Title Page

  • Generation Field Observation

  • Conducted on

  • Prepared by

  • Wolverine Personnel

  • Other Personnel onsite

Job Planning

  • Discussion on site?

  • Job Briefing?

  • Other documentation on site?

  • Proper Job Setup?

  • Does the job plan help reduce the risk of sprains and strains?

Personal Protective Equipment

  • Is eye protection with side shields being worn at all times?

  • Are hard hats worn as required?

  • Is hand protection used?

  • Is footwear appropriate for the job?

  • Is hearing protection used when needed?

  • Is clothing policy being followed?

  • Is FR clothing/rain gear in good condition?

Energized Work

  • Are gloves and sleeves correct rating and date?

  • Are gloves air tested and visually inspected prior to use?

  • Is adequate cover-up material utilized?

  • Was a clearance required to complete the task?

  • Are MAD approach distances understood and maintained?

  • Are hot sticks cleaned before use?

  • Is company policy being followed for proper rubber glove use, hot sticking, and working in energized work areas?

  • Is the proper level of FR clothing being worn?

  • Is the FR clothing tucked in?

Work Zone

  • Is all test equipment inspected prior to use?

  • Is all the equipment used correctly?

  • Is equipotential grounding being used?

  • Are personal protective grounds being used?

  • Are grounds in good condition?

  • If there are other personnel near work area have they communicated with each other?

  • Are excavations evaluated and safe?

  • Is test equipment properly grounded?

General

  • Have all hazardous energy sources been isolated?

  • Was LO/TO performed properly?

  • Has daily walk down of LO/TO clearance(s) been completed?

  • Are there prints for the work being performed?

  • Is there an AED on site?

  • Is weather affecting how the work is done?

  • Was a barricade used to isolate work or test area?

  • Are ladder requirements and rules being followed?

  • Are hand and power tools being used properly?

  • Is work area clean when job is finished?

Confined Space

  • Has a confined space permit been completed properly?

  • Is confined space rescue equipment/support available?

  • Are first aid/CPR/AED items nearby for quick access?

  • Is proper confined space air tests and monitoring occuring?

  • Is confined space training certification cards readily available?

  • Is the entrance guarded or sealed in between work activity?

  • Does the attendant understand their role and how to summon for rescue?

  • Can the employees describe the hazards and the protection in place?

Hot Work/Welding

  • Has the "hot work permit" been properly completed?

  • Does the work area meet the restrictions of the permit?

  • Are sparks being controlled from extending beyond the immediate hot work area?

  • Is proper eye and face being worn per the type of hot work (lens shade)?

  • Are proper PPE clothing and gloves being worn?

  • Was a fire watch assigned and used?

Fall Protection

  • Is proper fall protection used?

  • Is the fall protection equipment in good condition?

  • Is the harness properly adjusted and secured to the individual?

  • Does the anchor point meet the use requirement?

  • Do guardrails comply by meeting the 200LB side force, 42" height, mid rail, and toe board (where needed)?

  • Are gates or chains in place openings?

  • Is proper protection and procedures being used for work on roofs or any elevated position?

  • Are scaffolds properly assembled?

  • Is a daily scaffold inspection occurring?

  • Has the user of the scaffold had scaffold training?

Mobile equipment

  • Are wheel chocks used?

  • Was a daily pre-trip inspection performed?

  • Daily preflight inspection on hydraulic equipment performed?

  • Does the operator of the aerial device have a current qualification card?

  • Vehicles grounded, bonded, or barricaded per procedure manual?

  • Are proper backing procedures being followed?

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.