Title Page
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Job Site
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Division
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Personnel
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Inspected by
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Date and Time
Positive Safety Mentions
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Click "add" and list good safety precautions and compliant procedures
Item
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Category
- Accessibility
- Working at Heights
- Scaffolding
- Moving Objects
- Slips Trips and Falls
- Material & Manual Handling
- Electrical Hazards
- Personal Protective Equipment (PPE)
- Fire Safety
- Other
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Identify category the item belongs to
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Enter description
Items Needing Improvement
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Click "add" and list items that need to be looked into or changed
Item
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Category
- Accessibility
- Working at Heights
- Scaffolding
- Moving Objects
- Slips Trips and Falls
- Material & Manual Handling
- Electrical Hazards
- Personal Protective Equipment (PPE)
- Fire Safety
- Other
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Identify category the item belongs to
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Enter description
Critical Action Items
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Click "add" and identify items in need of urgent action
Item
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Category
- Accessibility
- Working at Heights
- Scaffolding
- Moving Objects
- Slips Trips and Falls
- Material & Manual Handling
- Electrical Hazards
- Personal Protective Equipment (PPE)
- Fire Safety
- Other
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Identify category the item belongs to
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Enter description
Completion
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Additional Recommendations
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Inspector's Name & Signature
