Formal Site Inspection

• Conducted on:

  Date

• Building Name:

• Building Address:
  Address

• Inspector's Name:

  Select

Types of Work Being Performed

• Water-Fed Pole System Window Cleaning

• Squeegee Window Cleaning

• Eavestrough Cleaning

• Pressure Cleaning

• Solar Panel Cleaning

• Post Construction Window Cleaning

• Office / Administration

Personnel

• Site Supervisor:

  Select

• Site Supervisor:

• Workers on Site:

  Select

• Worker:

Items To Look For

• What type of inspection is taking place?

  Office Insection

  Worksite Inspection

• Hazard Assessment completed?

  Yes

  No

  N/A

• Priority of infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Equipment inspections completed?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Tailgate meeting completed?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Emergency response procedures discussed?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Safety controls implemented?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Caution signs and cones used?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Vehicles parked well?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Housekeeping - Are the vehicles clean/organized?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Housekeeping - Is the work site clean/organized?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• First aid kit accessible?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Fire extinguisher accessible?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Work shirts worn?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Required PPE is worn?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Do workers have access to a cell phone?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are workers behaving professionally?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are ladders being used in accordance to Paneless and OH&S regulations?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is there and aqua clean being used?

  Yes

  No

  N/A

• Has the machine been placed in an ideal location?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is the exit line placed in a good location?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is hosing on sidewalks or walkways identified/coned to prevent trip hazards?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is hosing crossing roads in an acceptable location to prevent damage of lines?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are water fed poles secured if left vertical?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are there workers rappelling?

  Yes

  No

  N/A

• Is fall protection worn when the worker is within 2m from unguarded edges?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are ropes at the the bottom of the drop in an acceptable location?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is equipment secure from falling when working near entrances, sidewalks, and roads?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are ropes protected against cuts and abrasions?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Corrective action:

• Corrected By:

  Sign

• Are bags and other materials that can be blown off roofs secure?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are descent and safety lines positioned straight or at acceptable angles?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are all figure 8 knots tied well?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is there a man lift in use?

  Yes

  No

  N/A

• Is fall protection used while operating the lift?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are traffic controls being used when operating on roads or parking lots?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are platform weight limits being followed?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is the lift being operated in a safe manner?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are Safe Work Practices and Safe Job Procedures being followed?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Has damaged equipment been reported and removed from service?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are floors free of debris and dry with no spills?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are all light bulbs in working order?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are all areas illuminated well?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are all hazardous materials properly labelled?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are MSDS sheets made available?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are materials neatly and safely piled?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are work areas free of garbage?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are cords tucked away to prevent tripping?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are washroom areas clean?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• First aid kit accessible?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Fire extinguisher accessible?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Are the Company rules posted?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is the Company Health & Safety Policy posted?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is the Alcohol and Drug Policy posted?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

• Is Alberta's OH&S available?

  Yes

  No

  N/A

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected By:

  Sign

Additional Items

• Additional items inspected?

Item inspected:

• Priority of Infraction:

  A: Imminent Danger

  B: Serious Danger

  C: Minor Infraction

  N/A

• Description of hazard/infraction:

• Corrective action:

• Corrected by:

  Sign

Overall Review

• Overall Comments:

• Positive Observations:

Signatures

• I hereby certify that all information is accurate and that an actual inspection was conducted as per company policy.

• Inspector's Printed Name & Signature:

  Sign

• Crew Manager's Printed Name & Signature:

  Sign