Information

  • Project:

  • Conducted on

  • Conducted by;

  • Location

1. Postings / Notices / Bulletins

  • 1.1 Required EEO, State, Federal and/or local agency required postings.

  • 1.2 Emergency Action Plan Posted

  • 1.3 Evacuation Plan, including muster points to account for employees<br>

  • 1.4 Spill Response Plan in place and posted<br>

  • 1.5 Notice to employees on where to find Material Safety Data Sheets<br>

  • 1.6 Signs indicating First Aid Station or First Aid Kit locations posted<br>

  • 1.7 No Trespassing Signs posted at entry points to the job site<br><br>

  • Site Observations:

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (If Applicable)

  • Relevant Photos
  • Photos:

  • Description:

2. Safety Meetings / Planning

  • 2.1 JHA has been completed for the observed tasks<br>

  • 2.2 Weekly Toolbox Talk completed<br>

  • Site Observations:

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (If Applicable)

  • Relevant Photos
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  • Description:

3. Training

  • 3.1 All employees have had required orientation (Sticker on Hard Hat)

  • 3.2 Employees have been trained for the assigned tasks<br>

  • 3.3 Crew has someone trained in First Aid / CPR

  • 3.4 Supervisors have been through supervisor safety training<br>

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

4. HazComm / Materials

  • 4.1 Material Safety Data Sheets available for all Hazardous Mat'l used on site<br>

  • 4.2 Hazardous mat'l list up-dated and current

  • 4.3 Materials/Containers properly labeled - Contents and Hazard Rating<br>

  • 4.4 Hazardous materials are properly stored<br>

  • 4.5 Employees aware of Right to Know (must ask crew members)

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

5. Housekeeping

  • 5.1 Project work areas are clean and free of excess trash, debris<br>

  • 5.2 Walkways and passageways clear

  • 5.3 Electrical Panels clear of debris/materials to allow full access<br>

  • 5.4 Fire Extinguishers clear of debris/materials to allow full access<br>

  • 5.5 Material and equipment properly stored<br>

  • 5.6 Electrical cords, hoses, welding leads positioned to prevent trip hazards<br>

  • 5.7 Scrap material free of protruding nails or other puncture hazards

  • 5.8 Trash receptacles are provided for work areas and water kegs

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

6. Fire Protection

  • 6.1 Hot Work Permits completed<br>

  • 6.2 Fire extinguishers properly located and accessible throughout job site

  • 6.3 Fire Extinguishers fully charged & inspected monthly/annually<br>

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

7. Welding and Cutting

  • 7.1 Welding Leads & Cutting Torch hoses maintained in good working order

  • 7.2 Combustibles moved a safe distance away from hot work operations

  • 7.3 Flash arrestors installed on all cutting torch setups<br>

  • 7.4 Oxygen, Acetylene & combustibles separated by 20' or 30 min fire rated wall installed / stored upright /secure

  • 7.5 Regulator gauges properly attached and maintained

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

8. Tools and Equipment

  • 8.1 Tools are maintained in a safe condition<br>

  • 8.2 Tools are properly carried and stored

  • 8.3 Pneumatic / hydraulic hose connections properly secured

  • 8.4 Proper tools used for the job performed

  • 8.5 All tools are properly guarded

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

9. Electrical Safety

  • 9.1 Cords to power tools inspected prior to each use

  • 9.2 No tape on any cords - Tools or Extension Cords

  • 9.3 Ground Pins in place when required

  • 9.4 Ground Fault Circuit Interruptors (GFCI) utilized with power tools

  • 9.5 Supply Cords protected against vehicular or pedestrian traffic damage

  • 9.6 Cords maintained "out of water" to prevent possible shock hazard

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

10. Personal Protective Equipment

  • 10.1 Hard hats worn and maintained as required<br>

  • 10.2 High visible/reflective apparel worn as required

  • 10.3 Hearing protection worn as required<br><br>

  • 10.4 Eye protection required and worn in a proper manner<br><br>

  • 10.5 Proper foot protection worn for job performed

  • 10.6 Face shield or goggles worn as required

  • 10.7 Gloves worn at all times

  • 10.8 Proper Cutting Goggles used during cutting operations (#3 Shade Min)

  • 10.9 Respiratory Protection worn and cared for as required

  • 10.10 Other: Paper cups available/provided at all water coolers as required. If reusable bottles are provided - Name must be written on Bottle

  • 10.11 Adequate number of sanitary facilities provided & maintained as required

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
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  • Description:

11. Fall Protection

  • 11.1 Full Body harnesses and lanyards worn properly and as required<br>

  • 11.2 Lanyards are adequately secured to suitable anchorage

  • 11.3 Perimeter guarding/Handrails in place where required<br>

  • 11.4 Static lines installed and capable of supporting 5,000 lbs. of force per user

  • 11.5 Fall protection equipment is used for fall protection ONLY

  • 11.6 Fall protection inspected and maintained in a safe-for-use condition

  • 11.7 Retrieval plan complete and communicated

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

12. Scaffolds

  • 12.1 Work Platforms fully decked between front uprights & guardrail<br>

  • 12.2 Scaffold grade planking utilized

  • 12.3 Planks extend no less than 6" , and no more than 12" over bearing rail<br>

  • 12.4 Ladder access with landing at 35' intervals as a minimum

  • 12.5 Scaffolds maintain a minimum of 15' from un-insulated electrical lines

  • 12.6 Scaffold Stairways provided with landings at 12' intervals

  • 12.7 Daily inspections conducted by competent person

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

13. Ladders, Stairways and Access

  • 13.1 Ladder access clear and unobstructed<br>

  • 13.2 Ladders positioned at 4:1 ratio - (4 feet high to 1 foot out from wall)

  • 13.3 Ladders extend 3 feet higher than landing point

  • 13.4 Employees utilizing hoist to raise or lower materials (leaving hands free)

  • 13.5 Employees ascending/descending using three points of contact at all times

  • 13.6 All "Job Made" ladders constructed according to specific requirements<br>

  • 13.7 Ladders tied off/secured properly

  • 13.8 Safe and proper access to work area

  • 13.9 Step ladders used properly - full extend - no use of top two steps

  • 13.10 Stair handrails no less than 36" high from tread to top of stair rail

  • 13.11 Stairs having 4 or more risers or more than 30" in height, have handrails

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

14. Excavations

  • 14.1 Sloped and shored properly

  • 14.2 Utilities notified prior to opening excavations

  • 14.3 Competent Person designated as required by OSHA for excavations<br>

  • 14.4 Access and egress provided within 25 ft. of employee(s)

  • 14.5 Daily inspections conducted

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

15. Marine Work

  • Is there any Marine Work?

  • Move on to Next Section.

  • 15.1 Work Vests buckled and worn as required when working over water

  • 15.2 Gang Planks/Proper and Adequate Access in place with handrails<br><br>

  • 15.3 Adequate access to allow safe entry to barge from workboats<br><br>

  • 15.4 Barge(s) in neat and orderly condition

  • 15.5 Life Rings properly roped and located every 200 feet<br><br><br>

  • 15.6 Cranes Radius on barges barricaded/Warning devices in place<br><br><br><br>

  • 15.7 Cranes are positively secured to barges as required<br><br><br><br>

  • 15.8 Safety boats available as required<br><br><br><br>

  • 15.9 Water load charts posted and visible to operators<br><br><br><br>

  • 15.10 Rescue drill has been completed<br><br><br><br>

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

16. Railroad Safety Practices

  • Is there any work associated with the Rail road?

  • Please move on to the next section.

  • 16.1 Minimum distance from track (25') when train is passing, employees stopped work and observing passing train

  • 16.2 No movement towards trains or tracks after horn blown

  • 16.3 Employees know protection limits

  • 16.4 Unattended equipment is 25' from rail and 250' from crossing

  • 16.5 Unattended equipment properly secured (buckets, loads grounding)

  • 16.6 Employees look both ways before crossing rail and only do so with rail representative's authority

  • 16.7 All vehicles and equipment stop at rail crossings before crossing

  • 16.8 Self propelled equipment has first aid kit, fire ext and audible back up alarms

  • 16.9 Cranes have at least 3 orange cones displayed to designate work area

  • 16.10 Has proof of applicable and non expired railroad training along

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

17. Pile Driving

  • 17.1 Pile Handling Plan (documented)<br>

  • 17.2 Controlled Access Zone-posted,documented

  • 17.3 Cushion Blocks Protected from the Elements

  • 17.4 Have the Bardon chokers been inspected for wear?

  • 17.5 Shackle pins are safety wired on leads and hammer

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

18. Material Handling Equipment

  • 18.1 Back-Up Alarms operational and audible above area noise- 200 ft away

  • 18.2 Seat Belts worn by operators

  • 18.3 Daily, Pre-Operational Inspection Reports completed<br>

  • 18.4 Deficiencies noted on Inspection reports are corrected

  • 18.5 Loads properly secured prior to attempting to relocate

  • 18.6 Licenses or certifications as required

  • 18.7 Equipment operated at safe speeds

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

19. Hoisting and Lifting Equipment

  • 19.1 Chainfalls, come-a-longs and chokers in good condition with current inspection

  • 19.2 Rigging is stored properly

  • 19.3 Rigging inspected daily and prior to each use

  • 19.4 Proper rigging techniques are followed

  • 19.5 Proper crane set-up (swing radius, barricades, outrigger pads)

  • 19.6 Crane Inspections conducted daily and documented

  • 19.7 Legible capacity tags in place as required

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

20. Traffic Control

  • 20.1 Signage / Setup<br>

  • 20.2 Traffic Control Planning

  • 20.3 Certified Flaggers / Training

  • 20.4 Proper Equipment - Reflectors, arrays, crash cushion

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

22. Silica Dust Control

  • 22.1 Silica Control Plan Implemented for work performed

  • 22.2 Engineering Controls Implemented

  • Table 1 Link
    https://www.osha.gov/silica/Table1sect1926.1153.pdf

  • 22.3 Housekeeping

  • 22.4 Respiratory Protection Required?

  • 22.5 Are Other Crews at Risk of Exposure to Silica Dust?

  • Engineering Control Implemented

23. Monthly Focus

    Add Additional Inspections associated with Monthly Focus
  • Description of Inspection:

  • Compliant?

  • Site Obsevations

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

24. Employee Recognition

  • Recognize a job well done here

  • Employee
  • Name:

  • Describe Recognition

25. Subcontractor Safety Compliance

  • 24.1 Employees stop work while being observed

  • 24.2 Employees adjust position / PPE while being observed

  • 24.3 Employees are aware of other crews and other trades in the area

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

26. Employee Behaviors - Body Position

  • 25.1 Employees in pinch points of lines of fire?

  • 25.2 Employees can contact electricity, hot/cold, toxic chemical, other hazards?

  • 25.3 Employees at Risk for sprains/strains?

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

27. Employee Behavior - Tool Use

  • 26.1 Employees' tools are in good condition

  • 26.2 Employees are using the right tool for the job?

  • 26.3 Employees know and follow safety procedures / Rules.

  • Site Obsevations

  • Corrective Actions Assigned To (If Applicable)

  • Date Corrected (if Applicable)

  • Relevant Photos
  • Photos:

  • Description:

Sign off

    Crew Sign Off (Acknowledgment of Outcomes)
  • Print Name:

  • Signature

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