Basic Info

  • Site Name

  • Site Address
  • Inspection Conducted On

  • Site inspection being performed by:

  • Site Supervisor/Foreman

Page 1

Health & Welfare

  • First aid supplies available

  • Hand washing materials or facilities, available

  • Material Safety Data Sheets and Safety Manual, available.

  • Emergency preparedness: Evacuation route.

  • Safety Bulletin Board current and orderly.

  • Health & Welfare related comments

Housekeeping

  • Good site layout of materials.

  • Site access/dust control.

  • Site housekeeping- controls.

  • Trash containers/covers used.

  • Materials stacked and stable.

  • Flammable- combustibles stored/access clear.

  • All boards de-nailed and picked up.

  • Passageways/walkways clear at all times.

  • Holes covered, identified and secured.

  • Cords/cables routed properly out of walkways.

  • Housekeeping related comment

Page 2

Personal Protective Equipment

  • Head protection worn at all times.

  • Eye protection appropriate for hazards.

  • Foot protection- steal toed boots

  • Hearing protection appropriate for hazards.

  • Hand protection appropriate for hazards.

  • Respiratory protection as required for tasks.

  • Chemical protection appropriate for hazards.

  • Fall protection and anchor points adequate.

  • Proper work clothing.

  • NFPA 70E PPE available/used.

  • Personal Protective Equipment related comments.

Employee Work Observations

  • Employees wearing correct PPE for tasks

  • Employees working on scissor lifts properly.

  • Employees were handling materials properly.

  • Lifting and moving devices were available.

  • Employees observed using ladders properly.

  • No materials carried ascending/descending ladder.

  • Employees operating equipment were trained

  • Employees using fall protection properly.

  • Employee Work Observations related comments.

Page 3

Safety Procedures

  • Pre-Task Planning Form used before starting project.

  • Hazardous energy controls (lockout/tagout).

  • NFPA 70E Arc Flash procedures

  • Confined Space Entry controls procedures.

  • Hazard Communication labeling reqs. in use.

  • Safety Procedures related comments

Hand Tools

  • Correct tools and use for task observed.

  • Defective tool program in use.

  • Daily inspection.

  • No makeshift tools.

  • Hand Tools related comments.

Page 4

Power Hand Tools

  • Detective tool program in use.

  • Properly grounded or double insulated.

  • Ground Fault Interrupter use.

  • Properly guarded at all times.

  • Inspections of electrical cords and connectors.

  • Inspection and maintenance- daily/monthly.

  • Correct disc/speed/size/type.

  • Power Hand Tools related comments.

Ladders, Ramps and Stairs

  • Ladders inspected before use.

  • Ladder design and use correct for task.

  • Secured at top and/or base.

  • Side rails extend 3' above top of platform.

  • Rungs not over 12" on center & regular spacing.

Page 5

Environmental

  • Universal Waste labeled, separated and stored properly.

  • Used lamps and ballasts

  • Used batteries

  • Used refrigerant oil

  • Recovered refrigerant

  • Used electronic circuit boards

  • Used Mercury switches

  • List other Universal Waste as needed

  • Environmental related comments

Page 6

Fire Prevention/Protection

  • Adequate fire extinguishers for hazards

  • Proper type and location

  • Fire watches trained and posted where required

  • No smoking signs posted

  • Inspection and maintenance- monthly

  • Fire extinguisher use reported

  • Flammable materials in approved containers

  • Fire Prevention/Protection related comments

Safety Permits

  • Obtained as required/monitored, hot work, etc.

  • Smoking control in areas with flammable materials

  • Fire extinguishers - as required on permit

  • Safety Permits related comments

Page 7

Welding/Cutting

  • Cylinders secured and upright

  • Gauges removed during relocation (individual)

  • Condition of hoses inspected daily

  • Fire extinguishers - 10 ABC minimum within 50'

  • Personal protective equipment

  • Welding shields in use

  • Grounding- close to work station

  • Cable conditions inspected/rolled up - not in use

  • Hot work permits issued as required

  • Equipment off when not in use

  • Machine frame grounded

  • Flash back arrest it's installed - torch/gauge

  • Welding/Cutting related comments

Page 8

Scaffolding

  • Erect/dismant supervised by competent personnel

  • Connections secured

  • Platform free of debris

  • Base pads used/casters locked

  • Scaffolds plumb and braced

  • Guard rails 42" high/stable and toe boards

  • Material in good condition - no knots, splinters

  • Mobile scaffold use - stationary/no riders

  • Safe access/fall protection provided/used

  • Anchored, safety belts tied-off

  • Scaffold properly inspected/tagged

  • Scaffolding related comments

Page 9

Cranes and Lifting

  • Operator qualified/certification

  • Qualified rigger/signal person when required

  • Cranes and Lifting related comments

Page 10

Additional Comments

  • Comments

Signatures

  • Inspector Name

  • Inspector Signature

  • Supervisor/Foreman Name

  • Supervisor/Foreman Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.