Information
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Document No.
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Job Site
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Foreman
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Conducted on
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Prepared by
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Location
SHED
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ILLNESS & INJURY PREVENTION PROGRAM (IIPP)
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SAFETY DATA SHEETS (SDS)
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WATER & CUPS PROVIDED
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FIRST AID KIT - FULLY STOCKED
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FIRE EXTINGUISHER AVAILABLE
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SAFETY OSTERS VISIBLE
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THERMOMITER
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TRASH RECEPTICLE
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SHADE AREA (CANOPY OR GARAGE)
JOB SITE
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HARD HATS ON
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EYE PROTECTION ON
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PROPER SHOES ON
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SAW GUARDS IN PLACE
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POWER TOOLS IN GOOD CONDITION
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NAIL GUN SPRINGS ARE IN PLACE
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EXTENTION CORDS IN GOOD CONDITION
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POWDER ACUATED TOOLS IN GOOD CONDITION
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UNUSED/USED SHOTS UNATTENDED
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EXTENTSION LADDERS ARE SECURE
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"A" FRAME LADDERS ARE USED PROPERLY
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HANDRAILS INSTALLED ON STAIRWAYS AND SECOND FLOOR OPENINGS
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FALL PROTECTION/SCAFFOLDING SYSTEM PROPERLY INSTALLED
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HARNESSES ON AND OR ATTACHED WHEN NEEDED
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SECOND STORY WINDOW/BALCONY SAFETY GUARDS INSTALLED
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HAZARD TAPE AROUND OPEN TRENCH(ES)
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DEBRIS SAFE DISTANCE FROM HOUSES
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NAILS BENT OVER UNATTENDED LUMBER
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REMIND FORKIFT DRIVER TO WEAR SEATBELT
Corrective Actions
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Enter any corrective actions that will be undertaken
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