GRO-554-FRM - Daily Supervisor Area Inspection

Daily Supervisor Area Inspection Form

• Conducted on

  Date

• ATW Number:

• Name Of Work Area Inspected:

• Weather Conditions Expected:

• What Work Permit(s) Are In Place?

• Prepared by

I Have Checked That:

• 1. JSEA in place and current.

  Yes

  No

  N/A

• 2. Barrier and Barricading Plan in place and current.

  Yes

  No

  N/A

• 3. Traffic Management Plan in place and current.

  Yes

  No

  N/A

• 4. Workers are competent and authorised for tasks.

  Yes

  No

  N/A

• 5. Workers are fit for work.

  Yes

  No

  N/A

• 6. Emergency First Response Plan is in place and current.

  Yes

  No

  N/A

Are These Adequate:

• 7. Housekeeping.

  Yes

  No

  N/A

• 8. Clear and concise signage, including call up signs for site entry and exit.

  Yes

  No

  N/A

• 9. Clear access and egress.

  Yes

  No

  N/A

• 10. Waste management.

  Yes

  No

  N/A

• 11. Lighting.

  Yes

  No

  N/A

• 12. Machine gaurding.

  Yes

  No

  N/A

• 13. Material storage.

  Yes

  No

  N/A

• 14. Hoses and fittings.

  Yes

  No

  N/A

• 15. Material handling practices.

  Yes

  No

  N/A

• 16. First aid kits.

  Yes

  No

  N/A

• 17. Barriers and barricading.

  Yes

  No

  N/A

• 18. PPE

  Yes

  No

  N/A

• 19. Electrical leads on insulated hangers.

  Yes

  No

  N/A

• 20. Hazardous substance storage and separation.

  Yes

  No

  N/A

• 21. Secured loads.

  Yes

  No

  N/A

• 22. Prevention from slips, trips and falls.

  Yes

  No

  N/A

• 23. HV / LV separation.

  Yes

  No

  N/A

• 24. Equipment parked safely.

  Yes

  No

  N/A

Are These Present and Effective:

• 25. Fire fighting equipment.

  Yes

  No

  N/A

• 26. Scafftags present on all scaffolding.

  Yes

  No

  N/A

• 27. Drop zones established for lifting.

  Yes

  No

  N/A

• 28. Edge protection.

  Yes

  No

  N/A

• 29. Electrical equipment is in current test and tag date.

  Yes

  No

  N/A

• 30. Floor openings and penetrations are barricaded.

  Yes

  No

  N/A

• 31. Compressed gas cylinders are upright & restrained.

  Yes

  No

  N/A

• 32. Protection from sharp objects.

  Yes

  No

  N/A

• 33. Barricades are in place and in good condition, complete and tags are in place and legible.

  Yes

  No

  N/A

• 34. Compressed air (condition, use and clips present)

  Yes

  No

  N/A

• 35. Trenches and excavations are barricaded.

  Yes

  No

  N/A

• 36. Protection from dust, fumes, gases and vapours.

  Yes

  No

  N/A

• 37. Plant and equipment prestarts.

  Yes

  No

  N/A

• 38. Brake tests current for wheeled plant.

  Yes

  No

  N/A

• 39. Operational safety shower and eye wash.

  Yes

  No

  N/A

• 40. Other:

  Yes

  No

  N/A

Corrective Actions: Who is Responsible and When

• 1.

• 2.

• 3.

• 4.

• 5.

• 6.

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• 8.

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• 10.

• 11.

• 12.

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• 14.

• 15.

Additional Comments:

Supervisor Sign Off:

• Add signature

  Sign