seating?

  • Laser/Warning Signage/PAT?

  • Cutting/Grinding/Concrete/Wetting/Vacuuming?

Personal Protective Equipment (PPE)

  • Eye Protection/Side Shields/Face Shield/Goggles?

  • High Visibility Vest/Clothing

  • Foot Protection/Rubber Boots/Toe Caps?

  • Hands/Gloves/Leather/Nitrile?

  • Head Protection/Overhead Cover?

  • Hearing Protection/Plugs/Muffs?

  • Respiratory Protection/Storage/ Disposal?

HOUSEKEEPING AND MAINTENANCE

  • Floor/Aisles/Obstructions/Cords?

  • Parking Area/Storage Areas/Lunch Areas?

  • Secondary Containment/Diesel/Gasoline

  • Slipping/Tripping Hazard/Ramps/Walkways?

  • Toilet/Wash/Maintained/Covered Waste Disposal?

  • Tools and Material Properly Stored?

  • Work Areas Maintained Clean/Orderly?

MACHINERY AND EQUIPMENT

  • Cylinders/Stored/Secured/BFP/Cart Fire Wall?

  • Adequate Housekeeping on floorboards?

  • Equipment-Visual Inspection Documentation/Condition/ Records?

  • Air Compressor <30 psi/Pins/Valves/Whip Checks

  • Proper Tools/Good Condition?

  • Safeguards in Place/Guards/Tool Rest?

Corrective Actions

  • Enter any corrective actions that will be undertaken

Sign Off

  • On Site Representative

  • Auditor's 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.