Title Page
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Site conducted
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Conducted on
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Prepared by
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Job Number
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Personnel on job
Job site hazards
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Job site accessable?
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First aid kit on site?
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Fire extinguisher are available?
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Weather
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Does the job have electricity
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Job site has properly lighting?
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Is the work space clear of debris
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All floor openings covered
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Openings have proper railings
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Does the job have pinch points
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Does the job have overhead hazards
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Does the job have electrical hazards
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Does the job contain trip hazards
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Is alll material stored properly
PPE and Equipment
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Are hard hats used
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Is proper foot wear being used?
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Proper eye protection being used?
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Proper hand protection in use?
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Fall protection being used
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Proper respiratory protection being used?
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Ladders free from damage
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Electrical cords free from damage
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Scaffolding free from damage?
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Are power tools free from damage?
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All equipment being properly used?
Any other concerns
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Any other concerns or comments
Sign off
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Sign off