Information
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Client / Site / Job Number:
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Prepared by
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Location
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For the Week Ending:
Ensure that the Jobsite is safe in accordance with the PREVENT Safety Guide:
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All Sub-Contractors have an AWAIR Program if this site is in Minnesota
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Right To Know / GHS / SDS
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Lead, Asbestos, Silica Exposures
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Respiratory Protection (Voluntary & Required Use)
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Fall Protection (6' Trigger Height)
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Steel Erection (15' & 30' Trigger Heights, Controlled Decking Area, Controlled Access Below)
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Ladders (Proper Use)
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Stairways (Handrails, Steps, etc.)
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Scaffolding (10' Trigger Height for Fall Protection, fully planked, mud sills, safe access, secured)
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Cranes (Operator License, Inspections, Lifting Calculations, Critical Lifts)
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Hoisting & Rigging, Signalers (Must be Trained/Certified)
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Electrical Wiring & Equipment (Cords, Panels, Covers, Protect from Damage, Overhead Power Lines)
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Forklift Operators trained & certified 3 years, inspections, seatbelts
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Aerial Work Platforms (PFAS, Guardrails, Secured)
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Excavations (2,4,5 Rules - A,B,C Soil Types)
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First Aid & CPR (EMS Response within 4 Minutes)
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Woodworking Machines (Guards in Place, Push Sticks
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Power Tools (Cords, Guards/Shields, Proper Use
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Fire Extinguishers
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Demolition (Stability Dust Control, Safe Access/Egress, Holes)
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Personal Protective Equipment - Proper Use
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To the Best of Your Knowledge All Other Jobsite Hazards are Controlled
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Please Sign Here When Your Safety Inspection is Complete
Equipment In Use:
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Bobcat Days/Hours Used
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Bobcat Asset #BB-
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Bobcat Task Code
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Forklift Days/Hours Used
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Forklift Asset #FL-
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Forklift Task Code
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Generators Days/Hours Used
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Generators Asset #GN-
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Geneators Task Code
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Heaters Days/Hours Used
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Heaters Asset #H-
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Heaters Task Code
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Jobsite Trailer Days/Hours Used
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Jobsite Trailer Asset#TR-
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Jobsite Trailer Task Code
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Scaffold (Per End) Days/Hours Used
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Scaffold Task Code
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Concrete Blankets Days/Hours Used
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Concrete Blanket Task Code
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Plate Compactor Days/Hours Used
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Plate Compactor Asset #PC-
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Plate Compactor Task Code
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Other Equipment Days/Hours Used:
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Other Equipment Task Code:
Superintendent Weekly Job Update:
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Project Status:
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Equipment on Site:
Hospital
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Construction personnel are wearing appropriate ID
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Construction personnel are wearing appropriate PPE (hardhat, protective eyewear, footwear, covers)
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All windows, doors and debris chutes are secured after hours.
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All exits provide free and unobstructed egress
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There is free unobstructed access for emergency services.
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The temporary construction partitions are smoke tight and built of non-combustible materials.
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The temporary fire alarm devices and sprinklers are unimpaired
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There is additional firefighting equipment provided and personnel are trained to use it.
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Smoking is prohibited on hospital property.
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Storage, housekeeping and debris removal procedures are enforced daily.
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Construction area is cleaned daily to minimize infection control risks to adjacent areas.
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Construction area air is negative to adjacent areas.
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Hot Works are Conducted after Permit Approved?
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Possible disruption to water, oxygen, power, etc. is planned in advance of work to be performed
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Construction Progress Notes are Being Maintained/Kept
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Demolition practices minimize dust creation
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Debris carts are have tight fitting covers
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Hallways & Areas adjacent to Construction are clean
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Sufficient cleaning equipment is available