Information
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Daily Safety Meeting
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Job #
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Job Foreman
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Customer
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Conducted on
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Prepared by
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Location
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Personnel
Hazards
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Fall Hazards
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Has a Fall Hazard been identified, by a competent person, through a Fall Hazard Assessment?
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Can the Fall Hazard be eliminated or engineered out?
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If the Fall Hazard can not be eliminated or engineered out, is Personal Protection available to provide protection?
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Ladders
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Has the Ladder, being used, been thoroughly inspected and documented by an authorized person?
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Scaffolding
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Has the Scaffolding, being used, been thoroughly inspected and documented by an competent person?
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Platformlift
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Has the Platformlift, being used, been thoroughly inspected and documented by an authorized person?
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Forklift
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Has the Forklift, being used, been thoroughly inspected and documented by an authorized person?
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Rough Terrain Forklift
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Has the Rough Terrain Forklift, being used, been thoroughly inspected and documented by an authorized person?
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Mobile Crane
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Has the Mobile Crane, being used, been thoroughly inspected and documented by a qualified person?
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Add media
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Has the Mobile Crane, being used, had an annual, third party inspection?
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Add media
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Is the crane operator certified by an OSHA recognized certification program?
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What certification does the crane operator possess?
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Add media
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Industrial Crane (carry deck, shuttle lift)
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Has the Industrial Crane (carry deck, shuttle lift), being used, been inspected and documented by an authorized person?
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Is the crane operator certified by an OSHA recognized certification program?
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Overhead Crane
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Has the Overhead Crane, being used, been inspected and documented by an authorized person?
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Has the Overhead Crane, being used, had an annual, third party inspection?
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Add media
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What is the Overhead Crane's Duty Cycle?
- Yes
- No
- N/A
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Underhung Hoist
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Has the Underhung Hoist, being used, been, thoroughly inspected and documented by an authorized person?
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Hydraulic Gantries
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Have the Hydraulic Gantries, being used, been ,thoroughly inspected by an authorized person?
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Have the Hydraulic Gantries, being used, been set-up according to the manufacturer's specifications.
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Critical Lift
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Is a Critical Lift Plan Required
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Hydraulic Jacking System
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Has the Hydraulic Jacking System, being used, been thoroughly inspected by an authorized person?
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Jack & Slide System
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Has the Jack & Slide System, being used, been thoroughly inspected by an authorized person?
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Hydraulic Trailer
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Has the Hydraulic Trailer, being used, been thoroughly inspected by an authorized person?
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Line Breaking (exposure to released energy e.g. pneumatics, fluid)
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Will a Line Breaking permit be required?
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Will Lock-Out/Tag-Out be required?
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Confined Space Entry
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Will a Confined Space Entry permit be required?
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Will Lock-Out/Tag-Out be required?
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Electrical Hazard
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Will Lock-Out/Tag-Out be required?
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Hot Work
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Will a Hot Work permit be required?
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Traffic
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Barricades/Signs
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Is the construction area safely barricade with visible signage alerting and restricting non-Valley Group, Inc. employees of the surrounding hazards within the occupying area.
Power Tools
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Bandsaw
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Is the Bandsaw, being used, safe to operate?
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Are all guards in place on the Bandsaw?
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Circular Saw
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Is the Circular Saw, being used, safe to operate?
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Are all guards in place on the Circular Saw?
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Reciprocating Saw
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Is the Reciprocating Saw, being used, safe to operate?
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Are all guards in place on the Reciprocating Saw?
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Chain Saw
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Is the Chain Saw, being used, safe to operate?
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Are all guards in place on the Chain Saw?
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Drill
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Is the Drill, being used, safe to operate?
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Are all guards in place on the Drill?
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Magnetic Drill
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Is the Magnetic Drill, being used, safe to operate?
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Are all guards in place on the Magnetic Drill?
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Core Drill
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Is the Core Drill, being used, safe to operate?
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Are all guards in place on the Core Drill?
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Nut Turner
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Is the Nut Turner , being used, safe to operate?
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Are all guards in place on the Nut Turner?
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Impact Wrench
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Is the Impact Wrench, being used, safe to operate?
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Are all guards in place on the Impact Wrench?
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Hydraulic Torque Wrench
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Is the Hydraulic Torque Wrench, being used, safe to operate?
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Are all guards in place on the Hydraulic Torque Wrench?
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Grinder
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Is the Grinder, being used, safe to operate?
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Are all guards in place on the Grinder?
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Jacking System (electric pump)
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Is the Jacking System (electric pump), being used, safe to operate?
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Are all guards in place on the Jacking System (electric pump)?
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Steel Jacketed Heater (cow rod)
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Is the Steel Jacketed Heater (cow rod) , being used, safe to operate?
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Are all guards in place on the Steel Jacketed Heater (cow rod)?
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Pressure Washer
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Is the Pressure Washer , being used, safe to operate?
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Are all guards in place on the Pressure Washer?
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Cement Mixer
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Is the Cement Mixer, being used, safe to operate?
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Are all guards in place on the Cement Mixer?
Personal Protective Equipment
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Safety Shoes
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Safety Glasses
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Googles
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Burn Googles
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Welding Shield
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Safety Shoes
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Hard Hat
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High Visibility Vest/Shirt/Coat
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Hearing Protection
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Decibel Reading:
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Hand Protection
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Laynard/Harness
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Additional Fall Protection (list below)
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Ground Fault Circuit Interrupter
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Fire Extinguisher
Give a brief description of the today's task.
Emergency Information
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In case of an emergency contact Emergency Services by dialing 911
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List below the physical address of the nearest emergency room:
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Are personnel aware of that job foreman has access to MSDS?
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Are personnel aware that if an injury occurs, they are to report it, immediately, to their job foreman?
Weather
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List below, today's, weather conditions, e.g., temperature, windy, sunny, cloudy, fog, rain, snow, etc..
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Could the weather have an affect on today's operation? If so, list concerns below.
Pre-Shift Safe Work Acknowledgement
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I understand the hazards associated with the work I am performing today. I have discussed and reviewed the safety plan for today with my co-workers and job foreman. I understand that working safely is my top priority.
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Job Foreman:
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Post- Shift Safe Work Acknowledgment
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I have completed work today safely. I have discussed and documented any concerns, I may have, with my job foreman
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Job Foreman:
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