General Inspection (KCI)

• General Inspection (KCI)

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Project Manager or Designee

Focus Four Hazards

• Have struck by hazard concerns been addressed?

  Yes

  No

  N/A

• Have caught-in/between hazard concerns been addressed?

  Yes

  No

  N/A

• Have fall protection hazard concerns been addressed? (Also see expanded section below)

  Yes

  No

  N/A

• Have electrical hazard concerns been addressed? (Also see expanded section below)

  Yes

  No

  N/A

Housekeeping

• Is the work area clear of debris/trash?

  Yes

  No

  N/A

• Proper disposal of trash/debris?

  Yes

  No

  N/A

• Electrical cords, leads, hoses are routed out of walkways?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Hard Hats are being worn? (Mandatory)

  Yes

  No

  N/A

• Safety glasses are being worn as required?

  Yes

  No

  N/A

• Face Shields are being worn as needed?

  Yes

  No

  N/A

• Work boots are being worn as required?

  Yes

  No

  N/A

• High Visability Vest/Shirt/Clothing is being worn as required?

  Yes

  No

  N/A

• Gloves are being worn as needed?

  Yes

  No

  N/A

• Hearing Protection is being worn as necessary?

  Yes

  No

  N/A

• Respiratory Protection is being worn as necessary?

  Yes

  No

  N/A

Fire Protection & Flammable Liquids/Materials

• Fire Extinguisher available?

  Yes

  No

  N/A

• Flammable Liquids/Materials are in approved containers?

  Yes

  No

  N/A

• Flammable Liquids/Materials are transported, secured, and stored properly?

  Yes

  No

  N/A

Signs, Signals & Barricades

• Proper signs and signals are in place?

  Yes

  No

  N/A

• Barricades, Caution/Danger Tape is in place as necessary?

  Yes

  No

  N/A

Walking & Working Surfaces

• Have uneven surfaces been identified?

  Yes

  No

  N/A

• Have slip/trip/fall hazards been removed/addressed?

  Yes

  No

  N/A

• Is safe access/egress maintained as necessary?

  Yes

  No

  N/A

Material Handling

• Are proper lifting techniques being used?

  Yes

  No

  N/A

• Is material handling equipment available and being used as needed?

  Yes

  No

  N/A

Hand and Power Tools

• Hand and Power Tools inspected?

  Yes

  No

  N/A

• Defective tools removed from service?

  Yes

  No

  N/A

• Guards are in place as required?

  Yes

  No

  N/A

Welding, Cutting, Grinding, & Burning

• Welding, Cutting, Grinding, & Burning equipment inspected?

  Yes

  No

  N/A

• Compressed gas cylinders stored properly?

  Yes

  No

  N/A

• Hot Work Permit is completed when required?

  Yes

  No

  N/A

Electrical & Ground Fault Circuit Interrupters (GFCI)

• Electrical cords inspected and in good condition?

  Yes

  No

  N/A

• Ground Fault Circuit Interrupters (GFCI) used when required?

  Yes

  No

  N/A

• Panels covered and secured?

  Yes

  No

  N/A

• Power lines identified and warning signs are in place?

  Yes

  No

  N/A

Control of Hazardous Energy (Lockout/Tagout)

• Equipment shut down/off/de-energized?

  Yes

  No

  N/A

• Equipment tagged out?

  Yes

  No

  N/A

• Equipment locked out?

  Yes

  No

  N/A

Scaffolding, Aerial, Scissor & Boom Lifts

• Scaffold Competent Person designated?

  Yes

  No

  N/A

• Scaffold Inspected?

  Yes

  No

  N/A

• Scaffold erected properly?

  Yes

  No

  N/A

• Aerial, Scissor, Boom Lifts inspected?

  Yes

  No

  N/A

• Proper training in place for operator of Aerial, Scissor, Boom Lifts?

  Yes

  No

  N/A

Ladders, Stairways, & Ramps

• Ladder inspected?

  Yes

  No

  N/A

• Ladder used correctly/properly positioned and secured?

  Yes

  No

  N/A

• Stairways and/or Ramps in place as necessary?

  Yes

  No

  N/A

• Stairways and/or Ramps properly constructed/secured?

  Yes

  No

  N/A

Fall Protection & Prevention

• Fall protection being utilized at heights of 6 feet or greater?

  Yes

  No

  N/A

• Fall Protection equipment inspected?

  Yes

  No

  N/A

• Guardrails constructed properly?

  Yes

  No

  N/A

Cranes, Derricks & Hoists / Rigging

• Crane inspected?

  Yes

  No

  N/A

• Outriggers used?

  Yes

  No

  N/A

• Proper rigging equipment used?

  Yes

  No

  N/A

• Rigging inspected?

  Yes

  No

  N/A

• Signaling/communication in place?

  Yes

  No

  N/A

Motor Vehicles / Seat Belts

• Vehicle in safe working condition?

  Yes

  No

  N/A

• Seat belts used?

  Yes

  No

  N/A

Heavy Equipment & Mechanized Equipment

• Heavy Equipment & Mechanized Equipment inspected?

  Yes

  No

  N/A

• Deficient Heavy Equipment & Mechanized Equipment removed from service?

  Yes

  No

  N/A

• Roll-Over Protection (ROP's) are in place?

  Yes

  No

  N/A

• Back up alarms functional?

  Yes

  No

  N/A

Excavations, Trenching & Shoring

• Excavation/Trenching Competent Person Designated?

  Yes

  No

  N/A

• Excavation/Trench inspected daily prior to entry?

  Yes

  No

  N/A

• Excavation/Trench Permit completed?

  Yes

  No

  N/A

• Sloping, Benching, Shoring is established/installed as required?

  Yes

  No

  N/A

• Access/Egress maintained?

  Yes

  No

  N/A

Confined Space Entry

• Confined Space Entry Supervisor/Competent Person designated?

  Yes

  No

  N/A

• Attendant Designated?

  Yes

  No

  N/A

• Confined Space Assessment completed?

  Yes

  No

  N/A

• Atmospheric Monitoring Conducted?

  Yes

  No

  N/A

• Confined Space Permit Completed?

  Yes

  No

  N/A

• All workers have completed Confined Space Training?

  Yes

  No

  N/A

• Rescue procedure has been established?

  Yes

  No

  N/A

Other Observations:

• Other Observations/Hazards Addressed?

  Yes

  No

  N/A

General Comments

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