Crew Site Inspection Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Setup

• Job Briefing Conducted

  Yes

  No

  N/A

• Flaggers & Warning Signs in Place

  Yes

  No

  N/A

• Traffic Cones In Place

  Yes

  No

  N/A

• Flashing Beacons On

  Yes

  No

  N/A

• Wheel Chocks in Place

  Yes

  No

  N/A

• Add media

  Media

Personal Protected Equipment (PPE)

• High Visibility Vest Worn

  Yes

  No

  N/A

• Hard Hat Worn

  Yes

  No

  N/A

• Safety Glasses Worn

  Yes

  No

  N/A

• Hearing Protection Worn

  Yes

  No

  N/A

• FR Clothing Worn

  Yes

  No

  N/A

• Truck Grounds in Place

  Yes

  No

  N/A

• Personal Protective Grounds Installed

  Yes

  No

  N/A

• Cover-Up Used

  Yes

  No

  N/A

• Rubber Gloves Used

  Yes

  No

  N/A

• Chaps Worn When Using Chain Saw

  Yes

  No

  N/A

• Shoring Used

  Yes

  No

  N/A

• Add media

  Media

General Safety

• Switching & Tagging Done Properly

  Yes

  No

  N/A

• Safety Watcher Designated

  Yes

  No

  N/A

• Proper Storage & Handling of Hotline Tools

  Yes

  No

  N/A

• Add media

  Media

• Job Site Safe for Workers & Public

  Safe

  At Risk

  N/A