Basic Info
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Site Name
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Site Address
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Inspection Conducted On
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Site inspection being performed by:
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Site Supervisor/Foreman
Page 1
Health & Welfare
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First aid supplies available
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Hand washing materials or facilities, available
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Material Safety Data Sheets and Safety Manual, available.
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Emergency preparedness: Evacuation route.
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Safety Bulletin Board current and orderly.
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Health & Welfare related comments
Housekeeping
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Good site layout of materials.
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Site access/dust control.
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Site housekeeping- controls.
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Trash containers/covers used.
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Materials stacked and stable.
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Flammable- combustibles stored/access clear.
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All boards de-nailed and picked up.
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Passageways/walkways clear at all times.
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Holes covered, identified and secured.
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Cords/cables routed properly out of walkways.
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Housekeeping related comment
Page 2
Personal Protective Equipment
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Head protection worn at all times.
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Eye protection appropriate for hazards.
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Foot protection- steal toed boots
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Hearing protection appropriate for hazards.
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Hand protection appropriate for hazards.
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Respiratory protection as required for tasks.
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Chemical protection appropriate for hazards.
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Fall protection and anchor points adequate.
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Proper work clothing.
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NFPA 70E PPE available/used.
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Personal Protective Equipment related comments.
Employee Work Observations
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Employees wearing correct PPE for tasks
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Employees working on scissor lifts properly.
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Employees were handling materials properly.
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Lifting and moving devices were available.
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Employees observed using ladders properly.
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No materials carried ascending/descending ladder.
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Employees operating equipment were trained
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Employees using fall protection properly.
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Employee Work Observations related comments.
Page 3
Safety Procedures
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Pre-Task Planning Form used before starting project.
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Hazardous energy controls (lockout/tagout).
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NFPA 70E Arc Flash procedures
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Confined Space Entry controls procedures.
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Hazard Communication labeling reqs. in use.
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Safety Procedures related comments
Hand Tools
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Correct tools and use for task observed.
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Defective tool program in use.
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Daily inspection.
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No makeshift tools.
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Hand Tools related comments.
Page 4
Power Hand Tools
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Detective tool program in use.
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Properly grounded or double insulated.
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Ground Fault Interrupter use.
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Properly guarded at all times.
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Inspections of electrical cords and connectors.
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Inspection and maintenance- daily/monthly.
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Correct disc/speed/size/type.
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Power Hand Tools related comments.
Ladders, Ramps and Stairs
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Ladders inspected before use.
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Ladder design and use correct for task.
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Secured at top and/or base.
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Side rails extend 3' above top of platform.
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Rungs not over 12" on center & regular spacing.
Page 5
Environmental
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Universal Waste labeled, separated and stored properly.
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Used lamps and ballasts
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Used batteries
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Used refrigerant oil
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Recovered refrigerant
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Used electronic circuit boards
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Used Mercury switches
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List other Universal Waste as needed
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Environmental related comments
Page 6
Fire Prevention/Protection
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Adequate fire extinguishers for hazards
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Proper type and location
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Fire watches trained and posted where required
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No smoking signs posted
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Inspection and maintenance- monthly
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Fire extinguisher use reported
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Flammable materials in approved containers
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Fire Prevention/Protection related comments
Safety Permits
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Obtained as required/monitored, hot work, etc.
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Smoking control in areas with flammable materials
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Fire extinguishers - as required on permit
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Safety Permits related comments
Page 7
Welding/Cutting
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Cylinders secured and upright
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Gauges removed during relocation (individual)
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Condition of hoses inspected daily
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Fire extinguishers - 10 ABC minimum within 50'
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Personal protective equipment
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Welding shields in use
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Grounding- close to work station
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Cable conditions inspected/rolled up - not in use
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Hot work permits issued as required
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Equipment off when not in use
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Machine frame grounded
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Flash back arrest it's installed - torch/gauge
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Welding/Cutting related comments
Page 8
Scaffolding
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Erect/dismant supervised by competent personnel
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Connections secured
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Platform free of debris
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Base pads used/casters locked
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Scaffolds plumb and braced
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Guard rails 42" high/stable and toe boards
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Material in good condition - no knots, splinters
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Mobile scaffold use - stationary/no riders
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Safe access/fall protection provided/used
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Anchored, safety belts tied-off
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Scaffold properly inspected/tagged
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Scaffolding related comments
Page 9
Cranes and Lifting
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Operator qualified/certification
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Qualified rigger/signal person when required
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Cranes and Lifting related comments
Page 10
Additional Comments
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Comments
Signatures
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Inspector Name
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Inspector Signature
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Supervisor/Foreman Name
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Supervisor/Foreman Signature
