Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Project Manager

  • Superintendent

  • Foreman

Site Topics

  • Site Safety Binder

  • Tool Box Topics

  • MSDS Reviewed

(HIPP) Heat Illness Prevention Program

  • Prevention Program Reviewed

  • Water Supply

  • Shade Identified

(PPE) Personal Protective Equipment

  • Foot Protection<br>

  • Gloves & Clothing<br>

  • Respiratory Protection<br>

  • Hard Hat

  • Hearing Protection<br>

  • Eye & Face Protection<br>

Housekeeping

  • <br>Piling & Stacking

  • Debris Removal<br>

  • Exits and Stairs Clear<br>

Site & Public Protection

Required Postings

  • Traffic Signage

  • Warning Signs

  • Fed and State Postings

  • Emergency Numbers

  • Fences/ Barricades<br>

  • Sanitation - Toilets/ Wash Sinks Garbage Cans <br>

  • Excavation/Trenches<br>

  • Lighting<br>

  • Ventilation<br>

  • Dust Control

  • Rebar Protection<br>

Electrical

  • Lighting

  • Grounding

  • Cords, Plugs, Receptacles

  • Main Power, Temp Power, Generator

Ladders

  • Ladder Condition

  • Ladder Use

  • Extension Ladder Secured Properly

First Aid

  • Trained Person Identified

  • First Aid Kits

Fire Protection

  • Extinguishers

  • Flammable Storage

  • Welding and Cutting Equipment

  • Hot Work Permit

  • Fire Watch

Tools

  • Conditions

  • Guarding

  • Power Cords

  • Labeling

  • Proper Grounding

  • Lock Out - Tag Out - Test Out

Edge and Hole Protection

  • Hazard Zone Identified - Delineated

  • Perimeter Railing - Toe Boards

  • Floor and Wall Coverings

Scaffolding

  • Inspection Tags

  • Tieback - Supports - Footings

  • Locking Pins and Nuts

  • Railing

  • Planks - Platforms

Fall Protection

  • Administrative Controls<br>

  • Engineering Controls

  • Harness - Lanyard - SRL

  • Anchorage

  • Rescue Plan

Ergonomics

  • Equipment Used

  • Procedure Used

  • Lifting Techniques

Site Equipment

  • Pre-Use Inspections

  • Operator Certificated

  • Proper Use

Additional Notes/ Drawings

  • Note/ Drawing

Acknowledgement

  • Completed By

  • Safety Rating by Safety

  • Foreman

  • Safety Rating by Foreman

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.