Information
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Document No.
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Project #
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Project Name
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List of Subcontractors
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Signature
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Conducted on
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Location
Project Administration
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1) Have all workers onsite been orientated?
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2) Are AHA/JHAs completed for the activity?
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3) Are tools and equipment being inspected?
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4) Is there a documented rescue plan (Confined Space / Fall Rescue)?
Housekeeping
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5) Is housekeeping being conducted throughout the day?
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6) Are materials being stored properly?
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7) Have all nails been removed from boards?
Emergency Response, Medical Services & First Aid
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8) Are First Aid/CPR certified personnel on site?
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9) First Aid kits available & properly stocked?
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10) Are Emergency numbers readily available?
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11) Are there Rescue trained personnel onsite as necessary?
Sanitation / Health
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12) Is an adequate supply of drinking water provided?
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13) Are workers given adequate breaks?
Hazard Communication
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14) Are MSDS's available?
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15) Are all containers properly labeled?
Fall Prevention / Protection
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16) Are workers employing 100% fall protection (Guard rails / Passive Fall Arrest Systems)?
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17) Are daily harness inspections conducted?
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18) Are open holes covered / guarded?
Personal Protective Equipment
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19) Are all workers wearing hard hats?
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20) Are all workers wearing eye protection?
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21) Are all workers using ear protection when necessary?
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22) Are all workers using gloves when necessary?
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23) Are all workers dressed properly including footwear?
Fire Prevention / Protection
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24) Are fire extinguishers in place as required (within 75')?
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25) Are chemicals, flammable & combustible liquids properly stored?
Electrical
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26) Are GFCI's utilized?
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27) Are extension cords in serviceable condition?
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28) Are electrical tools maintained and used in a safe manner?
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29) Are temporary power panels / receptacles protected?
Cranes Hoists & Rigging
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30) Are crane inspections completed (annual / daily)?
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31) Is proper cribbing in place for mobile cranes?
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32) Is crane on firm level ground?
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33) Is rigging being used in good condition & properly labeled?
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34) Are critical lift plans completed as necessary?
Equipment
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35) Are all operators certified and trained as necessary?
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36) Are all operators completing daily equipment inspections?
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37) Are all operators wearing seat belts as required?
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38) Is equipment in use in good operating condition?
Tools - Hand and Power
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39) Are tools being used as intended by the manufacturer?
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40) Are tools in good working condition?
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41) Are all tool safeguards in place?
Excavation / Trenching
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42) Are ladders available & properly spaced in excavation / trench?
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43) Is excavation / trench properly shored / sloped (>5' deep)?
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44) Is competent person inspecting excavations / trench daily?
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45) Are spoils at least 2' from the edge?
Confined Space47)
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46) Has an AHA been completed for confined space work?
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47) Have workers been properly trained to work in confined spaces?
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48) Has confined space been tested / certified as NPCS?
Scaffolding
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49) Is competent person inspecting scaffolding daily?
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50) is scaffolding properly planked (not < 6" or > 12" over support)?
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51) Are all guardrails in place?
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52) Is scaffolding properly tagged?
Ladders
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53) Are ladders set up properly (4:1 ratio )?
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54) Do ladders extend 3' above landing & are tied off?
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55) Are ladders being used properly?
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56) Are job ,are ladders properly constructed?
Corrective Action
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Corrective Action Required?
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Item #
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Corrective Action
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Date and Time Corrected
