Title Page
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Generation Field Observation
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Conducted on
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Prepared by
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Wolverine Personnel
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Other Personnel onsite
Job Planning
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Discussion on site?
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Job Briefing?
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Other documentation on site?
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Proper Job Setup?
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Does the job plan help reduce the risk of sprains and strains?
Personal Protective Equipment
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Is eye protection with side shields being worn at all times?
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Are hard hats worn as required?
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Is hand protection used?
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Is footwear appropriate for the job?
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Is hearing protection used when needed?
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Is clothing policy being followed?
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Is FR clothing/rain gear in good condition?
Energized Work
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Are gloves and sleeves correct rating and date?
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Are gloves air tested and visually inspected prior to use?
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Is adequate cover-up material utilized?
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Was a clearance required to complete the task?
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Are MAD approach distances understood and maintained?
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Are hot sticks cleaned before use?
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Is company policy being followed for proper rubber glove use, hot sticking, and working in energized work areas?
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Is the proper level of FR clothing being worn?
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Is the FR clothing tucked in?
Work Zone
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Is all test equipment inspected prior to use?
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Is all the equipment used correctly?
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Is equipotential grounding being used?
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Are personal protective grounds being used?
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Are grounds in good condition?
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If there are other personnel near work area have they communicated with each other?
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Are excavations evaluated and safe?
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Is test equipment properly grounded?
General
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Have all hazardous energy sources been isolated?
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Was LO/TO performed properly?
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Has daily walk down of LO/TO clearance(s) been completed?
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Are there prints for the work being performed?
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Is there an AED on site?
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Is weather affecting how the work is done?
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Was a barricade used to isolate work or test area?
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Are ladder requirements and rules being followed?
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Are hand and power tools being used properly?
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Is work area clean when job is finished?
Confined Space
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Has a confined space permit been completed properly?
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Is confined space rescue equipment/support available?
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Are first aid/CPR/AED items nearby for quick access?
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Is proper confined space air tests and monitoring occuring?
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Is confined space training certification cards readily available?
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Is the entrance guarded or sealed in between work activity?
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Does the attendant understand their role and how to summon for rescue?
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Can the employees describe the hazards and the protection in place?
Hot Work/Welding
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Has the "hot work permit" been properly completed?
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Does the work area meet the restrictions of the permit?
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Are sparks being controlled from extending beyond the immediate hot work area?
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Is proper eye and face being worn per the type of hot work (lens shade)?
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Are proper PPE clothing and gloves being worn?
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Was a fire watch assigned and used?
Fall Protection
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Is proper fall protection used?
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Is the fall protection equipment in good condition?
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Is the harness properly adjusted and secured to the individual?
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Does the anchor point meet the use requirement?
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Do guardrails comply by meeting the 200LB side force, 42" height, mid rail, and toe board (where needed)?
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Are gates or chains in place openings?
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Is proper protection and procedures being used for work on roofs or any elevated position?
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Are scaffolds properly assembled?
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Is a daily scaffold inspection occurring?
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Has the user of the scaffold had scaffold training?
Mobile equipment
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Are wheel chocks used?
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Was a daily pre-trip inspection performed?
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Daily preflight inspection on hydraulic equipment performed?
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Does the operator of the aerial device have a current qualification card?
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Vehicles grounded, bonded, or barricaded per procedure manual?
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Are proper backing procedures being followed?